Self-Reported Symptoms of Depression by Changes in Sleeping Patterns and Appetites for Outpatients with a Major Depressive Disorder

To determine whether self-reported symptoms of depression are differentiated by changes in sleeping patterns or appetite, the Beck Depression Inventory-II (BDI-II; Beck et al. 1996) was administered to 1,250 outpatients diagnosed with a major depressive disorder. A series of focused contrasts supported the hypothesis that the mean BDI-II total scores and the majority of the symptom ratings of the outpatients who described increases or decreases in their sleeping patterns or appetites were comparable and higher than the mean BDI-II total scores and symptom ratings of the patients who reported no changes in their sleeping patterns or appetites. However, the patients who were sleeping less described themselves as being more agitated than those who were sleeping more. Decreases and increases in sleep or appetite were both discussed as indicating comparable levels of depressive symptomatology.

Self-Reported Depression in Mothers of Children Who Have Experienced Sexual Abuse

The Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) was administered to 164 biological mothers of sexually abused children to determine the psychometric characteristics of the BDI-II and to estimate the prevalence of self-reported depression in this population. The study also sought to ascertain whether the mothers’ BDI-II total scores were correlated with various psychosocial characteristics of the mothers and their children. It was found that there was only one dimension underlying the 21 BDI-II responses, and the internal consistency of the BDI-II total scores was high. Twenty-six percent of these mothers had scores indicative of clinical depression. The mothers’ BDI-II total scores were significantly correlated with their husbands’ or paramours’ having sexually abused their children and their ratings of the children’s internalizing behaviors. These results were discussed as supporting the use of the BDI-II with mothers of sexually abused children to measure self-reported depression.     

Common and Specific Dimensions of Self-Reported Anxiety and Depression in Adolescent Outpatients

To investigate the common and specific dimensions of anxiety and depression in adolescents, the Beck Anxiety Inventory (BAI; Beck, A. T., & Steer, R. A. Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation 1993a) and Beck Depression Inventory-II (BDI-II; Beck, A. T., Steer, R. A., & Brown, G. K. Manual for Beck Depression Inventory (2nd Ed.). San Antonio, TX: Psychological Corporation 1996) were administered to 840 adolescent (13–17 years old) outpatients who were diagnosed with various types of psychiatric disorders. A Schmid-Leiman transformation was used with the iterated-principal-factor pattern matrix of the BAI and the BDI-II loadings. The amounts of orthogonalized common variance that were explained by the one second-order (56%), one first-order depression (22%), and two first-order anxiety (22%) dimensions were comparable to those previously reported for adult psychiatric outpatients. The results were discussed as supporting the construct of negative affectivity that is proposed in L. A. Clark and Watson’s (1991) tripartite model of anxiety and depression.

抑郁和焦虑与心律失常

焦虑抑郁广泛存在于各种心血管疾病中已成共识。心律失常患者合并心理问题在临床上十分常见,焦虑抑郁导致的自主神经对心脏的调节失衡会进一步促使心律失常的发生与发展。对于非器质性心脏病,β受体阻滞剂与抗焦虑药物合用有很好的疗效;器质性心脏病患者并发心律失常时患者的焦虑抑郁会进一步加重,甚至导致恶性室性心律失常的发生,增加器质性心脏病患者的病死率;心律失常介入治疗引起的焦虑抑郁更为常见。临床上对焦虑抑郁症状要有充分的重视,积极识别并诊断,以期进一步提高心律失常患者的生活质量,减少病死率。     

抑郁症的脑网络失调:来自图论分析的证据

以脑成像数据为支撑,基于图论的复杂脑网络分析实现了在大尺度上对于大脑的整体定量分析,克服了传统抑郁症病理改变研究仅关注少数几个脑区的缺点。本文主要总结了:(1)基于图论的脑网络分析的概念;(2)基于图论的抑郁症研究现状;(3)以往传统研究的不足,抑郁症脑网络研究的当前总结和未来展望。总体来说:抑郁症病人脑网络的小世界属性依旧存在,但在节点指标上存在明显的异常,且随疾病发展呈线性变化,整个网络趋向于随机化。区域性的异常主要存在于默认网络和前额叶?边缘系统环路。未来研究中,任务状态下的脑网络构建和"最小生长树"技术的应用可能会为抑郁症病人的脑网络异常提供更多的信息。     

Psychosocial Family Treatment for a 10-Year-Old with Schizoaffective Disorder

Schizophrenia spectrum disorders are rare in childhood and little is known about their psychosocial treatment. Relevant findings from the adult and child literature are reviewed. The case of 10-year-old “Michael” is presented, who participated in a randomized clinical trial of a psychoeducational family treatment for mood disorders. Following treatment, quantitative and qualitative data show that Michael's mood and social functioning improved, utilization of mental health services improved, the overall family emotional climate became more positive, and his parents felt supported. He no longer met criteria for a mood episode but continued to display psychosis. This family's response suggests that group psychoeducation may be an effective treatment for families of children with emerging schizophrenia spectrum disorders.     

