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Biomedical subjects

Anu Aluoja

Publications and source records attributed to Anu Aluoja.

7 recordsLinked to original sources
PubMed2006

Family doctors' problems and motivating factors in management of depression.

BACKGROUND: Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. METHODS: In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. RESULTS: Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients, the patients' higher confidence in FDs and disappearance of somatic complaints during the treatment of depression were the motivating factors for FDs. FDs listed several important problems interfering with their work with depressive patients: limited time for one patient, patients' attitudes towards the diagnosis of depression, doctors' difficulties to change the underlying causes of depression, discontinuation of the treatment due to high expenses and length. Although 115(56%) respondents maintained that they had sufficient knowledge for diagnostics and treatment of depression, 181(88%) were of the opinion that they needed additional training. CONCLUSION: FDs are ready to manage patients who might suffer from depression and are motivated by good doctor-patient relationship. However, majority of them feel that they need additional training.

Attitude of Health Personnel↗
PubMed2006

Prediction of depression in European general practice attendees: the PREDICT study.

BACKGROUND: Prevention of depression must address multiple risk factors. Estimating overall risk across a range of putative risk factors is fundamental to prevention of depression. However, we lack reliable and valid methods of risk estimation. This protocol paper introduces PREDICT, an international research study to address this risk estimation. METHODS/DESIGN: This is a prospective study in which consecutive general practice attendees in six European countries are recruited and followed up after six and 12 months. Prevalence of depression is assessed at baseline and each follow-up point. Consecutive attendees between April 2003 and September 2004 who were aged 18 to 75 were asked to take part. The possibility of a depressive episode was assessed using the Depression Section of the Composite International Diagnostic Interview. A selection of presumed risk factors was based on our previous work and a systematic review of the literature. It was necessary to evaluate the test-retest reliability of a number of risk factor questions that were developed specifically, or adapted, for the PREDICT study. In a separate reliability study conducted between January and November 2003, consecutive general practice attendees in the six participating European countries completed the risk factor items on two occasions, two weeks apart. The overall response rate at entry to the study was 69%. We exceeded our expected recruitment rate, achieving a total of 10,048 people in all. Reliability coefficients were generally good to excellent. DISCUSSION: Response rate to follow-up in all countries was uniformly high, which suggests that prediction will be based on almost a full cohort. The results of our reliability analysis are encouraging and suggest that data collected during the course of PREDICT will have a satisfactory level of stability. The development of a multi-factor risk score for depression will lay the foundation for future research on risk reduction in primary care. Our data will also provide the necessary evidence base on which to develop and evaluate interventions to reduce the prevalence of depression.

Adolescent↗
PubMed2006

Symptoms of anxiety and depression in Estonian medical students with sleep problems.

High emotional stress in medical students has been observed in many studies. Our aim in this article was to assess the prevalence of symptoms of anxiety and depression among Estonian medical students and to find relationships between sleep complaints and emotional symptoms. The study group consisted of 413 medical students, ages 19-33 years, at the University of Tartu. Each was asked to complete two questionnaires: the Emotional State Questionnaire (EST-Q), containing 28 questions, and the Questionnaire on Sleep and Daytime Habits, with 25 questions. The anxiety and depression subscales from the EST-Q were applied. From the study group, 21.9% students had symptoms of anxiety, and 30.6% had symptoms of depression. The frequency of anxiety and depressive symptoms was higher in females. In regression and multiple regression analysis, we determined which sleep problems were related to emotional symptoms. The associations were different for men and women. In women, anxiety remained significantly related to waking up because of nightmares and feeling tired in the morning; depressive symptoms were related to difficulties in getting to sleep at night, waking up because of nightmares and nocturnal eating habits, daytime sleepiness, and sleepiness during school lessons. In men, significant relations were clear only for depression: difficulties in falling asleep at night before an exam and subjective sleep quality. The study demonstrated that a high percentage of medical students had emotional symptoms. We found that some sleep problems indicated underlying symptoms of anxiety and depression.

Adult↗
PubMed2005

Sleep quality and more common sleep-related problems in medical students.

