Pregnancy-related depression linked to eating disorders and abuse histories

ScienceDaily (June 16, 2011) — One in 10 women experience depression during pregnancy or shortly after giving birth. Although the problem has received increased attention in recent years, little is known about the causes or early-warning signs of pregnancy-related depression. In a study published in the June 2011 issue of Journal of Women's Health, researchers at the University of North Carolina at Chapel Hill School of Medicine offer new clues to help doctors identify at-risk patients and refer them to treatment early on.

The researchers surveyed 158 pregnant and postpartum women undergoing treatment for depression at UNC's Perinatal Psychiatry Clinic. One-third of the patients reported a history of eating disorders; in addition, many had a history of physical or sexual abuse. The findings suggest these psychiatric factors may increase a woman's likelihood of developing depression during pregnancy or postpartum.

Mental health screening tools that include questions about eating disorders, abuse and other factors should be incorporated into routine prenatal care, said Samantha Meltzer-Brody, MD, the lead author of the study and director of UNC's Perinatal Psychiatry Program. "Screening by obstetrical providers is really important because they can refer patients for appropriate treatment," she said. "And that can prevent long-lasting problems for mom and baby."

Undiagnosed and treated postpartum depression "causes enormous distress to the family, and it can have long-lasting consequences for the child," said Meltzer-Brody. Children of depressed mothers are more likely to develop mental health problems, and children of mothers with an active eating disorder may also be more likely to develop an eating disorder themselves. Making sure mothers struggling with mental health issues receive adequate assessment and treatment is critical to breaking that cycle, said Meltzer-Brody.

"The message we need to get out is that these things are incredibly common and routine screenings need to occur," said Meltzer-Brody. "The prevalence of abuse and eating disorder histories may be much higher than people appreciate."

Up to 25 percent of women experience physical or sexual abuse during their lifetime, a rate the UNC associate professor of psychiatry called "staggering." An estimated 6-8 percent of women are at some point affected by an eating disorder, with binge eating and bulimia nervosa being the most common, followed by anorexia and other disorders.

"Pregnancy and the postpartum period is a very vulnerable time for women," said Meltzer-Brody. Rapid changes in body shape, weight and hormone levels, combined with major lifestyle changes during the transition to motherhood, can take a toll on women -- especially those with a history of previous psychiatric issues.

Despite these challenges, Meltzer-Brody said pregnancy represents an ideal time for doctors to intervene and help women get mental health treatment if they need it. "[Pregnancy] is a time when people are really motivated to make changes and get treatment, because that can have serious consequences for how you do and for how your children do," she said, adding that by conducting mental health screens during prenatal care, doctors can help curb pregnancy-related depression.

The study's co-authors included Stephanie Zerwas, PhD, Jane Leserman, PhD, Ann Von Holle, Taylor Regis, and Cynthia Bulik, PhD, all from the Department of Psychiatry at the UNC School of Medicine, UNC Center for Women's Mood Disorders and UNC Eating Disorders Program.

Support for the research came from the NIH Building Interdisciplinary Careers in Women's Health (BIRCWH) Award to Dr. Meltzer-Brody.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Samantha Meltzer-Brody, Stephanie Zerwas, Jane Leserman, Ann Von Holle, Taylor Regis, Cynthia Bulik. Eating Disorders and Trauma History in Women with Perinatal Depression. Journal of Women's Health, 2011; 20 (6): 863 DOI: 10.1089/jwh.2010.2360

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View the original article here sciencedaily.com

Most would use genetic depression test results to reduce risky behavior, survey shows

ScienceDaily (Aug. 1, 2011) — Eight out of ten Australians would radically change their risky behaviour if tests showed they had a genetic susceptibility to depression, a national study has found.

The study, conducted by researchers at the University of New South Wales (UNSW) and published online in the Journal of Affective Disorders, is the first population-wide analysis of Australian attitudes towards genetic testing for risk of mental illness.

There was overwhelming support for the use of genetic tests to help people take steps to prevent depression before it occurs, especially among those who believe they or their children have a higher than average risk, a randomised phone survey of 1,046 adults found.

The preventive strategies that received support included helping children to be resilient to stress (92%), modifying their own stress (84%), starting therapies (80%) and reducing excessive drug and alcohol use (74%).

The widespread interest in prevention strategies was based on the understanding that while there may be a genetic predisposition to mental illness, environmental factors also played a major role.

The findings suggest there would be widespread community support for genetic screening as a valuable clinical tool for early intervention in high-risk groups.

"There is no certainty depression will manifest in someone with a higher-than-average genetic risk whether they are exposed to stressful life events or not," said study lead-author Dr Alex Wilde, from UNSW's School of Psychiatry.

"Yet most people were still overwhelming prepared to attempt to reduce the possibility of developing a depressive illness by modifying risky behaviours," Dr Wilde said.

Dr Wilde said people could try to change unhealthy aspects of their lives even without a genetic test, but the findings suggest that having test results at hand may act as a powerful motivator for change.

In general, Australians are very interested in knowing their genetic susceptibility to mental illness.

A linked study by the same research team, published this month in the UK-based journal Psychological Medicine, showed there was significant interest in genetic testing for depression, despite ongoing concerns about the tests' validity and that the results could potentially increase social stigma and discrimination.

"The scientific validity is not yet clear for most of the direct-to-consumer genetic tests currently marketed online, including tests for some mental illnesses, which could expose early users to discrimination, stigma and potentially misleading health risks," Dr Wilde said.

This was reflected in the survey result, with those questioned far more likely to support genetic tests carried out by their doctor (63%) than those undertaken through internet-based direct-to-consumer services (40%), Dr Wilde said.

Other study authors were Professor Philip Mitchell and Dusan Hadzi-Pavlovic from UNSW's School of Psychiatry, Associate Professor Bettina Meiser, from the Prince of Wales Clinical School, and Professor Peter Schofield, from Neuroscience Research Australia.

Funding for this study was provided by the Australian National Health and Medical Research Council.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of New South Wales.

Journal Reference:

Alex Wilde, Bettina Meiser, Philip B. Mitchell, Peter R. Schofield. Community attitudes to genetic susceptibility-based mental health interventions for healthy people in a large national sample. Journal of Affective Disorders, 2011; DOI: 10.1016/j.jad.2011.06.023

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Mothers with breastfeeding difficulties more likely to suffer postpartum depression, study finds

ScienceDaily (July 19, 2011) — Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill.

"We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

"We found that very commonly the same moms who were struggling with breastfeeding were also depressed," she said. "There was a tremendous clinical overlap."

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

"If they're struggling with breastfeeding, they should seek help and tell their provider. If they don't have joy in their life, if they wake up in the morning and think, 'I just can't do this another day' -- that's a medical emergency. They shouldn't just say, 'I'm going to power through this and snap out of it.' They should call their provider and say, 'I just don't feel right, I'm wondering if I could be depressed, can I come in and talk to you about it?' "

The study is scheduled for publication in the August 2011 print issue of the journal.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Persons displaced by war at increased risk of posttraumatic stress disorder, depression, anxiety

ScienceDaily (Aug. 3, 2011) — Residents of Sri Lanka who were internally displaced during the civil conflict that occurred in their country from 1983 to 2009 have a higher prevalence of war-related mental health conditions that include depression, anxiety and posttraumatic stress disorder, according to a study in the August 3 issue of JAMA, a theme issue on violence and human rights.

Armed conflicts may result in displacement of persons seeking refuge in neighboring countries or secure areas of their own country (internal displacement). "Nearly 2.7 million individuals worldwide are internally displaced annually by armed conflict. The Sri Lankan conflict resulted in approximately 100,000 deaths and displacement of 800,000 people during the 26-year war," according to background information in the article. In the Jaffna District of Sri Lanka, a peninsula in the far north of the country, it has been estimated that 23 percent of the population had been internally displaced by July 2009. "Although overall patterns of psychiatric morbidity among conflict-affected populations have been documented, less is known about the psychological effect of forced displacement among individuals who remain within their national borders."

