A prospective study of maternal anxiety, perceived stress, and depressive symptoms in relation to infant cognitive development
Maternal trait anxiety, depressive symptoms and stress had little negative influence on infant cognitive development. In fact, moderate psychosocial distress may slightly accelerate motor development in particular, and some aspects of language.
Conclusion: This study’s findings suggest that sensory impairment in older adults can increase their probability of experiencing depressive and anxiety syndrome. Correction of these deficits could improve the quality of life in this population.
Mortality and Nursing Care Dependency One Year After First Ischemic Stroke: An Analysis of German Statutory Health Insurance Data
Conclusion: Aphasia has a high impact on mortality and nursing care dependency after ischemic stroke, while dementia and depression are strongly associated with increasing nursing care dependency.
Patients with Posttraumatic Stress Disorder Show Decreased Cognitive Control: Evidence from Dichotic Listening
The influence of posttraumatic stress disorder (PTSD) on cognitive control and auditory attention modulation was examined with the use of a dichotic-listening (DL) task. The participants were 45 war-exposed refugees. The PTSD group comprised 22 participants meeting the DSM-IV criteria for PTSD, and the Control group comprised 23 war-exposed participants without PTSD. Both groups were tested with a consonant–vowel syllables DL task under three different attentional instructions. The two groups did not differ in the non-forced and forced-right conditions and showed, as expected, right-ear advantages. The Control group showed, as expected, a left-ear advantage in the forced-left (FL) condition. However, the PTSD group continued to show a right-ear advantage – and only minor modulation of the performance during the FL condition. This finding suggests that PTSD is associated with a reduced capacity for top-down attentional control of a bottom-up or stimulus-driven effect. The result shows that participants with PTSD have impaired cognitive control functions when tested on information processing of neutral stimuli. (JINS, 2011, 17, 344–353)
Culturally Deaf adults lost hearing at early ages, communicate primarily in American Sign Language (ASL), and self-identify as culturally Deaf. Communication barriers lead to isolation, low self-esteem, abuse, and inadequate health care. Screening Deaf patients for depressive symptoms poses challenge. Nurses are rarely familiar with ASL, and depression screening tools aren’t easily translated from English to ASL. Consequently, Deaf adults are not adequately screened for depression. Qualitative interviews were conducted with culturally Deaf adults, and certified interpreters helped to enhance understanding. Text was generated from interview transcriptions and researcher observations. No novel depressive symptoms were described. Various ASL signs were used to represent depression; two participants used a unique gesture that had no meaning to others. Childhood experiences leading to depression included sexual or physical abuse, feeling ostracized from family and like a burden. Suicidal gestures communicated severity of depression. Adults felt interpreters were unwelcome during mental health encounters. No participants were asked about depressive symptoms despite frank manifestations of depression. Study describes antecedents and consequences of depressive symptoms among Deaf adults. Understanding symptom manifestations and challenges experienced by Deaf patients helps identify those at risk for depression, thereby reducing morbidity and mortality.
Neurocognitive dysfunction and psychosocial outcome in patients with bipolar I disorder at 15-year follow-up
Processing speed is robustly associated with social and global functioning in bipolar disorder. Poor work functioning is significantly related to subsyndromal depression, course of illness, and verbal learning deficits. Cognitive and mood symptoms warrant consideration as independent determinants of functioning in patients with bipolar disorder many years after an index manic episode.
Health-related quality of life in people with aphasia: Implications for fluency disorders quality of life research
It is increasingly important that clinicians address the health-related quality of life (HRQOL) of adults with communication disorders in clinical practice. The overall aim of this paper is to draw conclusion about the suitability of the Short Form 36 Health Survey for the communication disorders of aphasia and stuttering. This study reports on the impact of post-stroke aphasia on 30 Australian older adults’ HRQOL. It also comments on the capacity of the SF-36 to measure HRQOL in this population, specifically whether it is sensitive to the three known determinants of post-stroke HRQOL–emotional, physical and social functioning. Comparisons with other data are made to assist interpretation of the SF-36 subscale scores: with 75 older adults with no history of neurological conditions; and with data from the 1995 National Health Survey data. The main findings are: (1) adults with post-stroke aphasia have similar HRQOL to their peers on six subscales, but significantly lower Role emotional and Mental health HRQOL (2) a substantial number of aphasic adults reported depressive mood; and (3) aphasic adults with depressive mood have significantly worse HRQOL on six subscales than aphasic adults without depressive mood, but similar Role emotional and Body pain HRQOL. In conclusion, stroke and aphasia have minimal impact on older adults’ HRQOL as measured by the SF-36, which conflicts with an established evidence base of the negative consequences of aphasia on life. Thus, the SF-36 is not advisable for use with aphasic adults. Implications of these findings for aphasia and stuttering are discussed.
The Sensitivity and Specificity of Cognitive Screening Instruments to Detect Cognitive Impairment in Older Adults With Severe Psychiatric Illness
Conclusions: Overall, the MMSE was found to be the more clinically useful cognitive screening tool for use in CMHC. Yet, because of the poor sensitivity of the MMSE for detecting CI in this patient population, alternative screening methods should be explored.
A personal account of a speech pathologist’s experience of major depression and how her work and research in speech pathology provided a way for her to understand this illness.