BACKGROUND AND PURPOSE: The aim of this paper is to conduct a survey based on a questionnaire that would characterize nighttime and daytime habits in medical students; to estimate how subjective sleep quality is associated with nighttime and daytime habits and sleep problems in students; to estimate how academic progress and workload is associated with subjective sleep quality, nighttime and daytime habits and sleep problems in students; and to estimate the prevalence of self-reported sleep problems in Estonian medical students. PATIENTS AND METHODS: The study group included 413 medical students of the University of Tartu, aged 19-33 years. The self-reported Sleep and Daytime Habits Questionnaire (S&DHQ) covered demographic characteristics (4 questions) and sleep and daytime habits (24 questions). Of the latter, 18 multiple-choice questions provided answers expressed as discontinuous variables on a nominal scale, 4 questions provided answers expressed as continuous variables on an interval scale, and 2 questions provided answers expressed as quality characterization on a five-point scale. The supplement includes information about lifestyle and academic progress on a four-point scale. RESULTS: The S & DHQ could be used to study sleep problems in young medical students. The subjective sleep quality of students was as follows: excellent-29%; good-40%; satisfactory-24%; poor 6%; very poor-1%. Sleep quality is associated with academic progress (R=0.174; P<0.001), leisure activity (R=0.210; P<0.001), and living conditions (R=0.195; P<0.001). Sleep quality is not associated with students' daily (R=0.021; P>0.05) or nightly workload (R=0.0664; P>0.05). Daytime sleepiness poses a significant problem for students and is associated both with sleep disorders and work while studying. CONCLUSIONS: The study demonstrates that complaints about sleep problems are common in young medical students.

Achievement↗
PubMed2004

Citalopram challenge in social anxiety disorder.

The aim of the present study was to evaluate neuroendocrine and behavioural responses to a challenge with the selective serotonin (5-HT) reuptake inhibitor citalopram (Cit) in patients with social anxiety disorder (SAD). Cit was given intravenously (20 mg over 30 min) to 18 patients with SAD and 18 matched healthy subjects in a double-blind, placebo-controlled cross-over design. Cit challenge resulted in the increased plasma concentrations of cortisol and prolactin relatively to placebo without significant differences between the patients and controls. The patients had higher ratings of anxiety that were not affected by Cit, and more headaches than controls after Cit. Thus, the neuroendocrine sensitivity to 5-HT stimulation with Cit in patients with SAD was not different from the response in controls indicating lack of major alterations in the function of 5-HT receptors. The increased headache in patients may suggest hypersensitivity of some subtypes of 5-HT receptors in SAD.

Adolescent↗
PubMed2004

Symptoms of depression in the Estonian population: prevalence, sociodemographic correlates and social adjustment.

OBJECTIVE: The current study presents data on the prevalence of depressive symptoms in the Estonian population and examines associated sociodemographic factors and subjective aspects of social adjustment. METHOD: The data came from the Estonian Health Interview Survey where 4711 persons aged 15-79 were interviewed. This study included 4677 respondents who answered the Emotional State Questionnaire (EST-Q), a self-rating scale of depression and anxiety. Data on the sociodemographic factors and domains of social adjustment were derived from structured interviews. RESULTS: Depressive symptoms were observed in 11.1% of the respondents. Depressiveness was more common among women, in older age groups, among those not married, in ethnic groups other than Estonians, in lower income groups, and among the unemployed and economically inactive respondents. Depressive subjects were less satisfied, had a more pessimistic prognosis about the future and lower self-rated health. A low level of perceived control was a significant correlate of depression. The association of depressiveness with poor subjective social adjustment remained significant even after controlling for objective circumstances. LIMITATIONS: Depression was identified by a self-rate questionnaire, therefore results can not be generalized to clinical depression without caution. CONCLUSION: Depressive symptoms in the Estonian population were strongly related to socioeconomic functioning. Results emphasize that subjective social adjustment and perceived control are important characteristics of depression and should be considered in assessment and treatment.

Adolescent↗