Farah Husain, D.M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a health survey among residents of Jaffna District to assess the association between displacement status and the prevalence of common war-related mental health conditions. The survey was conducted between July and September 2009 among 1,517 Jaffna District households, including 2 internally displaced persons camps. The response rate was 92 percent (1,448 respondents, 1,409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5 percent (n = 539) were recently resettled, and 68.5 percent (n = 790) were long-term residents. A total of 376 (31.8 percent) participants experienced no trauma events; 578 (44.0 percent) reported experiencing 1 to 4 events; 336 (20.2 percent) experienced 5 to 9 events; and 72 (4.0 percent) experienced 10 or more events.

The overall prevalences of posttraumatic stress disorder (PTSD), anxiety, and depression symptoms were 7.0 percent, 32.6 percent, and 22.2 percent, respectively. After adjusting for variables, the researchers found that the odds of having symptoms of depression, anxiety, and PTSD were significantly higher among displaced camp-based individuals compared with long-term residents and that the odds of reporting PTSD symptoms among recently resettled participants was higher than that of long-term residents. Female respondents were more likely to report symptoms of anxiety and depression. Older age was associated with PTSD, anxiety, and depression symptoms. The authors also found that displacement was no longer associated with mental health symptoms after controlling for trauma exposure.

"Although the association between displacement status and symptoms of PTSD, depression, and anxiety was no longer significant after adjusting for trauma exposure in this study, the act of being displaced and the daily stressors associated with it may be considered traumatic in themselves and may be an indicator or proxy for recent trauma as well. Therefore, the relationship between displacement status and mental health symptoms may be driven by the underlying trauma events displaced persons have experienced, events that likely caused them to leave their homes," they write.

The researchers suggest that interventions in Sri Lanka should target the most vulnerable populations, especially those living in displacement camps. "Internally displaced persons outnumber refugees globally and initiatives addressing mental health needs, such as those developed by the Inter-Agency Standing Committee, should be considered. In Jaffna District, interventions should include support from family, friends, religious leaders, and traditional counselors. Finally, a longitudinal study of displaced populations would help determine how the intensity of events, the time since events, and other factors, such as coping skills, affect mental health symptoms. In this way, stakeholders could begin to understand the short- and long-term mental health implications of armed conflict and traumatic events associated with displacement."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

F. Husain, M. Anderson, B. Lopes Cardozo, K. Becknell, C. Blanton, D. Araki, E. Kottegoda Vithana. Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka. JAMA: The Journal of the American Medical Association, 2011; 306 (5): 522 DOI: 10.1001/jama.2011.1052

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Spiritual retreat can lower depression, raise hope in heart patients

ScienceDaily (Aug. 1, 2011) — Attending a non-denominational spiritual retreat can help patients with severe heart trouble feel less depressed and more hopeful about the future, a University of Michigan Health System study has found.

Heart patients who participated in a four-day retreat that included techniques such as meditation, guided imagery, drumming, journal writing and outdoor activities saw immediate improvement in tests measuring depression and hopefulness. Those improvements persisted at three- and six-month follow-up measurements.

The study was the first randomized clinical trial to demonstrate an intervention that raises hope in patients with acute coronary syndrome, a condition that includes chest pain and heart attack. Previous research has shown that hope and its opposite, hopelessness, have an impact on how patients face uncertain futures.

"The study shows that a spiritual retreat like the Medicine for the Earth program can jumpstart and help to maintain a return to psycho-spiritual well-being," says study lead author Sara Warber, M.D., associate professor of family medicine at the U-M Medical School and director of U-M's Integrative Medicine program. "These types of interventions may be of particular interest to patients who do not want to take antidepressants for the depression symptoms that often accompany coronary heart disease and heart attack."

The findings were published in the July issue of Explore: the Journal of Science and Healing.

The retreat group was compared to two other groups: one received standard cardiac care and the other participated in a lifestyle change retreat run by the U-M Cardiovascular Center that focused on nutrition, physical exercise and stress management.

The spiritual retreat portion of the study was conducted at the Windrise Retreat Center in Metamora, Michigan, about 50 miles north of Detroit. In the Medicine for the Earth program, participants are encouraged to see themselves as part of an interconnected web of life. The approach is founded on the work of co-author Sandra Ingerman, M.A., who wrote the book Medicine for the Earth: How to Transform Personal and Environmental Toxins, which emphasizes principles of love, harmony, beauty, unity and peace.

The study used a number of standard mental and physical benchmarks to assess the success of the program.

The spiritual retreat group went from a baseline score of 12 on the Beck Depression Inventory, indicating mild to moderate depression, to an improved score of 6 immediately afterward, a 50-percent reduction. Their scores remained that low half a year later. The lifestyle group saw their scores drop from 11 to 7 and remain there. The control group's score started at 8 and went down to 6.

Participants also showed marked improvement in their scores on a test measuring hope. Scores on the State Hope Scale can range from 6 to 48, with higher scores indicating greater hope. All three study groups started with average scores between 34 and 36. After the spiritual retreat, participants' average scores rose and stayed at 40 or above, while the other two groups' averages remained significantly lower, ranging from 35 to 38, three and six months later.

"Our work adds an important spiritual voice to the current discussion of the importance of psychological well-being for patients facing serious medical issues, such as acute coronary artery disease," Warber says.

Citation: "Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients," Explore: The Journal of Science and Healing, July 2011.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Michigan Health System, via EurekAlert!, a service of AAAS.

Journal Reference:

Sara Warber et al. Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients. Explore: the Journal of Science and Healing, 2011

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Small hippocampus associated with depression in the elderly: Risk factor or shrinkage?

ScienceDaily (July 22, 2011) — Imaging studies have repeatedly found that people with depression have smaller hippocampal volumes than healthy individuals. The hippocampus is a brain region involved in learning and memory, spatial navigation, and the evaluation of complex life situations or "contexts." However, because in prior studies hippocampal volume was only measured in people once they became depressed, it has been unclear whether a small hippocampus renders a person vulnerable to developing depression, or whether it is a consequence of depression.

A new study published in Biological Psychiatry has approached that problem by following a large population of elderly individuals over a 10 year period.

Researchers performed an initial imaging scan on subjects to obtain a baseline measurement of their hippocampal volume and then performed follow-up scans 5 and 10 years later. During this time, they also repeatedly assessed the individuals for both depressive symptoms and depressive disorders.

Corresponding author Dr. Tom den Heijer explains their findings: "We found that persons with a smaller hippocampus were not at higher risk to develop depression. In contrast, those with depression declined in volume over time. Our study therefore suggests that a small hippocampal volume in depressed patients is more likely an effect of the depression rather than a cause."

"The principal importance of this type of research is that it may provide insight into age-related impairments in the function of the hippocampus," reflected Dr. John Krystal, Editor of Biological Psychiatry. "For example, in Alzheimer's disease, memory problems and disorientation are prominent symptoms, reflecting among other things the impaired function of the hippocampus."

Future studies will be needed to better understand whether current treatments protect the hippocampus and hippocampal function.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Elsevier, via AlphaGalileo.

