Adapted cognitive behavioral group therapy for depressed low-income African American women

In this study we examine the degree to which a manualized cognitive-behavioral therapy intervention can be adapted to be culturally sensitive in treating depressed low-income African American women with multiple stressors. We describe the adaptations we made to an existing intervention, a group treatment developed for depressed low-income medical patients. We also describe our evaluation of the adapted treatment in which outcomes of African American women treated in the culturally adapted group were compared to African American women treated in the non-adapted group. Following treatment, women in the adapted group exhibited a larger drop in average BDI scores. Implications are discussed in terms of challenges related to the development and evaluation of culturally adapted treatment.     

Depression in postpartum and non-postpartum women: prevalence and risk factors

OBJECTIVE: The aim of the study was to assess the prevalence of depression in postpartum women as compared with non-postpartum women, and to identify risk factors of depression in both groups. METHOD: A population based questionnaire study was performed among women 18-40 years in two municipalities in Norway in 1998-1999. A total of 2,730 women were included, of whom 416 were in the postpartum period. RESULTS: The prevalence of depression was higher in non-postpartum as compared with postpartum women. High scores on the life event scale, a history of depression and a poor relationship to the partner were associated with depression in both postpartum and non-postpartum women. When controlling for the identified risk factors of depression the odds-ratio for depression in the postpartum period was 1.6 (95% CI: 1.0-2.6). CONCLUSION: The risk for depression was increased in the postpartum period, when controlling for the uneven distribution of risk factors.     

The prevalence of major depression or dysthymia among aged Medicare Fee-for-Service beneficiaries

RESEARCH OBJECTIVE: Estimates of the prevalence of major depression vary widely. Current estimates range from 2 to 14 % depending upon the definition and procedure for diagnosis. Further, most estimates are for special populations, either living in selected geographic areas or receiving specific types of medical care. A national survey of Medicare Fee-for-Service (FFS) beneficiaries provides an opportunity to assess the current level of major depression or dysthymia among a diverse population of older Americans. STUDY DESIGN: The Health Outcomes Survey (HOS) was administered to a national random sample of 1,000 Medicare FFS beneficiaries. We used the Mental Component Summary (MCS) measure of the SF-36 to estimate the prevalence of major depression or dysthymia. Logistic regression was used to examine associated factors. RESULTS: The response rate was 61.7%. Using an MCS score of 42 or lower, prevalence of major depression or dysthymia was estimated to be 25% for respondents age 65 years and older. Logistic regression analysis revealed that the likelihood of major depression or dysthymia was associated with years of education (Odds Ratio (OR) = 0.87), difficulties performing activities of daily living (OR = 1.72), and Medicaid enrollment (OR = 2.67). CONCLUSIONS: The results revealed that one-quarter of the respondents reported mental health problems consistent with major depression or dysthymia. This is higher than previously reported. Like previous studies, years of education, physical impairment, and poverty are strong predictors of major depression or dysthymia. The high rate of major depression or dysthymia implies there may be considerable unmet need among elderly Medicare FFS beneficiaries for diagnosing and treating mental illness.     

Associations among acculturation stress,mental health literacy,and mental health of married immigrant women in Korea

Approximately one in 12 marriages in Korea is an international marriage between a Korean man and a foreign woman. Women immigrating by international marriage have often reported that they experience difficulties adapting to their Korean family and culture. This study was conducted to provide basic information for developing mental health programs for immigrant women in Korea by investigating their acculturation stress, mental health literacy, and mental health. A sample of 209 immigrant women completed scales measuring these three constructs, which correlation analyses revealed to be significantly interrelated. Immigrant women’s acculturation stress was significantly related to number of marriages, husbands’ number of marriages, original country, reason for marriage, and occupation. Mental health was significantly associated with women’s original country, reason for marriage, education, and house income. Mental health literacy was significantly related to nationality. This research provides an important evidence base for developing multicultural education, services, and programs.     

Frequency and Scope of Mental Health Service Delivery to African Americans in Primary Care

This study examines whether African Americans with mental health complaints visit primary care physicians more than psychiatrists, and whether they demonstrate this preference more than do Whites. It addresses also whether when presenting with mental health concerns, African Americans and Whites receive a comparable range of interventions, including psychotropic medications. National estimates using the National Ambulatory Medical Care Surveys conducted in 1995 and 1996 confirmed the first hypothesis: African American did make more mental health-related office visits to primary care physicians than did psychiatrists and they did so more than Whites. Mental health interventions on behalf of African Americans and Whites proved to be similar, except that African Americans were less likely to be provided a psychotropic medication. Because African Americans are especially likely to receive outpatient mental health services from primary care physicians, the lower quality of mental health care occurring in primary care disproportionately affects African Americans. Fewer African American visits resulted in prescribing psychotropic medications, and this corroborated findings by other researchers. More research is needed to understand this disparity.     

Diagnosing Depression in African Americans

Since the 1970s, articles have noted the increased presence of psychotic symptoms among depressed African Americans, the presence of diagnostic bias identified when structured clinical interviews are used, and the identification of misdiagnosis of affective illness among chronically, mentally ill, African Americans. This paper reviews this literature and describes three alternative presentations of depressive illness among African Americans that differ from the DSM IV criteria for Major Depressive Disorder: the stoic believer, the angry, evil one with a personality change, and the John Henry doer. Clinicians are encouraged to recall these presentations of depression when evaluating African American patients.     

