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Biomedical subjects

Harold G Koenig

Publications and source records attributed to Harold G Koenig.

At least 19 recordsLinked to original sources
PubMed2006

The WORD (wholeness, oneness, righteousness, deliverance): a faith-based weight-loss program utilizing a community-based participatory research approach.

Despite multidisciplinary efforts to control the nation's obesity epidemic, obesity has persisted as one of the U.S.'s top public health problems, particularly among African Americans. Innovative approaches to address obesity that are sensitive to the unique issues of African Americans are needed. Thus, a faith-based weight-loss intervention using a community-based participatory research approach was developed, implemented, and evaluated with a rural African American faith community. A two-group, quasi-experimental, delayed intervention design was used, with church as the unit of assignment (treatment n=2, control n=2) and individual as the unit of observation (treatment n=36, control n=37). Weekly small groups led by trained community members met for 8 weeks and emphasized healthy nutrition, physical activity, and faith's connection with health. The mean weight loss of the treatment group was 3.60+/-0.64 lbs. compared to the 0.59+/-0.59-lb loss of the control group.

Adult↗
PubMed2006

Religiousness and mental health: a review.

OBJECTIVE: The relationship between religiosity and mental health has been a perennial source of controversy. This paper reviews the scientific evidence available for the relationship between religion and mental health. METHOD: The authors present the main studies and conclusions of a larger systematic review of 850 studies on the religion-mental health relationship published during the 20th Century identified through several databases. The present paper also includes an update on the papers published since 2000, including researches performed in Brazil and a brief historical and methodological background. DISCUSSION: The majority of well-conducted studies found that higher levels of religious involvement are positively associated with indicators of psychological well-being (life satisfaction, happiness, positive affect, and higher morale) and with less depression, suicidal thoughts and behavior, drug/alcohol use/abuse. Usually the positive impact of religious involvement on mental health is more robust among people under stressful circumstances (the elderly, and those with disability and medical illness). Theoretical pathways of the religiousness-mental health connection and clinical implications of these findings are also discussed. CONCLUSIONS: There is evidence that religious involvement is usually associated with better mental health. We need to improve our understanding of the mediating factors of this association and its use in clinical practice.

Depression↗
PubMed2006

Depression outcome in inpatients with congestive heart failure.

BACKGROUND: High rates of depression are found among hospitalized patients with congestive heart failure. Little is known about the outcome of depression in these patients or factors that influence that outcome. METHODS: To assess baseline patient characteristics as predictors of time to remission in depressed inpatients with congestive heart failure, consecutive patients older than 50 years admitted with congestive heart failure were screened for major and minor depression using a structured clinical interview. Patients with minor depression were reevaluated at 6 and 12 weeks, and those with major depression at 6, 12, 18, and 24 weeks using the Longitudinal Interview Follow-up Evaluation. RESULTS: Of a total of 473 depressed patients, 404 (247 with minor depression and 157 with major depression) were identified and followed up. Patients with minor depression were followed up for an average of 11.3 weeks, during which 64.0% went into remission; those with major depression were followed up for 20.2 weeks, during which 47.8% went into remission. Baseline predictors of shorter time to remission for minor depression were less severe depression (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.92-0.98) and fewer comorbid illnesses (HR, 0.92; 95% CI, 0.87-0.98); patients who were younger and had better physical functioning and those not treated with antidepressants also tended to go into remission faster. For major depression, less severe depression was the primary predictor (HR, 0.92; 95% CI, 0.88-0.96), although patients who were younger, male, without a history of depression, and with fewer comorbid medical disorders also tended to go into remission faster. Fewer than 50% of patients with major depression received treatment, and only 12% had psychiatric consultations. CONCLUSIONS: The outcome of minor depression may be more dependent on physical stressors, whereas major depression seems more affected by intrinsic vulnerability. Many patients with major depression were not treated, and few had psychiatric consultations.

Aged↗
PubMed2006

Retaining the meaning of the words religiousness and spirituality: a commentary on the WHOQOL SRPB group's "a cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life" (62: 6, 2005, 1486-1497).

Recent years have seen increasing recognition paid to the relation of religiousness/spirituality (R/S) to health care and research. This has led to the development of more inclusive and trans-culturally validated measurements of R/S. This paper comments on the WHOQOL SRPB Group's "A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life" (62: 6, 2005, 1486-1497), a recently published paper in Social Science & Medicine, and illustrates a possible problem in the measurement of R/S, especially as related to the study of mental health outcomes. Some scales have included questions about psychological well-being, satisfaction, connectedness with others, hopefulness, meaning and purpose in life, or altruistic values as part of their measure of R/S. These questions are really tapping indicators of mental health, and should not be included in the definition of R/S itself. Otherwise, tautology is the result, and it should not be surprising that such measures of R/S (defined by questions tapping mental health) are related to mental health outcomes.