The aim of this study was to investigate the effectiveness of group psychotherapy, founded on a psychodynamic, interpersonal approach and influenced by techniques used in cognitive behavioural therapy, in alleviating severe refractory tinnitus as well as psychiatric symptoms. Consecutive tinnitus patients without socially disabling hearing loss were recruited if they fulfilled risk criteria for developing severe refractory tinnitus based on a screening procedure with established validity. Thirty-seven patients participated in the group psychotherapy and were compared to patients (n =38) not receiving group therapy, who were primarily recruited to participate in a placebo-controlled study of the effects of a selective serotonin reuptake inhibitor. Changes in the severity of tinnitus, anxiety and depression were the main outcomes. Assessments were performed at entry, after 12 weeks treatment, and for the psychotherapy group only, at follow-up three months after the intervention period. Between-group comparisons of change scores over 12 weeks showed no difference between treatment groups. Comparisons within the groups revealed no benefits at the end of the intervention period, but at follow-up a significant improvement in anxiety (p<0.01) was recorded for the psychotherapy group. The findings suggest that short-term group psychotherapy in severe refractory tinnitus is beneficial in terms of anxiety reduction. Group psychotherapy may also contribute to a raised awareness of the existence of a close association between emotional/physical arousal and tinnitus suffering.
To assess the impact of patient reported voice outcome on quality of life and emotional functioning in patients treated for recurrent respiratory papillomatosis (RRP).
All adult patients treated for RRP between 1984 and 2008 were asked to participate. Outcome measures were obtained from questionnaires including VHI (Voice Handicap Index), HADS (Hospital Anxiety and Depression Scale), 36-Item Short Form Health Survey (SF-36), and Utrechtse Coping List.
Out of 45 included patients, 34 (22 males,12 females) participated (76%). Mean age was 52 years (range, 25-85 years). RRP was located only in the larynx in 90% of the cases. Adult onset RRP was diagnosed in 29 cases, juvenile onset RRP in 5. Median number of surgical procedures was five (range, 1-17). In this study cohort, 68% scored above the VHI cutoff point, and 18% had an increased risk for depression or anxiety disorders (HADS). VHI scores were related to age, time between consecutive surgeries, time since last surgery, and passive coping. They were not related to gender, onset of RRP, or location. VHI scores were related to the SF-36 subscales social functioning (r = -0.43) and mental health (r = -0.43).
Patients with RRP often report voice problems in daily life, and this is related to (a passive) coping style, social functioning, and mental health. Psychosocial intervention targeting an adaptive coping style may be beneficial in selected cases. Laryngoscope, 2009
from The Laryngoscope
Effects of Selective Serotonin Reuptake Inhibitor on Treating Tinnitus in Patients Stratified for Presence of Depression or Anxiety
We evaluated the effects of a selective serotonin reuptake inhibitor, paroxetine, on treating tinnitus.Tinnitus patients stratified for the presence of depression and anxiety were studied retrospectively. Fifty-six patients were observed for more than 6 months. They were initially treated with paroxetine only at a dose of 10 mg/day for 2-4 weeks; thereafter, the dose was increased to 20 mg/day. Tinnitus distress was evaluated with the Tinnitus Handicap Inventory (THI) and with visual analog scales (VASs) for tinnitus loudness and annoyance. Depression and anxiety were measured with the Self-Rating Depression Scale (SDS) and the trait section of the State-Trait Anxiety Inventory (STAI). The patients were grouped according to their SDS and STAI scores, and each variable was compared at baseline and the 6-month follow-up. Changes among these variables were also examined to determine whether reduced tinnitus distress was related to the improvement of depression or anxiety. Patients with both depression and anxiety showed better results (decrease in THI, VASs, SDS and STAI scores) than patients with anxiety alone, or patients without depression and anxiety. In patients with depression and anxiety, changes in tinnitus variables and changes in depression and anxiety scores were strongly correlated. In other patients, however, changes in tinnitus variables and changes in depression and anxiety scores were not correlated. These results suggest that paroxetine is effective in treating distressed tinnitus patients with depression and anxiety by reducing their tinnitus severity as well as their depression and anxiety.
Few studies exist in the literature investigating the impact of idiopathic Parkinson’s Disease (IPD) on swallow-related quality of life. We therefore aimed in this project to: (1) evaluate swallow-specific quality of life in IPD; (2) delineate potential relationships between IPD duration and severity with swallow-specific quality of life; (3) investigate relationships between swallow-specific quality of life and general health-related quality of life; and (4) investigate relationships between swallow-specific quality of life and depression. Thirty-six patients diagnosed with IPD with and without dysphagia filled out self-report assessments of the SWAL-QOL, Parkinson’s Disease Questionnaire-39 (PDQ-39), and Beck Depression Inventory (BDI). A series of Mann Whitney U tests were performed between non-dysphagic and dysphagic groups for the total SWAL-QOL score and the 10 SWAL-QOL domains. Spearman’s Rho correlation analyses were performed between the SWAL-QOL and (1) PDQ-39; (2) Hoehn and Yahr stage; (3) PD disease duration; (4) UPDRS on score; and (5) the BDI. The dysphagia swallowing group reported significant reductions compared to the non-dysphagic group for the total SWAL-QOL score (P = 0.02), mental health domain score (P = 0.002) and social domain score (P = 0.002). No relationships existed between swallow-specific quality of life and disease duration or severity. Significant relationships existed between swallow-specific quality of life and general health-related quality of life (rs =-0.56, P = 0.000) and depression (rs = -0.48, P = 0.003). These exploratory data highlight the psychosocial sequelae that swallowing impairment can have in those with IPD and suggest a possible association between swallowing, social function, and depression. © 2009 Movement Disorder Society
from Movement Disorders
Psychogenic dysphonia refers to the loss of voice, in the absence of apparent structural or neurological pathology. It is a disorder seen more often in women and is usually associated with significant life events and emotional difficulties that may lead to conflict over speaking. Therapeutic interventions in voice disorders recommend the adoption of a multidisciplinary approach to treatment. The following is a case illustration of a 50 year- old married lady with dysphonia and significant marital difficulties.
from the Journal of Communication Disorders