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Biomedical subjects

Angela Bowen

Publications and source records attributed to Angela Bowen.

5 recordsLinked to original sources

Mood variability in anxiety disorders.

BACKGROUND: To investigate whether patients with anxiety disorders have more variable mood than control subjects. METHODS: Twenty-eight patients with anxiety disorders and 28 controls were assessed with the State-Trait Anxiety Inventory-Trait form (STAIT), Beck Depression Inventory (BDI), Mood Disorder Questionnaire (MDQ), and TEMPS-A questionnaire for temperament. Participants used Visual Analogue Scales (VAS) to rate low, high and anxious moods, morning and evening, for 7 consecutive days. Mood variability was calculated with the Mean Square Successive Difference (MSSD) and the Standard Error of the Mean (SEM), both derived from the VAS ratings. RESULTS: (1) The MSSD and SEM measures for low mood and anxiety variability were higher in patients than controls. The SEM for high mood was marginally higher in patients. (2) The high mood measures separated into two clusters: (a) the mean of the VAS high mood scale and the TEMPS hyperthymia scale apparently measure an adaptive high mood or hyperthymia that did not correlate or correlated negatively with depression (BDI). (b) The MSSD of the VAS high mood scale, the TEMPS cyclothymia scale, and the MDQ correlated with each other and with the BDI as variable high mood that is distressing. LIMITATIONS: Small sample size. CONCLUSIONS: Patients with anxiety disorders show more mood variability than controls. We also found a difference in the measures of adaptive high mood from variable high mood, the latter associated with depression. Mood variability is an important but neglected aspect of distress in patients with anxiety disorders.

Adult↗

Antenatal depression.

About 20 per cent of pregnant women experience antenatal depression (AD), which not only has deleterious effects on the woman and her baby but also increases the risk of developing postpartum depression. Nurses who understand the prevalence, signs and symptoms, and risk factors associated with AD can help to identify it and prevent the sequelae. The signs and symptoms of depression in pregnancy do not differ from depression at at any other time. However, AD may go undiagnosed because of a focus on maternal and fetal well-being and the attribution of complaints to the physical and hormonal changes associated with pregnancy. Risk factors include history of depression, lack of partner, marital difficulties, lack of social support, poverty, family violence, increased life stress, substance abuse, history of previous abortions, unplanned pregnancy, ambivalence toward the pregnancy and anxiety about the fetus. Most of the standard treatments for depression can be used in pregnant women, with the exception of some antidepressant medications. Supportive therapies--exercise, adequate nutrition, adequate sleep, and support from family and friends--are also indicated. Screening of women with known risk factors is crucial, but the authors suggest that the high overall prevalence of depressive symptoms during pregnancy indicates a need for universal screening.

Antidepressive Agents↗

Oversight of human participants research: identifying problems to evaluate reform proposals.

The oversight of research involving human participants is widely believed to be inadequate. The U.S. Congress, national commissions, the Department of Health and Human Services, the Institute of Medicine, numerous professional societies, and others are proposing remedies based on the assumption that the main problems are researchers' conflict of interest, lack of institutional review board (IRB) resources, and the volume and complexity of clinical research. Developing appropriate reform proposals requires carefully delineating the problems of the current system to know what reforms are needed. To stimulate a more informed and meaningful debate, we delineate 15 current problems into 3 broad categories. First, structural problems encompass 8 specific problems related to the way the research oversight system is organized. Second, procedural problems constitute 5 specific problems related to the operations of IRB review. Finally, performance assessment problems include 2 problems related to absence of systematic assessment of the outcomes of the oversight system. We critically assess proposed reforms, such as accreditation and central IRBs, according to how well they address these 15 problems. None of the reforms addresses all 15 problems. Indeed, most focus on the procedural problems, failing to address either the structure or the performance assessment problems. Finally, on the basis of the delineation of problems, we outline components of a more effective reform proposal, including bringing all research under federal oversight, a permanent advisory committee to address recurrent ethical issues in clinical research, mandatory single-time review for multicenter research protocols, additional financial support for IRB functions, and a standardized system for collecting and disseminating data on both adverse events and the performance assessment of IRBs.

Accreditation↗

Prevalence of antenatal depression in women enrolled in an outreach program in Canada.

OBJECTIVE: To determine the prevalence of depression and its correlates in pregnancy and to establish the appropriateness of using the Edinburgh Postnatal Depression Scale with inner-city, high-risk pregnant women. DESIGN: Convenience sample of women enrolled in a prenatal outreach program. Women were recruited and the Edinburgh Postnatal Depression Scale was administered during home visits. PARTICIPANTS: 39 women, most of whom were Aboriginal, participating in a prenatal outreach program. MAIN OUTCOME MEASURE: Edinburgh Postnatal Depression Scale score of >or=10 suggests minor depressive symptoms and >or=13 suggests probable major depression. RESULTS: 27% of women reported symptoms consistent with major depression. The Aboriginal women had higher levels of depressive symptoms than the non-Aboriginal women. Women who had stopped using tobacco or alcohol during pregnancy had more depressive symptoms than those who had quit before pregnancy. Acceptability of the Edinburgh Postnatal Depression Scale for use with high-risk, Aboriginal, and non-Aboriginal pregnant women was supported. CONCLUSIONS: The prevalence of depressive symptoms and concurrent substance use within this population is a major public health problem. Nurses can incorporate the Edinburgh Postnatal Depression Scale into routine prenatal visits to identify women at risk for depression.

Community-Institutional Relations↗