Journal Reference:

Tom den Heijer, Henning Tiemeier, Hendrika J. Luijendijk, Fedde van der Lijn, Peter J. Koudstaal, Albert Hofman, Monique M.B. Breteler. A Study of the Bidirectional Association Between Hippocampal Volume on Magnetic Resonance Imaging and Depression in the Elderly. Biological Psychiatry, 2011; 70 (2): 191 DOI: 10.1016/j.biopsych.2011.04.014

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Sweating the small stuff: Early adversity, prior depression linked to high sensitivity to stress

ScienceDaily (June 28, 2011) — We all know people who are able to roll with life's punches, while for others, every misfortune is a jab straight to the gut. Research examining this issue has found that although most people require significant adversity to become depressed -- the death of a loved one, say, or getting fired -- roughly 30 percent of people with first-time depression and 60 percent of people with a history of depression develop the disorder following relatively minor misfortunes. But no one knew why.

Now, a new study led by UCLA researchers suggests that people become depressed more easily following minor life stress in part because they have experienced early life adversity or prior depressive episodes, both of which may make people more sensitive to later life stress.

George Slavich, an assistant professor at the UCLA Cousins Center for Psychoneuroimmunology, and colleagues assessed individuals' experiences with early adversity, clinical depression and recent life stress. Slavich found that individuals who experienced an early parental loss or separation and people who had more lifetime episodes of depression became depressed following lower levels of life stress than those who didn't have these predisposing factors.

The study appears in the current online edition of the Journal of Psychiatric Research.

"We have known for a long time that some people are more likely to experience mental and physical health problems than others," Slavich said. "For example, while some people get depressed following a relationship breakup, others do not. In this study, we aimed to identify factors that are associated with this phenomenon and to examine whether increased sensitivity to stress might be playing a role."

The researchers recruited 100 individuals with depression, 26 men and 74 women, and interviewed them extensively to determine what types of adversity they were exposed to when they were young, how many episodes of depression they had experienced and what types of life stress they had encountered recently.

The results showed that people who had lost a parent or had been separated from a parent for at least one year before the age of 18 and individuals who had experienced more episodes of depression over their lifetime became depressed following significantly lower levels of recent life stress.

Additional analysis revealed that these effects were unique to stressors involving interpersonal loss.

"Researchers at UCLA and elsewhere have previously demonstrated that early adversity and depression history are associated with heightened sensitivity to stress," Slavich said. "The present study replicates this effect but suggests for the first time that these associations may be unique to stressors involving interpersonal loss. In other words, individuals who are exposed to early parental loss or separation and persons with greater lifetime histories of depression may be selectively sensitized to stressors involving interpersonal loss."

An important question raised by these findings is how adversity early in life and prior experiences with depression promote increased sensitivity to stress. One possibility, the researchers say, is that people who experience early adversity or depression develop negative beliefs about themselves or the world -- beliefs that get activated in the face of subsequent life stress. Another possibility, which is not mutually exclusive, is that early adversity and depression influence biological systems that are involved in depression, perhaps by lowering the threshold at which depression-relevant processes like inflammation get triggered.

"Although many factors impact stress sensitivity," Slavich said, "thoughts almost always play a role. For example, when your best friend doesn't call back, do you think she is angry at you or do you think it just slipped her mind? Our thoughts affect how we react emotionally and biologically to situations, and these reactions in turn greatly influence our health. Regardless of your prior experiences, then, it is always important to take a step back and make sure you are interpreting situations in an unbiased way, based on the information available."

Other authors on the study were Scott M. Monroe, the William K. Warren Foundation Professor of Psychology at the University of Notre Dame, and Ian H. Gotlib, the David Starr Jordan Professor of Psychology at Stanford University.

The study was funded by a Society in Science: Branco Weiss Fellowship and by the National Institutes of Health.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - Los Angeles. The original article was written by Mark Wheeler.

Journal Reference:

George M. Slavich, Scott M. Monroe, Ian H. Gotlib. Early parental loss and depression history: Associations with recent life stress in major depressive disorder. Journal of Psychiatric Research, 2011; DOI: 10.1016/j.jpsychires.2011.03.004

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Veterinary medicine students experience higher depression levels than peers, research finds

ScienceDaily (July 28, 2011) — Veterinary medicine students are more likely to struggle with depression than human medicine students, undergraduate students and the general population, according to several recent collaborative studies from Kansas State University researchers.

Mac Hafen, therapist and clinical instructor in K-State's College of Veterinary Medicine, and researchers from K-State, the University of Nebraska and East Carolina University decided to take a closer look at depression and anxiety among veterinary medical students. Although the mental health of human medicine students has been extensively studied, the same extent of study has not been performed with veterinary medicine students. Additionally, most veterinary research related to depression involves pet owners, not veterinarians or students.

"We are hoping to predict what contributes to depression levels so that we can intervene and make things run a little bit more smoothly for students themselves," said Hafen, who has spent five years researching the well-being and mental health of veterinary students.

Once a semester, the researchers anonymously surveyed veterinary medicine students in various stages of academic study. The survey helped uncover a rate of depression occurrence and understand how it related to the amount of stress veterinary students experience during their four years of study.

During the first year of veterinary school, 32 percent of the veterinary medicine students surveyed showed symptoms of depression, compared to 23 percent of human medicine students who showed symptoms above the clinical cutoff, as evidenced by other studies.

The researchers also discovered that veterinary students experience higher depression rates as early as the first semester of their first year of study. Their depression rates appear to increase even more during the second and third year of school. During the fourth year, depression rates drop down to first-year levels.

Hafen said several factors might contribute to the higher rate of depression in veterinary medicine students. Veterinarians deal with stressors that human medicine doctors do not have to experience, such as frequently discussing euthanasia with clients. Although both programs of study are intense, veterinarians must understand a variety of animal species rather than focusing on the human body. Struggles with balancing work, school and life could also lead to higher depression rates.

Hafen said gender differences could also play a role, although such claims are inconclusive so far. Whereas medical schools are nearly split evenly between male and female students, about 75 percent of veterinary medicine students are female. National studies indicate that women are two to three times more likely than men to suffer from mood disorders.

The research team's studies found several other factors connected with higher depression occurrence, including: homesickness; uncertainty about academic expectations; a feeling of not belonging or not fitting in; and perceived physical health. The researchers had students rate their own physical health to indicate how they felt about their overall health. Students who were happier with their physical health had lower depression rates.

But the studies contain more than just negative news; they offer interventions and ways that veterinary schools and their faculty and staff can help students struggling with depression and anxiety. Some of these ways include:

Having clearer expectations of veterinary students, especially during the first year.Sponsoring events and organizations that help improve physical health.Empathizing with students and their concerns about their studies.

The researchers are optimistic that by helping veterinary medicine students care for their own mental health, these students become better prepared to help clients.

"The hope is that we can identify some ways to help alleviate some of the depression and the symptoms of depression and anxiety that might be occurring," Hafen said.

The researchers have already published two articles in the Journal of Veterinary Medicine Education about their work and are in the process of preparing another publication.

Hafen is also working on other research that looks at companion animal loss. He and researchers from the University of Nebraska have interviewed pet owners who have experienced companion animal loss to better understand the grieving process. They continue to gather empirical data for this study and are analyzing their findings.

"I have a sense for the grieving process from my own clinical work," Hafen said. "But we wanted to look at it from more of an empirical standpoint."

Other K-State researchers involved in these projects include: Bonnie Rush, professor and department head of clinical sciences, and Susan Nelson, associate professor of clinical sciences.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Kansas State University.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Veterinary medicine students experience higher depression levels than peers, research finds

ScienceDaily (July 28, 2011) — Veterinary medicine students are more likely to struggle with depression than human medicine students, undergraduate students and the general population, according to several recent collaborative studies from Kansas State University researchers.

Mac Hafen, therapist and clinical instructor in K-State's College of Veterinary Medicine, and researchers from K-State, the University of Nebraska and East Carolina University decided to take a closer look at depression and anxiety among veterinary medical students. Although the mental health of human medicine students has been extensively studied, the same extent of study has not been performed with veterinary medicine students. Additionally, most veterinary research related to depression involves pet owners, not veterinarians or students.

