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Objective: Patients with persistent post-concussion symptoms (PPCS) experience prolonged recovery (e.g., headache, fatigue, or dizziness) lasting >2 months post injury. These symptoms are thought to be maintained by several biopsychosocial factors including dysregulated stress responses, such as pain catastrophizing, that may drive behavioral avoidance and contribute to mood symptoms and cognitive difficulties. Conditions with similar symptomatology to PPCS (e.g., anxiety disorders, somatosensory disorders, chronic pain, etc.) also exhibit maladaptive thought patterns like pain catastrophizing as well as decrements in certain aspects of cognitive performance; however little is known about how pain catastrophizing might relate to neuropsychological performance in youth with PPCS. Therefore, the purpose of this study was to examine the relationship between pain catastrophizing and neuropsychological performance in youth participants with PPCS. Participants and Methods: A prospective case-control study design was used to examine 29 participants between the ages of 13 to 23. Participants were divided into two groups: 1) patients with PPCS (2-16 months post-injury; n = 15) and 2) age-matched, non-injured controls (n = 14). Participants completed the Pain Catastrophizing Scale (PCS) to determine degree of catastrophic thinking related to pain experience and the Beck Depression Inventory (BDI). Neuropsychological performance was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and a modified version of the Paced Auditory Serial Addition Test (PASAT) where performance was evaluated by total correct and error type (i.e., commission and omission) across 5 trials. ANCOVA was used to compare group differences in pain catastrophizing and neuropsychological tests scores while controlling for age and linear regressions examined the relationship between PCS total score and each neuropsychological test score while controlling for level of depression. Results: Overall, the PPCS group reported significantly higher levels of pain catastrophizing on the PCS compared to the control group (p < 0.01). For neuropsychological performance, the PPCS group scored significantly lower than the control group on List Learning (p < 0.01), Semantic Fluency (p < 0.05), and List Recall (p < 0.01) on the RBANS and made significantly higher omission errors (but not commission) on the PASAT(p <.01). Higher pain catastrophizing was also associated with poorer neuropsychological performance on the exact same tasks the PPCS group performed worse than controls. There was no significant interaction by group in the impact of PCS scores on neurocognitive performance. Conclusions: Compared to controls, youth PPCS patients reported higher levels of pain catastrophizing. Additionally, pain catastrophizing was associated with poorer neuropsychological performance. These findings suggest that increased pain catastrophizing after head injury could contribute to poorer cognitive performance in youth. As such, interventions that target maladaptive cognitive coping styles like pain catastrophizing may be especially helpful for patients with PPCS. [ABSTRACT FROM AUTHOR]

Abstract: Background: Self-ratings of psychotic experiences might be biased by depressive symptoms. Method: Data from a large naturalistic multicentre trial on depressed inpatients (n =488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale. Results: At discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P <0.001) and with the BDI total score (0.64, P <0.001). Moderate correlations were found for the MADRS (0.34, P <0.001), HAMD (0.37, P <0.001) and AMDP depression score (0.33, P <0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P <0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P <0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P =0.02). Conclusions: In depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings. [Copyright &y& Elsevier]

This study examined, first, effectiveness of a brief behavioural activation treatment for depression, in which participants engaged concurrently in activities of various difficulty instead of a standard least-to-most difficult sequence; and second, the relationship between behavioural self-observations of changes in activity levels and depressive symptomatology. Two adults with mild to moderate BDI-II depressive symptoms participated in a with-in participant multiple baseline study that contained 8 weekly conjoint sessions. Results showed that depression decreased to minimal levels at posttreatment and 1-month follow-up as a function of increases in activities of various difficulty. Results suggest early initiation of more difficult activities, and corroborate the relationship between increased activities and decreased depressive symptoms. [ABSTRACT FROM AUTHOR]

Introduction Personality traits have been associated with risk for depressive disorders. Studies with premorbid measures on personality are uncommon. Objective Estimate effect of premorbid personality as a predictor for remission in depressive disorders. Aim To study premorbid personality as a predictor for remission in depression in a population based sample. Methods The sample is based on the large Northern Finland Birth Cohort 1966. Temperament traits were measured at age 31 years using the Temperament and Character Inventory. At the age of 46 years depressive symptoms were measured using the Beck Depression Inventory – II (BDI). The sample included those with self-reported life-time depression history at age 46 years but not yet at age 31 years ( n = 298). Temperament at age 31 years was used to predict remission (BDI≤13) at age 46 years using logistic regression analysis, with gender and educational level as confounders. Cohen's d was used as effect size measure. Results Two hundred and one (67.4%) of individuals with self-reported depression were on remission at the follow-up. Low harm avoidance (total scale, and subscales anticipatory worry, shyness, and fatigability), low impulsiveness and high exploratory excitability (subscales of novelty seeking), and low sentimentality (subscale of reward dependence) predicted significantly remission with effect sizes between 0.28 and 0.45, highest effect being in harm avoidance. Conclusions Different temperament traits were able to predict remission status in depression. Effect sizes were between small and moderate. Temperament may associate with treatment response in depression. [ABSTRACT FROM AUTHOR]

