Pharmacotherapy of seasonal affective disorder

Seasonal affective disorder is a common variant of recurrent major depressive disorder or bipolar disorder. Treatment with bright artificial light has been found to be effective in this condition. However, for patients who do not respond to light therapy or those who lack compliance, conventional drug treatment with antidepressants also has been proposed. Substances with selective serotonergic or noradrenergic mechanisms should be preferred over older antidepressants. Although there are a number of open and controlled studies evaluating different compounds, these studies were often limited by relatively small sample sizes. Furthermore, there are no studies specifically addressing bipolar seasonal depression. This article will review the published literature on pharmacotherapy of seasonal affective disorder.     

“My Plate is Full”: Reasons for Declining a Genetic Evaluation of Hearing Loss

The aim of this study was to obtain patient and parent perspectives on genetic evaluation of hearing loss, in order to identify motivators, expectations, and barriers. Three focus groups were conducted following a semi-structured discussion guide, led by an independent moderator. Participants were hearing parents of children with permanent hearing loss or deaf adults. Qualitative content analysis was used to develop a codebook and identify major themes and subthemes. Participant views were compared to national guidelines. The 28 participants comprised 23 parents representing 21 unique families and 5 deaf adults. 13/21 families and 0/5 adults reported comorbidities, 4/21 families and 3/5 adults had a positive family history, and 12/21 families versus 0/5 adults had utilized genetics services. A common theme among adults and parents was a curiosity as to the cause of hearing loss. Parents were motivated to detect comorbidities and optimize care for hearing loss. Some parents felt overwhelmed by the hearing loss and unprepared to pursue early genetic evaluation as recommended in guidelines. Several reported positive experiences following genetics consultation, while others reported unease and unmet expectations. Notably, both parents and adults expressed ambivalence regarding the desire for genetic knowledge. Financial concerns and difficulties obtaining a referral were cited as extrinsic barriers. For parents of children with hearing loss, both the presence of comorbidities and a positive family history were drivers of genetics consultation and/or genetic testing. We identified educational opportunities for both patients and providers that would improve informed decision-making and increase access to genetic services. Consideration of the patient/family perspective and their decision-making processes, along with flexibility in the approach to genetics evaluation and its timing, will optimize both the development and implementation of guidelines.     

Depression and Anxiety: Integrating the Tripartite and Cognitive Content-Specificity Assessment Models

The cognitive content-specificity hypothesis proposes that depression and anxiety can be discriminated on the basis of unique cognitive profiles. Alternatively, the Tripartite model suggests that, although depression and anxiety share a general distress factor, anhedonia is a characteristic of depression with anxious arousal a characteristic of anxiety. Past research devoted to integrating these two models has been limited in a number of ways. To remedy these limitations, this study attempted to assess the complete Tripartite model and used a multidimensional cognitive assessment tool to handle the heterogeneity of anxious cognitive content. Results on data collected from 411 clients seeking services at a university counseling center suggested that a one-to-one mapping between Tripartite dimensions and cognitive content was possible. Further, variables from each model simultaneously explained unique variance in depression and anxiety ratings.     

Schmerzmanagement bei fortgeschrittener Demenz

Typischerweise liegen bei geriatrischen Patienten mehrere Erkrankungen gleichzeitig vor, die sich wechselseitig in ihrem Verlauf, aber auch in ihrer symptomatischen Auswirkung, beeinflussen. Dies gilt besonders für Zusammentreffen chronischer Schmerzen mit einer Demenz.     

Sexuality,Capitalism, and Africa

ABSTRACT

This piece provides a general overview and analysis of the current imperative to decolonize in South Africa, linking the recent turn to identity politics with the transformation of the university in a neoliberal institution. Before introducing the several pieces that make up this special issue, the proposal is made that colonisation is perhaps best seen as a phenomenon that lies at the intersection of sexuality, capitalism and “Africa”, provided the latter is understood not necessarily or not only in a geographical sense as denoting a continent but, rater, as the devalued yet dangerous Other of the West.     

Being Tough Versus Tender: The Impact of Country-Level and Individual Masculinity Orientations as Moderators of the Relationship Between Job Insecurity and Job Attitudes

Having a job constitutes one of the most potent means of attaining ‘masculine’ goals such as status, success, and material rewards. In the present research, we examine whether masculinity, both as a country-level value and an individual orientation, moderates the relationship between job insecurity and job attitudes. In Study 1, we draw on cross-cultural data of 20,988 employees from 17 countries. We find that job insecure individuals from countries with higher masculinity values show stronger decrements in job satisfaction (but not commitment). Shedding light on the underlying mechanism, we show that the moderating effect of masculinity is transmitted through two social job characteristics, perceived supervisor interpersonal justice and coworker support. We then constructively replicate the moderating effect of masculinity in Study 2. In a one-country sample of 319 employees, individual masculinity orientations likewise strengthen the negative relationship between job insecurity and job satisfaction. Our research highlights that country-level and individual masculinity orientations yield comparable effects in the job insecurity appraisal process, and provides insight into how cultural values can be enacted at the individual level.