The mental health of elderly women in the community

This community study of the mental health of women demonstrates twice as much psychiatric ill-health among those over the age of 65 compared to younger women. The findings are best explained in terms of the loss of the work role for the elderly women rather than the loss of the domestic role. An apparently high frequency of phobia in the urban women is seen as an understandable reaction to their increased vulnerability and decreased mobility consequent on their chronic physical ill-health.     

Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used in two random population samples and among respondents at primary care and traditional healer settings, to assess common mental health problems, substance abuse problems and associated problems in social functioning. A high prevalence of mental health and substance abuse problems was observed in both communities, with highest rates in the peri-urban township. Even higher prevalences were found among respondents at primary health care or traditional healers. The study shows that mental health and substance abuse problems constitute a considerable burden of disease among disadvantaged communities in South Africa. The study further underscores the integral role of traditional healers in the mental health care system.     

The Diagnosis of Depression in People with Severe Limitations in Intellectual Functioning

People with intellectual disability (ID) were once considered immune to developing psychopathology, including affective disorders such as depression. Now research has shown that people with ID do suffer from depression, and the focus is on understanding how to best diagnose and provide treatment. Research has come a long way in adapting the diagnostic process for people with mild/moderate deficits in intellectual functioning and communication abilities. However, there is a lack of research and clinical understanding regarding how to assess depression in people who lack communication skills and function with severe or profound deficits in intellectual functioning. This paper reviews the available literature on the occurrence of depression in people with ID, specifically those with more significant deficits, and discusses the difficulties that arise in trying to determine a diagnosis of depression for this population.     

“Lifting More” is Associated with Lower Risks of Depression in University Students

Research on the population in western world showed that, MSE (muscle-strengthening exercise) is beneficial to the treatment of mental disorders. However, the situation in Chinese adults is little known. For this reason, the study is performed to understand the connection between depression and MSE among college and university students in China aged between 18 to 24.1793 college students have been recruited, and their average age is 20.67. A questionnaire has been developed and it is self-reported and designed to collect information about MSE and participants, including body mass index and sex and so on. Sleep and physical activity have been evaluated by introducing two scales, that is, Pittsburgh Sleep Quality Index and International Physical Activity Questionnaire-Short Form, respectively. Moreover, Patient Health Questionnaire-9 has been adopted to indicate the severity of depression of participants. The link between depression and MSE has been studied by introducing multilevel linear regression. Among all these study participants, just 24.87% of them met the MSE standards of World Health Organization, that is, more than 2 days every week. The average depression score was 6.80 (±5.19). Greater number of days for MSE shows negative association with the depression, with beta = −0.17, 95% CI: −0.31 to −0.03, p = 0.015). Those students failing to meet MSE standards are more susceptible to the depression risk (beta = 0.63, 95% CI: 0.09–0.19, p = 0.027). The results show that, there is a relationship between MSE participation and relieved status of depression among young adults in China. Interventions designed to relieve depression can be developed on the basis of MSE.     

Decline in Common Mental Disorder prevalence in men during the sixth decade of life

Abstract. Background: The impact of social transitions that might improve mental health, such as retirement, has attracted limited attention. Adverse occupational conditions and involuntary exit from work are linked to high rates of common mental disorders, but voluntary retirement is associated with improved mental health. Aims: We aimed to estimate the prevalence of common mental disorders around the conventional retirement age and to identify the associated factors that might explain differences in rates. Methods: Data were from the Psychiatric Morbidity Survey of Great Britain (2000), covering a sample of 8,580 respondents aged 16–74 years. Current common mental (neurotic) disorder presence was based on the revised Clinical Interview Schedule. Results: Prevalence rates for having any common mental disorder in men aged 65–69 years (5%; 95% CI: 2.7–7.3) were dramatically lower than in the agegroup 60–64 years (14.5%; 95 % CI: 10.6–18.5). This pattern applied to individual disorders and to the prevalence of very high symptoms counts. Prevalence rates in women peaked at age 50 and declined thereafter, but no large changes in prevalence are evident around age 60 or 65 years. In men leaving work early (aged 50–64 years), prevalence of common mental disorders remains high until the conventional retirement age. There is little change in exposure to other studied risk factors capable of explaining prevalence reduction, with the exception of decreased economic hardship in the older group. Conclusion: In the general population aged 50–74 years,there is a dramatic improvement in mental health in men after the conventional retirement age, but not in women. In men who leave work earlier, prevalence remains relatively high until after age 65.     

Help-Seeking Behavior for Depression in Japanese Schoolteachers

This correlational field study investigated the relationship between depression and help-seeking behavior in Japanese schoolteachers. Thirty-four primary schoolteachers from a rural area of Japan were surveyed using both quantitative and qualitative measures related to help-seeking and depression. Survey packets included a demographic questionnaire, the Center for Epidemiologic Studies depression scale (CES-D), the help-seeking scale for depression (HSSD), and a modified version of Kleinman’s (1980) explanatory model of help-seeking behavior. Findings from the study indicate a gap between participants’ awareness of depression and help-seeking behavior; participants had good awareness of depression and its severity, but they were not likely to seek professional help. We propose that social stigma may be one of the major deterrents to seeking such help. Furthermore, we found evidence that participants would seek professional help if motivated by family and friends and that family and friends could become strong motivators for increasing the use of mental health services. Findings also indicate that both utilizing one’s parent(s) as a source of help and taking action for alleviating depressive symptoms predict a higher likelihood of less severe depression. Practical implications of findings and future directions are discussed.