"We are hoping to predict what contributes to depression levels so that we can intervene and make things run a little bit more smoothly for students themselves," said Hafen, who has spent five years researching the well-being and mental health of veterinary students.

Once a semester, the researchers anonymously surveyed veterinary medicine students in various stages of academic study. The survey helped uncover a rate of depression occurrence and understand how it related to the amount of stress veterinary students experience during their four years of study.

During the first year of veterinary school, 32 percent of the veterinary medicine students surveyed showed symptoms of depression, compared to 23 percent of human medicine students who showed symptoms above the clinical cutoff, as evidenced by other studies.

The researchers also discovered that veterinary students experience higher depression rates as early as the first semester of their first year of study. Their depression rates appear to increase even more during the second and third year of school. During the fourth year, depression rates drop down to first-year levels.

Hafen said several factors might contribute to the higher rate of depression in veterinary medicine students. Veterinarians deal with stressors that human medicine doctors do not have to experience, such as frequently discussing euthanasia with clients. Although both programs of study are intense, veterinarians must understand a variety of animal species rather than focusing on the human body. Struggles with balancing work, school and life could also lead to higher depression rates.

Hafen said gender differences could also play a role, although such claims are inconclusive so far. Whereas medical schools are nearly split evenly between male and female students, about 75 percent of veterinary medicine students are female. National studies indicate that women are two to three times more likely than men to suffer from mood disorders.

The research team's studies found several other factors connected with higher depression occurrence, including: homesickness; uncertainty about academic expectations; a feeling of not belonging or not fitting in; and perceived physical health. The researchers had students rate their own physical health to indicate how they felt about their overall health. Students who were happier with their physical health had lower depression rates.

But the studies contain more than just negative news; they offer interventions and ways that veterinary schools and their faculty and staff can help students struggling with depression and anxiety. Some of these ways include:

Having clearer expectations of veterinary students, especially during the first year.Sponsoring events and organizations that help improve physical health.Empathizing with students and their concerns about their studies.

The researchers are optimistic that by helping veterinary medicine students care for their own mental health, these students become better prepared to help clients.

"The hope is that we can identify some ways to help alleviate some of the depression and the symptoms of depression and anxiety that might be occurring," Hafen said.

The researchers have already published two articles in the Journal of Veterinary Medicine Education about their work and are in the process of preparing another publication.

Hafen is also working on other research that looks at companion animal loss. He and researchers from the University of Nebraska have interviewed pet owners who have experienced companion animal loss to better understand the grieving process. They continue to gather empirical data for this study and are analyzing their findings.

"I have a sense for the grieving process from my own clinical work," Hafen said. "But we wanted to look at it from more of an empirical standpoint."

Other K-State researchers involved in these projects include: Bonnie Rush, professor and department head of clinical sciences, and Susan Nelson, associate professor of clinical sciences.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Kansas State University.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Restoring happiness in people with depression

ScienceDaily (July 28, 2011) — Practicing positive activities may serve as an effective, low-cost treatment for people suffering from depression, according to researchers at the University of California, Riverside and Duke University Medical Center.

In "Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders," a paper that appears in the August 2011 issue of the Journal of Alternative and Complementary Medicine, the team of UCR and Duke psychology, neuroscience and psychopharmacology researchers proposed a new approach for treating depression -- Positive Activity Interventions (PAI).

PAIs are intentional activities such as performing acts of kindness, practicing optimism, and counting one's blessing gleaned from decades of research into how happy and unhappy people are different. This new approach has the potential to benefit depressed individuals who don't respond to pharmacotherapy or are not able or willing to obtain treatment, is less expensive to administer, is relatively less time-consuming and promises to yield rapid improvement of mood symptoms, holds little to no stigma, and carries no side effects.

More than 16 million U.S. adults -- about 8 percent of the population -- suffer from either major or chronic depression. About 70 percent of reported cases either do not receive the recommended level of treatment or do not get treated at all, according to the National Institute of Mental Health. Globally, the World Health Organization estimates that depression affects more than 100 million people.

Although antidepressants can be lifesaving for some individuals, initial drug therapy produces full benefits in only 30 percent to 40 percent of patients. Even after trying two to four different drugs, one-third of people will remain depressed.

The research team -- Kristin Layous and Joseph Chancellor, graduate students at UC Riverside; Sonja Lyubomirsky, professor of psychology and director of the Positive Psychology Laboratory at UC Riverside; and Lihong Wang, M.D., and P. Murali Doraiswamy, M.B.B.S., FRCP, of Duke University -- conducted a rigorous review of previous studies of PAIs, including randomized, controlled interventions with thousands of normal men and women as well as functional MRI scans in people with depressive symptoms.

"Over the last several decades, social psychology studies of flourishing individuals who are happy, optimistic and grateful have produced a lot of new information about the benefits of positive activity interventions on mood and well-being," Lyubomirsky said.

However, such findings have not yet entered mainstream psychiatric practice.

"Very few psychiatrists collaborate with social scientists and no one in my field ever reads the journals where most happiness studies have been published. It was eye-opening for me as a psychopharmacologist to read this literature," Doraiswamy said.

Lyubomirsky said that after she and Doraiswamy exchanged notes, "the obvious question that popped up was whether we can tap into the PAI research base to design interventions to galvanize clinically depressed people to move past the point of simply not feeling depressed to the point of flourishing."

Although the paper found that positive activity interventions are effective in teaching individuals ways to increase their positive thinking, positive affect and positive behaviors, only two studies specifically tested these activities in individuals with mild depression.

In one of these studies, lasting improvements were found for six months. Effective PAIs used in the study included writing letters of gratitude, counting one's blessings, practicing optimism, performing acts of kindness, meditating on positive feelings toward others, and using one's signature strengths, all of which can be easily implemented into a daily routine at low cost.

People often underestimate the long-term impact of practicing brief, positive activities, Lyubomirsky said. For example, if a person gets 15 minutes of positive emotions from counting her blessings, she may muster the energy to attend the art class she'd long considered attending, and, while in class, might meet a friend who becomes a companion and confidant for years to come. In this way, even momentary positive feelings can build long-term social, psychological, intellectual, and physical skills and reserves.

The researchers' review of brain imaging studies also led them to theorize that PAIs may act to boost the dampened reward/pleasure circuit mechanisms and reverse apathy -- a key benefit that does not usually arise from treatment with medication alone.

"The positive activities themselves aren't really new," said Layous, the paper's lead author. "After all, humans have been counting their blessings, dreaming optimistically, writing thank you notes, and doing acts of kindness for thousands of years. What's new is the scientific rigor that researchers have applied to measuring benefits and understanding why they work."

A major benefit of positive activities is that they are simple to practice and inexpensive to deliver.

"If we're serious about tackling a problem as large as depression, we should be as concerned about the scalability of our solutions as much as their potency," Chancellor said,

While PAIs appear to be a potentially promising therapy for mild forms of depression," Doraiswamy cautioned, "they have not yet been fully studied in people with moderate to severe forms of depression. We need further studies before they can be applied to help such patients."

Kim Jobst, a physician and editor-in-chief of the Journal of Alternative and Complimentary Medicine, said the review provides one location in which to reference all relevant PAI findings to date, and includes recommendations that should prove useful to researchers, clinicians and the public. The journal is devoted to publishing research about novel and unconventional treatment approaches.

The research was supported by the authors themselves. Lyubomirsky's research has been funded by a Templeton Positive Psychology Prize and the National Institute of Mental Health. Doraiswamy has received research grants from NIMH and served as an advisor/investigator to several pharmaceutical companies.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - Riverside.