Introduction Depression is common in patients suffering from somatic diseases particularly chronic, life threatening and disabling diseases such as renal impairment requiring hemodyalisis. It contributes to further deterioration of the quality of life. The goal of consultation psychiatry is to advise screening and early interventions for this most often treatable disorder. Aims To assess and compare presence and severity of depression, and subjective assessment of QOL between patients on hemodialysis and healthy subjects. Methods This study included 80 subjects age between 19 and 82 (× 49.6 ± 14.2) on continuous hemodyalis and 40 subjects from the general population of Zenica. Assessment instruments used: Beck Depression Inventory – BDI; SF36- QOL, and sociodemographic questionnaire. Results The subjects in the experimental group had significantly higher ( p <0.05) average score on BDI, 17.1 ± 9.4, corresponding to mild to moderate depression compared with the subjects in control group who scored an average of 8.5 ± 7.0 (range 2-39), which corresponds to absence of depression. Comparison of results on a scale for assessing the quality of life SF 36, indicates that the subjects in the control had a higher average score or higher quality of life compared to the experimental group. Conclusion The research results indicate a significant difference in the presence of depressive symptoms and in the subjective assessment of QOL in patients on hemodialysis compared to healthy subjects. This justifies routine screening for depression in this group of patients. [ABSTRACT FROM AUTHOR]

Introduction: Depression is one of the most common health issues impacting the university student population. The Patient Health Questionnaire (PHQ-9) is a short measure that has the potential to serve as a dual-purpose instrument that establishes depressive disorder diagnoses as well as grades the depressive symptom severity. Objectives: The current study was designed to study the psychometric properties of a Portuguese version of the PHQ-9 in a sample of university students. Aims: Specifically, we examined the internal reability and convergent validity of the measure. Methods: The English language of the PHQ-9 was translated into Portuguese. The process involved back-translation, crosscultural adaptation, field testing of the pre-final version, as well as final adjustments. A sample of university students completed the PHQ-9, the Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory (BDI). Results: Complete data were obtained from 1241 participants. The mean age of the participants was 23.81 years (SD = 4.87) and 75.3% of them were females. The mean PHQ-9 score was 4.15 (SD = 4.05). The Portuguese version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.86) and showed moderate convergent validity with the HADS anxiety (r = 0.61; p < 0.01) and HADS depression (r = 0.59; p < 0.01), and strong convergent validity with the BDI (r = 0.85; p < 0.01). Conclusions: The PHQ-9 has good psychometric properties amongst Portuguese university students. Implications for using the measure as an assessment instrument in the university setting are discussed. [Copyright &y& Elsevier]

Introduction: An adequate assessment of depression has been a concern to many researches over the last half-century. These efforts have brought forth a manifold of depression rating scales, of which one of the most commonly used self-assessment scales is the Beck Depression Inventory (BDI). Since its revision by Beck, Steer, and Brown (1996), the item structure of the BDI-II has been examined in many factor analyses, both, exploratory and confirmatory. Yet, a consensus about the underlying factor structure could not be achieved. Aim/objectives: The present study was conducted to reexamine the item structure based on robust Nonmetric Multidimensional Scaling (NMDS). The NMDS solution allows for evaluating the diverging results from the factor analyses conducted so far. Methods: The norm sample of the German version of the BDI-II was used (Hautzinger, Keller, & Kühner, 2006), which consisted of N =266 patients diagnosed with a major depressive disorder. Results: The NMDS solution emphasized a facet oriented structure and revealed the insufficiency of the factor analyses to adequately capture the data. Conclusions: Based on the NMDS solution, we propose an item structure consisting of a depressive core syndrome, surrounded by five specific facets (Figure 1). The core syndrome measures the severity of the depression mainly, whereas the five facets pronounce different qualities inherent to depression. Display Omitted [ABSTRACT FROM AUTHOR]

