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Biomedical subjects

Barry W Rovner

Publications and source records attributed to Barry W Rovner.

11 recordsLinked to original sources
PubMed2007

Dissatisfaction with performance of valued activities predicts depression in age-related macular degeneration.

OBJECTIVE: To determine whether dissatisfaction with performance of valued activities predicts depression in patients with age-related macular degeneration (AMD). PATIENTS: Two hundred and six patients with newly diagnosed neovascular AMD in one eye and pre-existing AMD in the fellow eye who were participating in a clinical trial of a psychosocial intervention to prevent depression. MEASURES: Structured clinical evaluations of vision function, depression, visual acuity, contrast sensitivity and medical morbidity. Subjects were classified as dissatisfied if they indicated that they were dissatisfied with their performance of a valued activity. RESULTS: Subjects who were dissatisfied with performance of valued activities (n = 71) had similar demographic characteristics to satisfied subjects (n = 135) but had worse visual acuity (p < 0.054), greater medical comorbidity (p < 0.006), and lower vision function (p < 0.001). Dissatisfied subjects were almost 2.5 times more likely (OR = 2.41; [95% CI 1.02, 5.65]; p = 0.044) to become depressed within 2 months than satisfied subjects independent of baseline visual acuity, vision function, and medical comorbidity. CONCLUSION: Dissatisfaction with performance of valued activities in older persons with AMD predicts depression over a 2-month period. Assessing the ability to pursue valued activities may identify patients at risk for depression and prompt clinicians to initiate rehabilitative interventions and careful surveillance for depression.

Activities of Daily Living↗
PubMed2006

Minimal depression and vision function in age-related macular degeneration.

OBJECTIVE: To evaluate the impact of minimal depression on subjective and objective vision function measures in age-related macular degeneration (AMD). DESIGN: Prospective cross-sectional study. PARTICIPANTS: Two hundred six outpatients with newly diagnosed neovascular AMD in one eye and preexisting AMD in the fellow eye. METHODS: Structured clinical evaluations of visual acuity (VA), contrast sensitivity, vision function, and depression. MAIN OUTCOME MEASURES: The 17-item National Eye Institute Visual Function Questionnaire (NEI VFQ 17), Melbourne Low-Vision Index (MLVI), Chronic Disease Score, and Hamilton Depression Rating Scale. RESULTS: Minimally depressed subjects had significantly worse vision function on both the NEI VFQ 17 and performance-based tasks of the MLVI than nondepressed subjects, independent of severity of VA, contrast sensitivity, and medical status. CONCLUSIONS: Minimally depressed patients with AMD, who would not be considered depressed according to current diagnostic standards, suffer decrements in vision function that cannot be accounted for by the severity of their eye disease or general medical problems. These data emphasize the need to assess depressive symptoms in research studies that use vision function outcome measures and in clinical practice to identify excess vision-related disability in patients with AMD.

Aged↗
PubMed2006

Preventing depression after stroke.

Mental health prevention research is an emerging and intriguing field. Preventing mental disorders is attractive as successful prevention, as it could potentially avert both emotional suffering and illness related morbidity and mortality. Several studies have looked at preventing post-stroke depression, a common complication of stroke. In this review article, we will first provide a conceptual overview of mental health prevention research. Then, we will discuss recent research supporting the prevention of depression after stroke and the likely positive effect successful prevention may have on non-psychiatric outcomes.

Depression↗
PubMed2006

The Charles Bonnet syndrome: a review of recent research.

PURPOSE OF REVIEW: The Charles Bonnet syndrome is a disorder of visual hallucinations typically occurring in older persons with vision impairment or deafferentation of the visual cortex. This review cites recent studies on Charles Bonnet syndrome and discusses treatment options. The numbers of affected persons will increase with aging of the population, making recognition and treatment important components of ophthalmologic care. RECENT FINDINGS: The etiology of the Charles Bonnet syndrome is varied; most often it involves direct damage to the visual system (e.g. age-related macular degeneration, glaucoma) but it may also result from cerebral pathology interrupting connections between the eye and the occipital cortex. Case reports of different management approaches demonstrate the range of treatment options. SUMMARY: This review suggests that the Charles Bonnet syndrome will affect an increasingly large number of older persons as the population ages and the occurrence of vision and cerebral disorders increases. Clinical trials of antipsychotic and other medications, as well as low-vision rehabilitation, are necessary to establish valid treatments for this disorder.

