Depression and marital status determine the 10-year (2004–2014) prognosis in patients with acute coronary syndrome: The GREECS study

Background: The aim of the present work was to examine the association of depression and marital status, with the long-term prognosis of acute coronary syndrome (ACS), among a Greek sample of cardiac patients.

Methods: From October 2003 to September 2004, a sample of 2172 consecutive ACS patients from 6 hospitals was enrolled. In 2013–2014, the 10-year follow-up was performed in 1918 participants. Depressive symptoms were evaluated using the validated CES-D score (range 0–60), while marital status was classified as: single, married/cohabitants, divorced and widowed at the time of entry to the study.

Results: Patients in the upper tertile of CES-D (>20 score) had 41% (95%CI 14%, 75%) higher risk of ACS incidence as compared with those in the lowest (<7 score). In contrary, married patients had 29% lower risk (95%CI 6%, 46%) of ACS mortality compared with single, widowed or divorced. Multi-adjusted analysis revealed that among the ‘not married’ patients, 1-point increase in the CES-D score was associated with 2% (p = .02) and 4% (p = .001) higher risk of having non-fatal and fatal cardiac events, respectively.

Conclusions: The present study highlights the important role of depression in the context of marital relationships among ACS patients. Secondary public health care intervention programmes are needed to improve patient outcomes and minimise disease burden in clinical and community setting.     

Myths and Mates in Childbearing Depression

Abstract

Many myths exist about postpartum depression (PPD), all of which are based on the assumption that PPD differs qualitatively from depression that occurs at other times in women's lives. These myths paint a misleading picture of how PPD arises and may prevent women from receiving treatment for their difficulties. In this article, I identify five common myths and review the research literature to demonstrate that each lacks an empirical basis. Next, I present a model based on attachment theory, which I use to conceptualize PPD that occurs in the context of relationship distress. Finally, I illustrate this model with a clinical case.     

Women and Physical Distinction:

With few exceptions, the special concerns and status of women with physical distinctions (physical disability and facial disfigurement) have been largely ignored in the disability literature. Women with physical distinctions are perceived negatively and are devalued and marginalized in our culture. They face a double discrimination due to their gender and their disability. The situation is even more acute for ethnic minority women with physical distinctions. This paper will review the literature on women with physical distinctions and explore some of the issues for ethnic minority women with physical distinctins. Recommendations are offered for feminist therapists who work with this population.     

Book reviews

Abstract

Eldercare by James Kenny&;Stephen Spicer. Buffalo, NY: Prometheus Books, 1988, 152 pages, $11.95 paper

Lonely All the Time: Recognizing, Understanding and Overcoming Sex Addiction, for Addicts and Co-dependents by Ralph Earle&;Gregory Crow with Kevin Osborn. New York: Pocket Books, 1989, 337 pages, $19.95

The Imperfect Therapist: Learning from Failure in Therapeutic Practice by Jeffrey A. Kotter&;Diane S. Blau. San Francisco: Jossey-Bass, 1989, 188 pages, $19.95

Families with a Difference: Varieties of Surrogate Parenthood by Michael Humphreys&;Heather Humphreys. New York: Routledge, 1988, 177 pages, $45.00

Between Husbands and Wives: Communication in Marriage by Mary Anne Fitzpatrick. Newbury Park, CA: Sage Publications, 1988, 283 pages, $35.00 hardbound, $16.50 paperback     

Attributions for spousal behavior in relation to criticism and perceived criticism

This study examined relations between spousal attributions and criticism in a sample of 118 married couples. Spouses rated general perceived criticism (PC) and their own expressed criticism as well as interaction-specific PC from a videotaped discussion. Independent judges also coded criticism from the discussion. Spouses’ self-reported causal and responsibility attributions for hypothetical spousal negative behavior were related to all types of criticism. Attributions were also associated with unique variance in spouses’ reports of general PC and criticism, even after controlling either for judges’ or partners’ ratings of criticism and marital adjustment. General PC and expressed criticism appear to reflect more than either the amount of criticism present or feelings about the marriage; rather, general PC and expressed criticism are uniquely associated with the cause and responsibility ascribed to partners’ behavior.     