Psychometric Properties of the Beck Depression Inventory-II in a Clinically-Identified Sample of Mexican American Adolescents

We examined the internal consistency reliability, convergent and divergent validity, and factor structure of the Beck Depression Inventory-II (BDI-II) in a sample of 131 Mexican American youth. The BDI-II demonstrated excellent internal consistency reliability (α=.90) and solid convergent and divergent validity with various clinical scales of the Adolescent Psychopathology Scale. Two factors, Cognitive-Somatic and Affective, emerged from an exploratory factor analysis and suggested that depressive symptomology may manifest somewhat differently in Mexican American youth. In sum, results provide tentative support for the use of the BDI-II as a measure of depression for this sample.     

Attempted Suicide in a Xhosa Schizophrenia and Schizoaffective Disorder Population

Suicide risk behavior is a significant contributor to the mortality and morbidity of schizophrenia. We previously reported affected sibship status in a Xhosa schizophrenia or schizoaffective disorder sample to be protective in nature; given the counterintuitive nature of this finding, we expanded the sample size to seek further clarification. Subjects were assessed with the Diagnostic Interview for Genetic Studies and then stratified into two groups: with (n = 137) or without (n = 837) a previous suicide attempt. The presence of lifetime bizarre behavior (OR 1.5; 95%CI 1.12–1.87) or cannabis use or abuse (OR 1.2; 95%CI 10.01–1.47) was a significant predictor of suicide attempts, while a higher global alogia score (OR 0.84; 95%CI 0.74–0.96) was a protective factor. Our data seem to support that in this population, encouraging family members to report bizarre behavior and implementing dual diagnosis interventions for cannabis use or abuse could be an appropriate starting point toward developing a targeted suicide prevention program for further research.     

Depression Screening,Assessment, and Treatment for Patients with Coronary Heart Disease: A Review for Psychologists

Depression prevalence is between 15% and 20% in coronary heart disease patients, such as those with angina, or after a myocardial infarction or coronary artery bypass graft surgery. The presence of depression places a coronary heart disease patient at twofold higher risk for further major cardiac events and death, as well as poor quality of life and early exit from the labour force. As a consequence, several learned societies, including the National Heart Foundation of Australia, have published guidelines that recommend questionnaire screening to improve identification and management strategies for depression in coronary heart disease patients. Psychologists in hospitals, community settings, and private practice can have a key role in the realisation of the National Heart Foundation of Australia's aims. We review the recent guidelines and outline implications for psychologists to identify and manage depression in coronary heart disease patients. The evidence reviewed suggests that cognitive‐behavioural therapy and problem‐solving therapy are frontline non‐pharmacological interventions for depression in CHD patients.     

冠心病患者的抑郁和焦虑

许多临床研究表明,冠心病患者常发生抑郁及焦虑。而在严重精神症状（如抑郁或/和焦虑）者中有较高的冠心病发生率。抑郁增加冠心病患者的不良心血管事件发生率,影响预后。其机制有如下几个方面：对医疗措施及生活方式改变的依从性差、血小板功能异常、血管内皮功能紊乱以及心率变异性降低。选择性5-羟色胺再摄取抑制剂由于其较好的耐受性且无明显的心血管副作用而应用于冠心病合并抑郁及焦虑的药物治疗并改善患者的生活质量。但仍需要更大规模的临床研究以确定抑郁及焦虑对冠心病预后的影响。临床上应更加关注焦虑对冠心病的影响,进一步探讨焦虑能否作为冠心病的危险因素。     

Treating Depression in Older Medical Patients with Psychotherapy

This purpose of this paper is to discuss the effectiveness of psychotherapy for treating depression in older, primary care patients. This paper highlights the feasibility of implementing psychotherapy in primary care settings, patient preference for psychotherapy, and the utility of primary care versions of therapy in treating depression in older adults. The discussion is supported with examples from three ongoing research projects, specifically the San Francisco General Hospital Depression in Late Life Study, the Hartford Foundation/California Healthcare Foundation IMPACT study, and the NIMH PROSPECT study. The findings presented here support the value of offering psychotherapy as a treatment alternative in primary care medicine.     

尿毒症血液透析患者抑郁状况的研究

随着透析技术的不断完善,尿毒症患者的生存期明显延长,尿毒症患者的心理障碍问题也日益受到重视,本文通过标准化的心理测量工具,分析不同的自然因素及疾病因素对尿毒症透析患者抑郁的影响,目的在于为寻求有效的综合式生物-心理-社会干预治疗提供有效的临床依据。     

Use of the Beck Depression Inventory-II with Adolescent Psychiatric Outpatients

To provide information on the use of the Beck Depression Inventory-II (BDI-II) with adolescents, the BDI-II was administered to 105 male and 105 female outpatients between 12 and 18 years old who were seeking psychiatric treatment. The internal consistency of the BDI-II was high (coefficient = .92). The mean BDI-II total score of the girls was approximately 5 points higher than that of the boys (p < .001), and age (years) was positively correlated with the BDI-II total scores (r = .18, p < .01). An iterated principal-factor analysis identified three factors, but only the Cognitive and Somatic-Affective factors were generalizable.     