Journal Reference:

Kristin Layous, Joseph Chancellor, Sonja Lyubomirsky, Lihong Wang, P. Murali Doraiswamy. Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders. The Journal of Alternative and Complementary Medicine, 2011; 17 (8): 675 DOI: 10.1089/acm.2011.0139

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Restoring happiness in people with depression

ScienceDaily (July 28, 2011) — Practicing positive activities may serve as an effective, low-cost treatment for people suffering from depression, according to researchers at the University of California, Riverside and Duke University Medical Center.

In "Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders," a paper that appears in the August 2011 issue of the Journal of Alternative and Complementary Medicine, the team of UCR and Duke psychology, neuroscience and psychopharmacology researchers proposed a new approach for treating depression -- Positive Activity Interventions (PAI).

PAIs are intentional activities such as performing acts of kindness, practicing optimism, and counting one's blessing gleaned from decades of research into how happy and unhappy people are different. This new approach has the potential to benefit depressed individuals who don't respond to pharmacotherapy or are not able or willing to obtain treatment, is less expensive to administer, is relatively less time-consuming and promises to yield rapid improvement of mood symptoms, holds little to no stigma, and carries no side effects.

More than 16 million U.S. adults -- about 8 percent of the population -- suffer from either major or chronic depression. About 70 percent of reported cases either do not receive the recommended level of treatment or do not get treated at all, according to the National Institute of Mental Health. Globally, the World Health Organization estimates that depression affects more than 100 million people.

Although antidepressants can be lifesaving for some individuals, initial drug therapy produces full benefits in only 30 percent to 40 percent of patients. Even after trying two to four different drugs, one-third of people will remain depressed.

The research team -- Kristin Layous and Joseph Chancellor, graduate students at UC Riverside; Sonja Lyubomirsky, professor of psychology and director of the Positive Psychology Laboratory at UC Riverside; and Lihong Wang, M.D., and P. Murali Doraiswamy, M.B.B.S., FRCP, of Duke University -- conducted a rigorous review of previous studies of PAIs, including randomized, controlled interventions with thousands of normal men and women as well as functional MRI scans in people with depressive symptoms.

"Over the last several decades, social psychology studies of flourishing individuals who are happy, optimistic and grateful have produced a lot of new information about the benefits of positive activity interventions on mood and well-being," Lyubomirsky said.

However, such findings have not yet entered mainstream psychiatric practice.

"Very few psychiatrists collaborate with social scientists and no one in my field ever reads the journals where most happiness studies have been published. It was eye-opening for me as a psychopharmacologist to read this literature," Doraiswamy said.

Lyubomirsky said that after she and Doraiswamy exchanged notes, "the obvious question that popped up was whether we can tap into the PAI research base to design interventions to galvanize clinically depressed people to move past the point of simply not feeling depressed to the point of flourishing."

Although the paper found that positive activity interventions are effective in teaching individuals ways to increase their positive thinking, positive affect and positive behaviors, only two studies specifically tested these activities in individuals with mild depression.

In one of these studies, lasting improvements were found for six months. Effective PAIs used in the study included writing letters of gratitude, counting one's blessings, practicing optimism, performing acts of kindness, meditating on positive feelings toward others, and using one's signature strengths, all of which can be easily implemented into a daily routine at low cost.

People often underestimate the long-term impact of practicing brief, positive activities, Lyubomirsky said. For example, if a person gets 15 minutes of positive emotions from counting her blessings, she may muster the energy to attend the art class she'd long considered attending, and, while in class, might meet a friend who becomes a companion and confidant for years to come. In this way, even momentary positive feelings can build long-term social, psychological, intellectual, and physical skills and reserves.

The researchers' review of brain imaging studies also led them to theorize that PAIs may act to boost the dampened reward/pleasure circuit mechanisms and reverse apathy -- a key benefit that does not usually arise from treatment with medication alone.

"The positive activities themselves aren't really new," said Layous, the paper's lead author. "After all, humans have been counting their blessings, dreaming optimistically, writing thank you notes, and doing acts of kindness for thousands of years. What's new is the scientific rigor that researchers have applied to measuring benefits and understanding why they work."

A major benefit of positive activities is that they are simple to practice and inexpensive to deliver.

"If we're serious about tackling a problem as large as depression, we should be as concerned about the scalability of our solutions as much as their potency," Chancellor said,

While PAIs appear to be a potentially promising therapy for mild forms of depression," Doraiswamy cautioned, "they have not yet been fully studied in people with moderate to severe forms of depression. We need further studies before they can be applied to help such patients."

Kim Jobst, a physician and editor-in-chief of the Journal of Alternative and Complimentary Medicine, said the review provides one location in which to reference all relevant PAI findings to date, and includes recommendations that should prove useful to researchers, clinicians and the public. The journal is devoted to publishing research about novel and unconventional treatment approaches.

The research was supported by the authors themselves. Lyubomirsky's research has been funded by a Templeton Positive Psychology Prize and the National Institute of Mental Health. Doraiswamy has received research grants from NIMH and served as an advisor/investigator to several pharmaceutical companies.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - Riverside.

Journal Reference:

Kristin Layous, Joseph Chancellor, Sonja Lyubomirsky, Lihong Wang, P. Murali Doraiswamy. Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders. The Journal of Alternative and Complementary Medicine, 2011; 17 (8): 675 DOI: 10.1089/acm.2011.0139

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Pregnancy-related depression linked to eating disorders and abuse histories

ScienceDaily (June 16, 2011) — One in 10 women experience depression during pregnancy or shortly after giving birth. Although the problem has received increased attention in recent years, little is known about the causes or early-warning signs of pregnancy-related depression. In a study published in the June 2011 issue of Journal of Women's Health, researchers at the University of North Carolina at Chapel Hill School of Medicine offer new clues to help doctors identify at-risk patients and refer them to treatment early on.

The researchers surveyed 158 pregnant and postpartum women undergoing treatment for depression at UNC's Perinatal Psychiatry Clinic. One-third of the patients reported a history of eating disorders; in addition, many had a history of physical or sexual abuse. The findings suggest these psychiatric factors may increase a woman's likelihood of developing depression during pregnancy or postpartum.

Mental health screening tools that include questions about eating disorders, abuse and other factors should be incorporated into routine prenatal care, said Samantha Meltzer-Brody, MD, the lead author of the study and director of UNC's Perinatal Psychiatry Program. "Screening by obstetrical providers is really important because they can refer patients for appropriate treatment," she said. "And that can prevent long-lasting problems for mom and baby."

Undiagnosed and treated postpartum depression "causes enormous distress to the family, and it can have long-lasting consequences for the child," said Meltzer-Brody. Children of depressed mothers are more likely to develop mental health problems, and children of mothers with an active eating disorder may also be more likely to develop an eating disorder themselves. Making sure mothers struggling with mental health issues receive adequate assessment and treatment is critical to breaking that cycle, said Meltzer-Brody.

"The message we need to get out is that these things are incredibly common and routine screenings need to occur," said Meltzer-Brody. "The prevalence of abuse and eating disorder histories may be much higher than people appreciate."

Up to 25 percent of women experience physical or sexual abuse during their lifetime, a rate the UNC associate professor of psychiatry called "staggering." An estimated 6-8 percent of women are at some point affected by an eating disorder, with binge eating and bulimia nervosa being the most common, followed by anorexia and other disorders.

"Pregnancy and the postpartum period is a very vulnerable time for women," said Meltzer-Brody. Rapid changes in body shape, weight and hormone levels, combined with major lifestyle changes during the transition to motherhood, can take a toll on women -- especially those with a history of previous psychiatric issues.

