Treatment of depressed in-patients: cognitive therapy plus medication, relaxation plus medication, and medication alone

Article Abstract:

Cognitive therapy has been found to be useful for treating depression, but research has mostly focused on an outpatient population. This therapy has been most effective when treatment was given to nonpsychotic individuals suffering from mild to moderate depression. To study the usefulness of cognitive therapy for depressed inpatients, 30 such patients were divided into three groups of 10 patients each. Group one was offered treatment with anti-depressant medication. Group two was offered the same medication plus relaxation therapy. Group three was offered cognitive therapy plus medication. It was predicted that: (1) patients treated with cognitive therapy plus medication would show the greatest improvement when compared with the other two groups, and (2) this group of patients would show improvement earlier in therapy than the other two groups. Twenty-four of the 30 subjects were female and the average age for the sample was 36 years. Assessment of depressive symptoms was made using the Beck Depression Inventory and the Hamilton Rating Scale for Depression. Cognitive process and content ratings were made using the Dysfunctional Attitudes Scale, the Automatic Thoughts Questionnaire, and the Hopelessness Scale. Results showed that patients in group three (cognitive therapy plus medication) were rated as less depressed upon discharge from the hospital than patients in the other two groups, but, interestingly, there was little difference in patients' self-ratings of depression at treatment's end between group three and group two (relaxation therapy plus medication). Both groups reported more relief from depression than group one, in which patients received medication only. This suggests that therapeutic contact is important in the treatment program. There was also an earlier treatment response in groups receiving therapy plus medication. Similarity in results for group two and group three was not expected but may be explained in several ways. It is possible that the cognitive rationale for depression that was part of both techniques played a part or that the consistent application of a therapeutic framework helped mediate the integration of techniques. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Cognitive therapy

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Affective disorders among women in the general population and among those referred to psychiatrists: clinical features and demographic correlates

Article Abstract:

Ninety women diagnosed with affective disorder (depression, anxiety, or schizoaffective, panic or phobic disorders) who were living in the community were compared with 63 women diagnosed with affective disorder (35 inpatients and 28 outpatients) who were attending psychiatric hospital clinics. The great majority of women in both patient populations were diagnosed with depressive syndromes (major and minor depressive disorder, or schizoaffective depression). Thirteen percent of the hospital group and 23 percent of the community group were diagnosed with generalized anxiety disorder. In the hospital group, frequent symptoms other than depression were worry, loss of interest and concentration, social unease, muscular tension, and physical (somatic) manifestations. The community population differed in that they did not exhibit the same high degree of loss of interest or inability to concentrate. While nearly one-third of the hospital depressives demonstrated hypochondriasis, only 3 percent of the community group did. Severe forms of depression were found to occur more often in the hospital group. Mixed states combining anxiety and depression were found in equal proportions in both communities, as were symptoms of guilt, early morning awakening, poor appetite, and the loss of pleasure. However, the hospital population tended to have more concurrent symptoms. Weight loss was also more common among hospital patients. The tendency to experience worse depression in the morning (diurnal mood variation) was similar in the two groups. The community population had a significantly younger average age than the hospital population, and more hospital patients were single. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Analysis, Research, Affective disorders, Mood disorders, Anxiety, Psychology, Comparative, Comparative psychology

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Sex differences in suicidal behavior of referred adolescents

Article Abstract:

Research has shown that suicidal behavior in adolescence is more frequent than in other age groups, and male adolescents are more often successful in committing suicide than female adolescents. Overall, however, suicide is relatively infrequent and is difficult to predict. To investigate sex differences in suicidal behavior and the factors underlying them, 480 adolescents and their parents were studied. Adolescents were psychiatrically evaluated and grouped by diagnosis, suicidal behavior was measured through responses of subjects and their parents to standardized questionnaires, and data regarding socioeconomic status were obtained. Analysis showed that suicidal behavior was evident in 34 to 56 percent of the cases studied, depending upon such factors as sex and whether behavior was reported by parents or subjects. Reports of suicidal behavior were more frequent for girls than for boys overall and in self-reports than in parent reports. This challenges the notion that suicidal behavior follows a continuum from thoughts of suicide to attempt to completion, which is based upon the established fact that more boys actually commit suicide despite a higher rate of suicidal behavior in girls. Being diagnosed with an affective, or mood, disorder such as depression was related to a more than doubled incidence of suicidal behavior in both boys and girls, and high psychosocial stress was related to a high incidence of suicidal behavior, especially in those with affective disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Suicide, Demographic aspects, Teenagers, Youth

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