Introduction: The main description of alexithymia is a personality construct characterized by difficulties in experiencing and verbalizing emotions, and a poor capacity for symbolic thought reflected as a tendency toward externally oriented thinking. Objectives: The aim of the present study is to investigate the effects of alexithymia on tendency of somatization and sleep quality in depressive patients. Methods: Eighty-five major depression patientswere included in the study. The Beck Depression Inventory (BDI), Toronto Alexithmia Scale, Symptom Interpretation Questionairre (SIQ) and Pittsburgh Sleep Quality Index (PSQI) were used for assesments and measurements. Results: Patients with major depression were divided into two groups that alexithymic and non-alexithymic according to the aim of the study. There were significant differences in the BDI scores, the number of somatizating symptoms and psychologizing and somatizing scale scores in the SIQ, and daytime functionality scores in PSQI between alexithmic and non-alexithymic depressive patients. Conclusions: Alexithymia seems to be related with depressive symptomatology. Depressive patients with alexithymia may display abnormal health belief and difficulty in expressing their complaints. Therefore, alexithymia is a feature that affects the pattern of depressive symptoms. This present study confirmed that depressive patients have high prevalence of alexithymia, somatization and difficulty in expressing the feelings. Because of the loss of daytime functionality in the alexithymic depressive patients, clinicians should consider alexithymia in clinical practices. [ABSTRACT FROM AUTHOR]

Introduction: Research indicates that subjective tinnitus severity varies among tinnitus patients. One of the variables held responsible for these differences is depression. However the relationship between depression and tinnitus severity was never investigated more in depth. Objectives: If depression is responsible for differences in subjective tinnitus severity two conditions need to be fulfilled. First, there should be evidence for the presence of moderate to severe depressive symptomatology in a substantial group, and second, there should be evidence for a substantial relationship between depressive symptoms and tinnitus severity which can not be explained due to method and content overlap. Aims: In this study we investigated whether tinnitus severity is a depression related problem. Methods: 136 consecutive help-seeking tinnitus patients were seen by a psychologist and an audiologist. All patients filled in the Beck Depression Inventory (BDI-II), the Tinnitus Handicap Inventory (THI), and underwent psychoacoustic measurement (pitch and loudness). Results: Mean scores indicate the presence of no or minimal depressive symptoms. There was only a positive correlation (p<.01) between the BDI-II and the THI. No correlations were found between psychoacoustic measures and the self-report questionnaires. Linear regression analysis revealed that only the somatic depression subscale significantly predicted tinnitus severity. Conclusions: Tinnitus does not seem to be a depression-like problem. There is no substantial group of tinnitus patients with moderate to severe depressive symptoms. The relation between depressive symptoms and tinnitus severity seems to be an artefact due to content overlap between de THI and the somatic subscale of the BDI-II. [ABSTRACT FROM AUTHOR]

Introduction: The literature indicates that most patients with Major Depression mention sudden short “mood swings” (MI) when asked. MI is known to be distressing but little is known about the treatment. Objectives: To determine whether MI changes with community treatment of depression. Aim: To study changes in MI with 3-6 months of treatment for depression in patients with Major Depression and complaints of MI. Methods: 34 patients with Major Depression and complaints of “mood swings” were recruited from 4 psychiatric practices. They were interviewed with the MINI diagnostic interview and the Mood Disorders Questionnaire. They completed the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory Trait Form (STAI-T), and Visual Analogue Scales for Depressed Mood (VAS) and Anxious Mood twice a day for a week. The Mean Square Successive Difference Statistic (MSSD) was calculated from the VAS readings. The BDI, STAI-T, and VAS were repeated after 6 months of treatment. Results: 25/34 patients reported past hypomania. Most patients were treated with a combination of antidepressants and mood stabilizers. The BDI and STAI-T scores improved with treatment. There was no overall change in depressed and anxious MI. Change in Depressed MI and Anxiety MI correlates with change in BDI from T1 to T2 Conclusions: Anxiety and depression improved with treatment as expected. Change in MI is inconsistent. Research into medications and psychosocial treatments that improve MI is needed and this will probably improve depression treatment outcome. [ABSTRACT FROM AUTHOR]

In order to compare efficacy of antidepressant monotherapies and combinations of antidepressants, we reviewed retrospectively chart documents of treatment resistant depressive inpatients treated at least 4 weeks with a new antidepressant. Depressive symptoms were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form and Clinical Global Impression at the baseline, week 2, and at the end of treatment. We identified 78 patients (27 treated with combinations and 51 with monotherapies) that fulfilled the criteria for analyses. In comparison with patients on monotherapy, the combination group achieved higher reduction of MADRS score (14.6 vs 10.2 pts., p=0.02) and response rate (≥ 50% reduction of MADRS, 67% vs 39%, p=0.03). Number needed to treat for response was 4. Based on these results, we suggest that combination of antidepressants might be more effective than monotherapy in clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: To describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers Methods: Is selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers. Results: Most of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression. Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively. Conclusions: There are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver’ws work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country. [ABSTRACT FROM AUTHOR]