Epistemic Presuppositions and their Consequences

Traditional epistemology has, in the main, presupposed that the primary task is to give a complete account of the concept knowledge and to state under what conditions it is possible to have it. In so doing, most accounts have been hierarchical, and all assume an idealized knower. The assumption of an idealized knower is essential for the traditional goal of generating an unassailable account of knowledge acquisition. Yet we, as individuals, fail to reach the ideal. Perhaps more important, we have epistemic goals not addressed in the traditional approach – among them, the ability to reach understanding in areas we deem important for our lives. Understanding is an epistemic concept. But how we obtain it has not traditionally been a focus. Developing an epistemic account that starts from a set of assumptions that differ from the traditional starting points will allow a different sort of epistemic theory, one on which generating understanding is a central goal and the idealized knower is replaced with an inquirer who is not merely fallible but working from a particular context with particular goals. Insight into how an epistemic account can include the particular concerns of an embedded inquirer can be found by examining the parallels between ethics and epistemology and, in particular, by examining the structure and starting points of virtue accounts. Here I develop several interrelated issues that contrast the goals and evaluative concepts that form the structure of both standard, traditional epistemological and ethical theories and virtue–centered theories. In the end, I sketch a virtue–centered epistemology that accords with who we are and how we gain understanding.     

休谟的经济正义思想

休谟从分析人类获取生活资料的方式入手,认为正义是一种社会契约,是尊重个人财产权的人为美德;他提出了正义的三大法则,即财产稳定地占有的法则,根据同意转移所有物的法则,履行许诺的法则,并强调政府在落实经济正义三大法则过程中的作用。休谟的经济正义思想反映了市场经济的某些一般特征,对于今天我们研究中国社会的经济正义问题仍有不可替代的借鉴价值。     

Is marriage/cohabitation beneficial for young people? Some evidence on psychological distress among Norwegian college students

Although a large number of studies have examined the association between marital status or cohabitation on the one hand and psychological distress on the other, few have looked specifically at young people. Theoretically, the effects of marriage may be expected to vary with age, and differential selection into or out of marriage/cohabitation may also have different implications at different age levels. This paper uses cross‐sectional data on about 2300 Norwegian college students aged from 19 to 30; for nearly 1000 of these two‐wave panel data are also used. Psychological distress is measured by the General Health Questionnaire (GHQ), and linear regression analysis is used. Cross‐sectional analyses show that among female students marriage/cohabitation is associated with less distress. For male students the association changes with age; in the youngest group, married/cohabiting men are more distressed than those living alone, this is reversed beyond about 23 years of age. The longitudinal analyses show that termination of marriage/cohabitation is associated with increased distress. Going from single living to marriage/cohabitation does not seem to have any effect, however. These results are interpreted as providing some tentative support for social selection effects, and for the stressfulness of terminating a marriage or relationship of cohabitation. Copyright © 2006 John Wiley & Sons, Ltd.     

儒家伦理讨论中的六大概念问题

关于儒家伦理问题的讨论一直是中国哲学史界与伦理学界的一个热门话题,许多学者都抱着真挚的热情与善良的意愿努力开掘儒家传统伦理思想中的精微意蕴,并力图为现实生活与社会提供某种可资借鉴的范本。应当说其中的不少工作都有着深刻的理论价值和一定的现实意义,但也不能不看到,在讨论中有不少关涉核心问题的概念显得比较模糊甚或混乱,主要有伦理与德性、实践与思想、当然与可能、大众与精英、他律与自律、早期(先秦)儒家与后期(宋明)儒家等。对这些不同的概念做一辨析和梳理,将有利于关于儒家伦理问题的讨论在更深入和更精确的层面上进行。