Biomedical Research↗
PubMed2005

Stability of visual acuity measurement in depression.

OBJECTIVE: The authors sought to determine whether depression influences the measurement of visual acuity (VA) in older persons. METHODS: This was a prospective study, in a geriatric psychiatry inpatient unit. Participants were 32 older patients with major depression. Authors measured VA before and after treatment of major depression, as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: As depression resolved, there was no significant change in VA from admission to discharge. CES-D scores significantly declined from admission to discharge. VA was not correlated with depression severity (CES-D score) either at baseline or at discharge. CONCLUSION: This study found no evidence that depression influenced VA testing in older adults. Additional studies in patients with major eye diseases are necessary to evaluate the generalizability of this finding.

Aged↗
PubMed2004

Age-related macular degeneration and depression: a review of recent research.

PURPOSE OF REVIEW: The purpose of this review is to summarize current research findings regarding relationships between depression and age-related macular degeneration (AMD). RECENT FINDINGS: The current literature indicates that the prevalence of depression among patients with AMD is fairly high (approximately 30%) and that depression is a major cause of disability among patients with AMD, even when severity of vision loss is considered. Interventions to alleviate the emotional distress associated with vision loss are also discussed. SUMMARY: Several studies indicate that AMD is a risk factor for depression, and this has serious consequences for the quality of life among patients with AMD.

Biomedical Research↗
PubMed2002

Effect of depression on vision function in age-related macular degeneration.

OBJECTIVES: To report the prevalence rate of depression in older patients with recent vision loss due to age-related macular degeneration (AMD) and to describe the effect of depression on self-reported vision function during 6 months. METHODS: Prospective cohort study of 51 older patients with recent-onset bilateral AMD attending the Retina Clinic of Wills Eye Hospital, Philadelphia, Pa. Main outcome measures included the Center for Epidemiological Studies Depression Scale, visual acuity, Functional Vision Screening Questionnaire, Chronic Disease Score, and Community Disability Scale. RESULTS: Seventeen patients (33%) were depressed at baseline and had worse visual acuity (P =.04) and greater levels of vision-specific (P =.03) and general (P =.002) physical disability than nondepressed patients. The correlations of Center for Epidemiological Studies Depression Scale score with visual acuity and visual-specific disability, however, were not significant after controlling for general physical disability. An increase in depressive symptoms over time predicted decline in self-reported vision function independent of changes in visual acuity or medical status (P<.05). CONCLUSIONS: The prevalence and disabling effects of depression in older patients with AMD are substantial. Recognizing that depression is a treatable disorder that exacerbates the effects of AMD will lead to improved outcomes. Innovative interventions to prevent or treat depression in specialty eye clinics are possible.

Aged↗
PubMedDate not supplied

Provisional diagnostic criteria for depression of Alzheimer disease.

The authors, a group of investigators with extensive research and clinical experience related to both late-life depression and Alzheimer disease (AD), propose provisional affective and behavioral inclusion and exclusion diagnostic criteria for Depression of AD.

Aged↗
PubMedDate not supplied

Activity loss and depression in age-related macular degeneration.

Age-related macular degeneration (AMD) is the most frequent cause of severe vision loss in older persons and is associated with high rates of disability and depression. The authors evaluated 51 patients with bilateral AMD to investigate the interrelationships of disease severity, disability, and depression and focused on loss of valued activities as an emblematic disabling consequence of AMD. They characterized depression by the Center for Epidemiologic Studies-Depression (CES-D) score, a syndromal state based on the CES-D, and as a level of distress (Index of Affective Suffering; IAS). Thirty subjects (58.8%) had loss of a valued, discretionary activity. They had worse visual acuity and more depressive symptoms and were represented in higher IAS levels than other subjects. Visual acuity was significantly correlated with IAS levels, but not with CES-D scores or syndromal depression. A regression model demonstrated that activity loss mediated the relationship between visual acuity and IAS level. Affective distress occurs in AMD, largely to the extent that valued activities are relinquished because of vision loss. IAS levels best illuminated this relationship, suggesting the value of this dimension of affective functioning in studies of the consequences of chronic disease.

Affective Symptoms↗