Despite these challenges, Meltzer-Brody said pregnancy represents an ideal time for doctors to intervene and help women get mental health treatment if they need it. "[Pregnancy] is a time when people are really motivated to make changes and get treatment, because that can have serious consequences for how you do and for how your children do," she said, adding that by conducting mental health screens during prenatal care, doctors can help curb pregnancy-related depression.

The study's co-authors included Stephanie Zerwas, PhD, Jane Leserman, PhD, Ann Von Holle, Taylor Regis, and Cynthia Bulik, PhD, all from the Department of Psychiatry at the UNC School of Medicine, UNC Center for Women's Mood Disorders and UNC Eating Disorders Program.

Support for the research came from the NIH Building Interdisciplinary Careers in Women's Health (BIRCWH) Award to Dr. Meltzer-Brody.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Samantha Meltzer-Brody, Stephanie Zerwas, Jane Leserman, Ann Von Holle, Taylor Regis, Cynthia Bulik. Eating Disorders and Trauma History in Women with Perinatal Depression. Journal of Women's Health, 2011; 20 (6): 863 DOI: 10.1089/jwh.2010.2360

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Small hippocampus associated with depression in the elderly: Risk factor or shrinkage?

ScienceDaily (July 22, 2011) — Imaging studies have repeatedly found that people with depression have smaller hippocampal volumes than healthy individuals. The hippocampus is a brain region involved in learning and memory, spatial navigation, and the evaluation of complex life situations or "contexts." However, because in prior studies hippocampal volume was only measured in people once they became depressed, it has been unclear whether a small hippocampus renders a person vulnerable to developing depression, or whether it is a consequence of depression.

A new study published in Biological Psychiatry has approached that problem by following a large population of elderly individuals over a 10 year period.

Researchers performed an initial imaging scan on subjects to obtain a baseline measurement of their hippocampal volume and then performed follow-up scans 5 and 10 years later. During this time, they also repeatedly assessed the individuals for both depressive symptoms and depressive disorders.

Corresponding author Dr. Tom den Heijer explains their findings: "We found that persons with a smaller hippocampus were not at higher risk to develop depression. In contrast, those with depression declined in volume over time. Our study therefore suggests that a small hippocampal volume in depressed patients is more likely an effect of the depression rather than a cause."

"The principal importance of this type of research is that it may provide insight into age-related impairments in the function of the hippocampus," reflected Dr. John Krystal, Editor of Biological Psychiatry. "For example, in Alzheimer's disease, memory problems and disorientation are prominent symptoms, reflecting among other things the impaired function of the hippocampus."

Future studies will be needed to better understand whether current treatments protect the hippocampus and hippocampal function.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Elsevier, via AlphaGalileo.

Journal Reference:

Tom den Heijer, Henning Tiemeier, Hendrika J. Luijendijk, Fedde van der Lijn, Peter J. Koudstaal, Albert Hofman, Monique M.B. Breteler. A Study of the Bidirectional Association Between Hippocampal Volume on Magnetic Resonance Imaging and Depression in the Elderly. Biological Psychiatry, 2011; 70 (2): 191 DOI: 10.1016/j.biopsych.2011.04.014

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Mothers with breastfeeding difficulties more likely to suffer postpartum depression, study finds

ScienceDaily (July 19, 2011) — Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill.

"We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

"We found that very commonly the same moms who were struggling with breastfeeding were also depressed," she said. "There was a tremendous clinical overlap."

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

"If they're struggling with breastfeeding, they should seek help and tell their provider. If they don't have joy in their life, if they wake up in the morning and think, 'I just can't do this another day' -- that's a medical emergency. They shouldn't just say, 'I'm going to power through this and snap out of it.' They should call their provider and say, 'I just don't feel right, I'm wondering if I could be depressed, can I come in and talk to you about it?' "

The study is scheduled for publication in the August 2011 print issue of the journal.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Group therapy helps multiple sclerosis patients cope with depression, study finds

ScienceDaily (June 13, 2011) — Offering Multiple Sclerosis sufferers emotional support through group therapy sessions could improve their quality of life and save the NHS almost £500 per patient, a study at The University of Nottingham has discovered.

Researchers are now planning a larger multi-centre study into the issue to establish whether psychological therapy should be incorporated into the MS services currently provided by the NHS.

The study, funded by the MS Society, was led by Professor Nadina Lincoln, of the University's Institute of Work, Health and Organisations. She said: "These are very encouraging findings as many people with MS have problems with depression and anxiety and there are few treatments provided in NHS clinical services to address these. It is important that the psychological effects of MS are fully recognised as they can have a devastating effect on people's lives."

Depression and anxiety are common among sufferers of MS, a disabling neurological condition that affects around 100,000 people in the UK.

Previous studies have suggested that depression in MS can lead to patients failing to take their medication and a reduced quality of life. National Institute for Health and Clinical Excellence (NICE) guidelines also recognise that many people with both MS and depression or anxiety would prefer not to take antidepressants and recommends that psychological therapies should be offered as an alternative.

For the Nottingham study researchers recruited MS patients currently attending clinics run by Nottingham University Hospitals NHS Trust, as well as inviting referrals from specialist MS nurses and placing adverts in publications produced by the MS Society.

The volunteers were asked to complete questionnaires about how MS affects their daily lives and the extent to which they felt in control.

The patients were then randomly divided into two groups of just over 70 people. One group received all the usual care offered to MS and were put on a waiting list to receive group therapy at the end of the study.

The other group were invited to attend a course of six two-hour sessions of group therapy attended by up to eight participants at a time. Each session was led by a research psychologist, supervised by a qualified clinical psychologist with experience of working with people with MS.

Each session focussed on a topic, such as worry, gloom and relationships and was followed by practical exercises in strategies to cope with emotional problems and group discussion. They finished with relaxation exercises and group members were given tasks centred on practising coping strategies between sessions.

To assess the effectiveness of the sessions, questionnaires were sent to the participants at both four and eight months later and the results of those who received treatment were compared to those on the waiting list only.

The researchers found that those MS sufferers who attended the group sessions had fewer problems with anxiety and depression, the impact of the disease on their daily lives was reduced and their quality of life improved.

In terms of potential savings to the NHS, the researchers have also collected information on cost, which will be submitted for a future publication. They found that costs were reduced by £470 per patient for those who attended the therapy sessions compared with usual care. It was shown to almost halve the cost of visits to the GP, falling from £11,340 at the start of the study to just £5,832 at the eight month follow up. The costs of outpatient hospital visits were also slashed from £32,592 at the beginning of the study to £21,534 at the eight-month follow-up.

The next stage of the research will be to assess whether the group therapy approach works equally well in other centres through a larger study with the hope that the treatment could potentially be provided through NHS services for those with MS.

Dr Susan Kohlhass from the MS Society said: "Knowing group-based sessions can reduce anxiety and depression is a strong development towards improving the quality of peoples' lives with MS. We are committed to funding work that will imminently benefit people with the condition and this is a great example. The next stage will be to find if this approach is as effective in other areas of the country."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Nottingham.

Journal Reference:

N. B. Lincoln, F. Yuill, J. Holmes, A. E. Drummond, C. S. Constantinescu, S. Armstrong, C. Phillips. Evaluation of an adjustment group for people with multiple sclerosis and low mood: a randomized controlled trial. Multiple Sclerosis Journal, 2011; DOI: 10.1177/1352458511408753

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Current, not prior, depression predicts crack cocaine use

ScienceDaily (July 14, 2011) — Even after accounting for current crack use, a new study finds that women in drug court who are experiencing current major depression are more likely to use crack within four months than other women in drug court. The paper's lead author argues that depression screening and treatment may be important components of drug court services for crack-using women.

