Abstract: Major depression does not always remit. Difficult-to-treat depression is thought to contribute to the large disease burden posed by depression. Treatment-resistant depression (TRD) is the conventional term for nonresponse to treatment in individuals with major depression. Indicators of the phenomenon are the poor response rates to antidepressants in clinical practice and the overestimation of the efficacy of antidepressants in medical scientific literature. Current TRD staging models are based on anecdotal evidence without an empirical rationale to rank one treatment strategy above another. Many factors have been associated with TRD such as inflammatory system activation, abnormal neural activity, neurotransmitter dysfunction, melancholic clinical features, bipolarity, and a higher traumatic load. This narrative review provides an overview of this complex clinical problem and discusses the reconceptualization of depression using an illness staging model in line with other medical fields such as oncology. PubDate: Thu, 03 Aug 2017 10:33:21 +000
Abstract: Objective. Spiritual struggle (SS) is associated with poorer health outcomes including depression. The study’s main objectives were to characterize change in depression over time, examine longitudinal associations between SS and depression, and determine the extent to which experiencing SS at baseline was predictive of developing depression at follow-up. Methods. A two-site study collected questionnaire responses of parents (; 72% female) of children with cystic fibrosis followed longitudinally. Generalized linear mixed effects modeling examined the association between depression and SS over time and assessed potential mediators, moderators, and confounders. Results. Prevalence of depression increased from baseline to follow-up (OR: 3.6, ), regardless of degree of SS. Parents with Moderate/Severe SS were more likely to have depressive symptoms, compared to parents without SS (OR: 15.2, ) and parents who had Mild SS (OR: 10.2, ). Being female and feeling less “at peace” also significantly predicted increased depression (OR: 2.5, , and OR: 1.15, , resp.). Experiencing SS at baseline was not predictive of having depression subsequently at follow-up. Conclusions. Parents experiencing SS were significantly more likely to report depressive symptoms. Interventions to reduce SS have shown efficacy and may be considered. PubDate: Mon, 31 Jul 2017 00:00:00 +000
Abstract: Background. Thalassemia major has become a public health problem worldwide, particularly in developing and poor countries, while the role of educating the family and community has not been considered enough in patients’ care. Objectives. This study examines the impact of partnership care model on mental health of patients with beta-thalassemia major. Materials and Methods. This experimental study, with pretest and posttest design, was performed on patients with beta-thalassemia major in Jiroft city. 82 patients with beta-thalassemia major were allocated randomly into two groups of intervention (41 patients) and control () groups. Mental health of the participants was measured using the standard questionnaire GHQ-28 before and after intervention in both groups. The intervention was applied to the intervention group for 6 months, based on the partnership care model. Results. There were significant differences between the scores of mental health and its subscales between two groups after the intervention (). Conclusions. The findings of the study revealed the efficacy and usefulness of partnership care model on mental health of patients with beta-thalassemia major; thus, implementation of this model is suggested for the improvement of mental health of patients with beta-thalassemia major. PubDate: Wed, 21 Jun 2017 00:00:00 +000
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