自动思维及归因方式对抑郁症作用的多因素分析

目的：探讨抑郁症患者治疗前后自动思维、应付方式变化对抑郁严重程度变化的影响及其相互作用。方法：对97例抑郁症患者分别在其入、出院时进行测评,测评工具包括自评抑郁量表、自动思维问卷和归因方式问卷。此外对100例正常对照亦进行上述测评,其中29例在15—20天后重测。结果：自动思维问卷得分、归因方式问卷得分的logistic回归分析、路径分析表明,自动思维、对正性事件的整体性维度的归因方式对抑郁程度的影响有显著作用,自动思维的变化对SDS的变化的直接影响最大(路径系数为0．572),归因方式中正性事件整体性归因的变化为其次(路径系数为一0．193),而自动思维的变化与归因方式中正性事件整体性归因的变化的相互影响较小(路径系数为-0．188)。结论：自动思维、对正性事件的整体性维度的归因方式对抑郁严重程度有显著影响。     

一种认知分析心理治疗模式对抑郁症患者的干预

为了探索基于"自我"与感受、需要、能力和角色交互相整合的认知分析心理治疗模式及其在抑郁症患者治疗中的效果,对7例门诊和8例住院抑郁症患者进行心理治疗,采用HAMD和CGI-GI评估治疗的效果,并追踪治疗1年后患者的社会功能及健康状况。所有患者治疗前后HAMD分值差异显著,配对t=8.08(P0.01),门诊与住院治疗患者HAMD分值和CGI-GI分值均无明显差异(P0.05),但产生治疗有效的平均时间差异显著,住院者(11.6±3.6)天,门诊者(60.6±25.0)天(P0.01)。该心理治疗模型能够整合到抑郁症患者的药物治疗中,产生整体治疗效果。     

The Depression Anxiety Stress Scale-21: Spanish Translation and Validation with a Hispanic Sample

The English-language version of the Depression Anxiety Stress Scale-21 (DASS-21) was professionally translated into Spanish and field-tested among 98 bilingual Hispanic adults. Participants who were diagnosed with an anxiety disorder on the Anxiety Disorders Interview Schedule-IV completed the DASS-21, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Results indicated strong indices of internal consistency and expected patterns of discriminant, convergent, and structural validity. A confirmatory factor analysis compared a model fit of a first order 1-factor model, a first order 3-factor model, and a second order factor model. The latter 2 models were significantly better than the 1-factor model. Psychometric data were comparable to those of an English version. Clinicians and researchers in need of a brief, Spanish-language, screening measure of general psychopathology may want to consider this newly translated DASS-21.     

Comparing the Family Environments of Adolescents with Conduct Disorder or Depression

We attempted to differentiate the family environments of youth with Conduct Disorder (CD) compared to youth with a depressive disorder. Participants were 34 adolescents from a residential treatment facility. The K-SADS-P was used to determine the youth's diagnosis, while their family environment was assessed by the Self Report Measure of Family Functioning Child Version. A MANOVA was used to compare the two diagnostic groups on seven family environment variables. Results indicate that adolescents with CD described their parents as having a permissive and ambiguous discipline style, while adolescents with a depressive disorder described their relationship with their parents as enmeshed. A discriminant function analysis, using the two family environment variables of enmeshment and laissez-faire family style as predictors, correctly classified 82% of the participants. Implications for treatment of youth with both types of diagnoses and their families are discussed.     

Autobiographical Memory Specificity in Patients with Tinnitus Versus Patients with Depression and Normal Controls

Several studies show that patients with depression and post-traumatic stress disorder respond with fewer specific autobiographical memories in a cued memory task (i.e. the autobiographical memory test; AMT) compared to healthy controls. One previous study found this phenomenon among tinnitus patients as well (Andersson, Ingerholt, & Jansson, 2003). The aim of this study was to replicate the previous study with an additional control group of depressed patients and memory errors as measured with the AMT as an additional outcome. We included 20 normal hearing tinnitus patients, 20 healthy controls and 20 persons diagnosed with clinical depression. The AMT was administered together with self-report measures of depression, anxiety and tinnitus distress. Both the tinnitus and depression groups differed from the healthy control group in that they reported fewer specific autobiographical memories. There were, however, differences between the tinnitus and depression groups in terms of the errors made on the AMT. The depression group had more overgeneral memories than the normal control group, whereas the tinnitus group did not differ from the control group on this memory error. The tinnitus group had more semantic associations and non-memories than the other two groups, suggesting that executive functioning may play a role for the tinnitus group when completing the AMT. Clinical and theoretical implications of the findings are discussed.     

前额叶皮质损伤患者的情绪异常

人类前额叶皮质与情绪之间有着密切的关系,文章在相关的临床和神经成像研究结果基础上,分析了前额叶皮质损伤对情绪行为造成的影响,分别概述了精神分裂症、重性抑郁和焦虑患者的情绪变化、前额叶切除对情绪的影响以及左右前额叶皮质与情绪的关系,重点阐述了前额叶功能异常的神经生理学特点,认为情绪的改变会随着前额叶皮质不同部位的结构缺损或功能变化而有所不同,此有利于对前额叶皮质损伤患者情绪异常的评价与防治。