Women who are clinically depressed at the time they enter drug court have a substantially higher risk of using crack cocaine within four months, according to a new study. Because current but not past depression was associated with a higher risk of use, the study published in the journal Addiction suggests that addressing depression could reduce the number of women who fail to beat crack addiction in drug court.

"We found that current major depression increased the risk of crack use, but depression in the past year that had gotten better did not," said Jennifer Johnson, assistant professor (research) of psychiatry and human behavior in the Warren Alpert Medical School of Brown University and lead author of the study. "This suggests that if the depression remits, the risk of crack use goes down. Screening for depression and effective depression treatment may be important components of drug court services."

Addiction and depression are closely associated, said Johnson, who is also affiliated with Brown's Center for Alcohol and Addiction Studies. It isn't always clear how the two affect each other, especially at an urgent moment such as entry into the court system. Johnson set out to untangle the two by analyzing data gathered by researchers at Washington University in St. Louis as part of an HIV prevention study.

Among the 261 women in the study, 16 percent had a current major depressive episode and 40 percent had experienced a major depressive episode in their lifetime. Among the women currently depressed, 46 percent used crack during the next four months. Among women who weren't currently depressed, only 25 percent used crack in the next four months.

At the beginning of the study, the analysis statistically adjusted for whether women were using crack, which is highly addictive, and took the timing of the women's depression into account, said Johnson, who is also affiliated with the Center for Prisoner Health and Human Rights, a collaboration of Brown University and The Miriam Hospital.

Women who had been depressed at some time in the past, even in the last year, did not have an increased risk of crack use compared to women who had never been depressed, Johnson found. Women who were currently depressed, however, were significantly more likely to use crack than women who were never depressed. Furthermore, currently depressed women had nearly four times the odds of using crack during follow-up compared to women who had been depressed at some point in their past. The odds were nearly six times greater compared to women who were depressed within the last year, but not currently.

"It doesn't matter if they've been depressed in the past," she said, "only how they're doing right now."

The data hint that depression may have contributed to crack use in this population, Johnson said.

"It is well known that crack use can cause depression and depression can contribute to crack use," Johnson said. "However, in this study baseline depression [at the beginning of the study] was not associated with baseline crack use, but was associated with future crack use, suggesting that depression may have led to crack use and not vice versa."

If women in drug court can be successfully screened and treated for depression, Johnson said, the resulting reduction in crack use predicted by the analysis might benefit not only the women but also the community.

"The public ends up paying the cost of drug court and incarceration," she said. "Depression treatment isn't that expensive."

In addition to Johnson, the paper's other authors are Linda B. Cottler, Catina O'Leary, Catherine W. Striley, Arbi Ben Abdallah, and Susan Bradford, all of Washington University. Cottler's grant from the National Institute of Nursing Research funded the original HIV-prevention study for which the data was acquired. Johnson's analysis of addiction and depression was supported by a grant from the National Institute on Drug Abuse.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Brown University.

Journal Reference:

Jennifer E. Johnson, Catina C. O'Leary, Catherine W. Striley, Arbi Ben Abdallah, Susan Bradford, Linda B. Cottler. Effects of major depression on crack use and arrests among women in drug court. Addiction, 2011; 106 (7): 1279 DOI: 10.1111/j.1360-0443.2011.03389.x

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Sweating the small stuff: Early adversity, prior depression linked to high sensitivity to stress

ScienceDaily (June 28, 2011) — We all know people who are able to roll with life's punches, while for others, every misfortune is a jab straight to the gut. Research examining this issue has found that although most people require significant adversity to become depressed -- the death of a loved one, say, or getting fired -- roughly 30 percent of people with first-time depression and 60 percent of people with a history of depression develop the disorder following relatively minor misfortunes. But no one knew why.

Now, a new study led by UCLA researchers suggests that people become depressed more easily following minor life stress in part because they have experienced early life adversity or prior depressive episodes, both of which may make people more sensitive to later life stress.

George Slavich, an assistant professor at the UCLA Cousins Center for Psychoneuroimmunology, and colleagues assessed individuals' experiences with early adversity, clinical depression and recent life stress. Slavich found that individuals who experienced an early parental loss or separation and people who had more lifetime episodes of depression became depressed following lower levels of life stress than those who didn't have these predisposing factors.

The study appears in the current online edition of the Journal of Psychiatric Research.

"We have known for a long time that some people are more likely to experience mental and physical health problems than others," Slavich said. "For example, while some people get depressed following a relationship breakup, others do not. In this study, we aimed to identify factors that are associated with this phenomenon and to examine whether increased sensitivity to stress might be playing a role."

The researchers recruited 100 individuals with depression, 26 men and 74 women, and interviewed them extensively to determine what types of adversity they were exposed to when they were young, how many episodes of depression they had experienced and what types of life stress they had encountered recently.

The results showed that people who had lost a parent or had been separated from a parent for at least one year before the age of 18 and individuals who had experienced more episodes of depression over their lifetime became depressed following significantly lower levels of recent life stress.

Additional analysis revealed that these effects were unique to stressors involving interpersonal loss.

"Researchers at UCLA and elsewhere have previously demonstrated that early adversity and depression history are associated with heightened sensitivity to stress," Slavich said. "The present study replicates this effect but suggests for the first time that these associations may be unique to stressors involving interpersonal loss. In other words, individuals who are exposed to early parental loss or separation and persons with greater lifetime histories of depression may be selectively sensitized to stressors involving interpersonal loss."

An important question raised by these findings is how adversity early in life and prior experiences with depression promote increased sensitivity to stress. One possibility, the researchers say, is that people who experience early adversity or depression develop negative beliefs about themselves or the world -- beliefs that get activated in the face of subsequent life stress. Another possibility, which is not mutually exclusive, is that early adversity and depression influence biological systems that are involved in depression, perhaps by lowering the threshold at which depression-relevant processes like inflammation get triggered.

"Although many factors impact stress sensitivity," Slavich said, "thoughts almost always play a role. For example, when your best friend doesn't call back, do you think she is angry at you or do you think it just slipped her mind? Our thoughts affect how we react emotionally and biologically to situations, and these reactions in turn greatly influence our health. Regardless of your prior experiences, then, it is always important to take a step back and make sure you are interpreting situations in an unbiased way, based on the information available."

Other authors on the study were Scott M. Monroe, the William K. Warren Foundation Professor of Psychology at the University of Notre Dame, and Ian H. Gotlib, the David Starr Jordan Professor of Psychology at Stanford University.

The study was funded by a Society in Science: Branco Weiss Fellowship and by the National Institutes of Health.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - Los Angeles. The original article was written by Mark Wheeler.

Journal Reference:

George M. Slavich, Scott M. Monroe, Ian H. Gotlib. Early parental loss and depression history: Associations with recent life stress in major depressive disorder. Journal of Psychiatric Research, 2011; DOI: 10.1016/j.jpsychires.2011.03.004

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Biological links found between childhood abuse and adolescent depression

ScienceDaily (Apr. 20, 2011) — Kate Harkness has found that a history of physical, sexual or emotional abuse in childhood substantially increases the risk of depression in adolescence by altering a person's neuroendocrine response to stress.

Adolescents with a history of maltreatment and a mild level of depression were found to release much more of the stress hormone cortisol than is normal in response to psychological stressors such as giving a speech or solving a difficult arithmetic test.

"This kind of reaction is a problem because cortisol kills cells in areas of the brain that control memory and emotion regulation," explains Dr. Harkness, a professor in the Department of Psychology and an expert in the role of stress and trauma in adolescent depression. "Over time cortisol levels can build up and increase a person's risk for more severe endocrine impairment and more severe depression."