Aims: The role of perfectionism as a correlate of perinatal depressive symptomatology, and as a predictor of postpartum depressive disorder was examined. Methods: 386 women in their third trimester of pregnancy (mean age=30.08 years; SD=4.205; range=19–44) completed the Portuguese versions of Multidimensional Perfectionism Scale, Beck Depression Inventory-II/BDI-II, Postpartum Depression Screening Scale/PDSS and three additional questions evaluating anxiety trait, life stress perception and social support. Diagnoses of depression (ICD-10/DSM-IV) were obtained using the Portuguese version of the Diagnostic Interview for Genetic Studies/OPCRIT system. Women who were clinically depressed in pregnancy (ICD-10/DSM-IV) were excluded from the analysis. Results: Self-Oriented Perfectionism/SOP and Socially Prescribed Perfectionism/SPP subcomponents were significant correlates of depressive symptomatology (BDI-II/PDSS) in pregnancy. SPP-Others High Standards/OHS was a significant predictor of postpartum depressive symptomatology (BDI-II/PDSS), and SPP-Conditional Acceptance/CA was a predictor of postpartum depressive symptomatology (PDSS). None of the perfectionism subscales predicted postpartum depressive disorder (ICD-10/DSM-IV). Conclusions: SOP and SPP have shown to be relevant correlates of depressive symptomatology in pregnancy. In the present study, SPP-OHS and SPP-CA were also significant correlates of perinatal depressive symptomatology, as well as important risk factors for depressive symptomatology in postpartum. Perfectionism subscales were not significant predictors of postpartum depressive disorder (ICD-10/DSM-IV). While SPP maladaptive influence was supported, SOP was shown to be more heterogeneous in its consequences. These findings may have important implications both for clinical practice and for research. [ABSTRACT FROM AUTHOR]

Depression is a prevalent, often chronic and disabling disease. Current psychosocial and antidepressant treatments result in similar response rates with mostly symptom reduction, but not complete remission. Poor treatment adherence complicates depression management and prevention of recurrent episodes. Therefore, new therapies must be developed urgently, that alone or combined with present treatments, can significantly improve therapy outcomes. Depression is potentially associated with decreased heart rate variability (HRV). Based on our previous studies'' results which demonstrated HRV increase following auditory stimulation, we developed two interventions based on specifically for depression treatment composed and arranged music and tested the efficacy in a waiting list and placebo controlled double-blind study with depressed outpatients. Depression status was assessed at the beginning of T1 and T2 using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS-D) and by a composite (COMP) scale based on HAM-D, BDI and HADS-D z-scores. Changes in depressive symptoms between T1 and T2 (5 week period) were assessed based on COMP and on HAM-D, BDI and HADS-D scores alone. Compared to the control arm, a significant, positive effect in COMP was observed for MT1 at T2. Both MT1 and MT2 were associated with significant positive effects (HAM-D and HADS-D scores). MT2 resulted in positive effects on BDI scores. No significant change in any depression score was detected in the placebo arm. Treatment continuation was associated with an effect increase (mean HAM-D score reduction of 60%) after 10 to 15 weeks of treatment. [Copyright &y& Elsevier]

Objectives: Many studies have attempted to delineate the positive relationship between anxiety and depressive symptomatology in outpatients with bronchial asthma. However, do not exist reports on the relation between the depression, anxiety and vital exhaustion in these patients. Aim of the study is to investigate the levels and the associations between anxiety, depression and vital exhaustion in outpatients with bronchial asthma. Methods: The study was performed in one of the largest hospitals of chest diseases in Greece. Forty (14 men και 26 women) outpatients with bronchial asthma participated in the study. Using the BDI (Beck Depression Inventory), the STAI (Spielberger Anxiety Trait Inventory) and the Maastricht Questionnaire (MQ) we assessed depression, anxiety and vital exhaustion, respectively. Age and duration of the disease were also recorded. Results: Means of age and of duration of the disease were 43.22±13.05 and 9.24±6.01 years, respectively. The mean STAI score was 42.47±9.9, mean BDI score was 14,16±7,54, and the mean MQ score was 21.02±11.05. Percentages of 29% and 60% of the sample were presented with significant anxiety and depressive symptoms, respectively. No correlation was observed between the demographics (age and duration of disease) and the STAI''s and MQ''s scores. In contrary, a positive correlation was observed between the levels of depression, anxiety and vital exhaustion (pearson correlation p< 0.001). Conclusions: The study confirms the coexistence of the depressive symptomatology with anxiety and vital exhaustion in outpatients with bronchial asthma. Therefore, this comorbidity should be taken into account in order to develop specific supportive psychological interventions. [Copyright &y& Elsevier]