At severe levels of depression, Dr. Harkness' team saw that the youths with a history of maltreatment had a total blunting of the endocrine response to stress. These findings suggest that the normal operation of the stress response system can breakdown in severely depressed adolescents.

These results are important because they show that environmental stress in childhood changes the function of the brain in ways that may cause and/or maintain severe psychiatric disorders such as depression.

Dr. Harkness recently presented her findings at the International Society for Affective Disorders Conference in Toronto. The research was funded by the Ontario Mental Health Foundation and conducted in collaboration with Queen's researcher Jeremy Stuart and Kathy Wynne-Edwards from the University of Calgary.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Queen's University.

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Positive effects of depression

ScienceDaily (May 4, 2011) — Sadness, apathy, preoccupation. These traits come to mind when people think about depression, the world's most frequently diagnosed mental disorder. Yet, forthcoming research in the Journal of Abnormal Psychology provides evidence that depression has a positive side-effect.

According to a new study by Bettina von Helversen (University of Basel, Switzerland), Andreas Wilke (Clarkson University), Tim Johnson (Stanford University), Gabriele Schmid (Technische Universität München, Germany), and Burghard Klapp (Charité Hospital Berlin, Germany), depressed individuals perform better than their non-depressed peers in sequential decision tasks.

In their study, participants -- who were healthy, clinically depressed, or recovering from depression -- played a computer game in which they could earn money by hiring an applicant in a simulated job search.

The game assigned each applicant a monetary value and presented applicants one-at-a-time in random order. Experiment participants faced the challenge of determining when to halt search and select the current applicant.

In addition to resembling everyday decision problems, such as house shopping and dating, the task has a known optimal strategy. As reported, depressed patients approximated this optimal strategy more closely than non-depressed participants did.

While healthy participants searched through relatively few candidates before selecting an applicant, depressed participants searched more thoroughly and made choices that resulted in higher payoffs.

This discovery provides the first evidence that clinical depression may carry some benefits. For decades, psychologists have debated whether depression has positive side-effects.

While researchers have recognized that most symptoms of depression impede cognitive functioning, scholars such as Paul Andrews of the Virginia Institute for Psychiatric and Behavioral Genetics and Andy Thomson of the University of Virginia have proposed that depression may promote analytical reasoning and persistence -- that is, qualities useful in complex tasks.

Past research provides some evidence in support of this possibility, but it focuses on individuals with low levels of non-clinical depression.

The forthcoming article shows that even severe depression might yield some beneficial side effects. Fully understanding the consequences of depression may help uncover its evolutionary roots and thus opening avenues for treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Clarkson University.

Journal Reference:

Bettina von Helversen, Andreas Wilke, Tim Johnson, Gabriele Schmid, Burghard Klapp. Performance benefits of depression: Sequential decision making in a healthy sample and a clinically depressed sample.. Journal of Abnormal Psychology, 2011; DOI: 10.1037/a0023238

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Depression: Not just for adults

ScienceDaily (June 2, 2011) — From a distance, Callie (not her real name) appears to be a normal if quiet 5-year-old girl. But when faced with a toy that blows large soap bubbles -- an activity that makes the vast majority of kindergarteners squeal and leap with delight -- she is uninterested in popping the bubbles or taking a turn with the gun herself. When offered dolls or other toys, she is equally unmoved. When groups of children congregate to play, Callie does not join them. Even at home, she is quiet and withdrawn. While Callie's mother explains this lack of interest in play as simple "shyness," researchers are now discovering that children as young as 3 years of age can meet the clinical criteria for major depressive disorder (MDD). What's more, they demonstrate patterns of brain activation very similar to those seen in adults diagnosed with the disorder.

Brain changes in pre-school depression

Joan Luby, director of the early emotional development program at Washington University in St. Louis, has been studying pre-school depression for almost two decades. Developmental psychologists have argued that young children did not have the emotional or cognitive competence to experience depression, but Luby's clinical experience contradicted the party line.

"When you think about it, most of the core symptoms of depression are developmentally broad," says Luby. "Sadness and irritability can occur at any age from infancy to very old age. But symptoms like anhedonia were thought to be adult problems because it's often talked about as decreased libido. That, obviously, doesn't occur in young children. But when you developmentally translate it to an absence of joyfulness, especially when joyfulness is the dominant mood state of young children, you have a pretty robust clinical marker."

Depressed pre-schoolers do not just show synonymous clinical symptoms to adult depression -- they also show similar patterns of brain activity when scanned using a functional magnetic resonance imaging (fMRI) techniques. In a study published in the March 2011 issue of the Journal of Affective Disorders, Luby and colleagues scanned 11 depressed children with an average age of 4.5 years while they viewed faces with different expressions of emotion. The group found that there was a significant correlation between the severity of the depression and increased activity in the right amygdala, the same pattern of activity viewed in adults with depression.

"There is something about the experience of depression in very early childhood that seems to leave an enduring mark on the brain -- these kids are more likely to be depressed as adults, too," she says. "So these results suggest that there may be very early markers of a depressed brain that can be picked up in kids as early as age 4 or 5 and may open the door to much earlier intervention."

Risk factors for early childhood depression

Daniel Klein, a psychologist at Stony Brook University, is investigating potential factors in early childhood that may predict later chronic depression.

"When clinicians ask a depressed person when they first started feeling depressed, they'll often report having been depressed their entire lives," he says. "It's not clear when the onset is so I study pre-school age children with the intent of trying to identify behavioral and emotional precursors that will later evolve into chronic depression."

He is currently following more than 600 families from the local community sample in a longitudinal study. Though preliminary, a few factors appear to play a large role in the onset of depression later in life.

"In terms of temperament, a lack of exuberance and joy in situations where most kids get very excited about and then a lot of feelings of fearfulness and sadness stand out," he says. "These kids tend to have parents who have a history of depression and we're seeing some abnormalities in electrical activity when we take EEGs. There's some evidence now that these patterns predict not necessarily clinical depression but more depressive symptoms three or four years later."

Treating children with depression

While understanding the origins of MDD is of great biological interest, parents of depressed pre-schoolers are more interested in viable treatment options than brain scans. While anti-depressants have been used with some success in the adult population, there is wide concern about whether they should be used in children, let alone children of such a young age whose brains are going through critical periods of development.

"Certainly, with kids, there are all kinds of concerns particular to their age and level of neurological and physical development when we're talking about drug treatments," says Michael Yapko, a former clinical psychologist and author of Depression is Contagious. "Despite those concerns, the Food and Drug Administration estimates that 7% of antidepressants are still being prescribed to children."

While Luby does not dismiss the idea of a pharmacological treatment in the future, Luby's lab is currently testing a unique early intervention called dyadic play therapy. Children work with their primary caregivers, who are coached via an earpiece by a therapist, on emotional regulation and development.

"So far, the treatment appears promising," she says. "We are just now writing up the results of a small randomized, controlled trial suggesting there may be large effect sizes with this intervention."

Both Luby and Klein emphasize that our biological understanding of pre-school depression is still very preliminary. And while there is no one treatment option for these children at this point, Luby offers this advice to parents -- especially parents who have a child like Callie.

"Be attentive. If you have a child who is persistently irritable, persistently sad, who does not brighten in play or when fun and exciting things happen, that's every bit as much of a concern as a child who is disruptive in pre-school," says Luby. "We don't tend to pay as much attention to it but it is every bit as much of a concern. And treating it early may make all the difference."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by DANA Foundation. The original article was written by Kayt Sukel.

Journal Reference:

Michael S. Gaffrey, Andy C. Belden, Joan L. Luby. The 2-week duration criterion and severity and course of early childhood depression: Implications for nosology. Journal of Affective Disorders, 2011; DOI: 10.1016/j.jad.2011.04.056

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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