Activities of Daily Living↗
PubMed2006

Functional limitations and religious service attendance among African American and white older adults.

Church attendance is associated with improved health and well-being among older adults, but older adults with functional limitations may have difficulty attending church services. This article examines differences in the association between functional limitations and church attendance in a sample of 987 elderly African American and white individuals. African American and white elderly people without limitations attended church at virtually the same rate (69 percent). Despite their higher scores on religiousness measures, elderly African Americans with one or more limitations were significantly less likely to attend church regularly than were white counterparts. Health status measures did not help explain older African Americans' lower attendance rates. Differences in attendance were associated primarily with educational attainment and cognitive functioning. The article recommends social work intervention to reduce barriers to church attendance for older adults who want to attend services.

Black or African American↗
PubMed2006

Differences between depressed patients with heart failure and those with pulmonary disease.

OBJECTIVE: The objective of this study was to examine differences between depressed medical inpatients with congestive heart failure (CHF) and chronic pulmonary disease (CPD) that could impact the etiology and management of depression in this setting. METHODS: Patients aged 50 years or over consecutively admitted to Duke University Medical Center and three community hospitals were screened for depressive disorder using the Structured Clinical Interview for Depression (SCID-IV). Characteristics of depressed patients with CHF (N = 174) and CPD (N = 527) were compared. Analyses were stratified by type of depressive disorder (major versus minor). RESULTS: Depressed hospitalized medical patients with CHF and CPD are similar to one another in many respects, particularly with regard to severity of depressive symptoms and shortness of breath. However, patients with CHF in this study had greater medical comorbidity and overall more severe medical illnesses but less severe CHF-specific disease severity compared with patients with CPD. Patients with CPD, however, were more likely to have psychologic risk factors such as a psychiatric history, comorbid psychiatric illness, and stressful life events. CONCLUSION: These findings suggest important differences between depressed patients with CHF and those with CPD, perhaps reflecting differences in depression etiology and need for specific strategies for managing depression in each of these conditions.

Aged↗
PubMed2006

Predictors of depression outcomes in medical inpatients with chronic pulmonary disease.

OBJECTIVE: Baseline patient characteristics and depression treatments were examined as predictors of speed of depression remission in hospitalized medical patients with chronic pulmonary disease (CPD). METHODS: Consecutively admitted patients over age 50 years with CPD were screened for major and minor depression using the Structured Clinical Interview for Depression. Patients with minor depression were followed up over 12-24 weeks with the Longitudinal Interview Follow-up Evaluation. Course of depression and predictors of remission were examined. RESULTS: Seven hundred eleven depressed patients with CPD (410 with minor, 301 with major depression) were identified and assessed over time. Two-thirds with minor depression had remitted by 12 weeks compared with 26.9% with major depression at 12 weeks and 49.2% at 24 weeks. Predictors of faster remission for minor depression were black race, community hospital admission, less severe depression, less medical comorbidity, less severe CPD, more social support, and no antidepressant treatment. For major depression, less severe depression, no past antidepressant drug treatment, and less intense current antidepressant treatment predicted faster remission. CONCLUSIONS: The course of depressive disorder after discharge in patients hospitalized with CPD can be predicted by characteristics during admission. Although patients with minor depression may be followed and treatment initiated only if depression persists, those with major depression need more aggressive treatment and psychiatric consultation if improvement does not occur.

Adaptation, Psychological↗
PubMed2006

Do people turn to religion in times of stress?: an examination of change in religiousness among elderly, medically ill patients.

This study examined the effect of health-related stress on changes in religiousness in a sample of elderly, medically ill patients. Patients admitted to Duke University Medical Center (N = 745) were interviewed at baseline and 3-month follow-up. Increases in illness severity (from baseline to follow-up) were associated with decreases in both organizational and private religiousness at follow-up. Effect of illness severity on organizational religiousness was statistically mediated by changes in physical activity, while its effect on private religiousness remained significant after controlling for physical activity. These findings encourage further research investigating causal relationships between stress and religion, as well as identifying measures of religiousness that may capture this construct in the medically ill population.

Adaptation, Psychological↗
PubMed2006

Minor depression and physical outcome trajectories in heart failure and pulmonary disease.

We examined conjoint trajectories of depression-physical illness outcomes in elderly inpatients with minor depression and heart failure or pulmonary disease, and identified demographic, psychosocial, physical, and treatment predictors of trajectory. Consecutively admitted patients over age 50 with heart failure and/or chronic pulmonary disease were screened for minor depression using the Structured Clinical Interview for Depression. Follow-up evaluations were performed at 6 and 12 weeks using the Longitudinal Interview Follow-Up Evaluation, Hamilton Depression Scale, and Chronic Heart Failure-Chronic Respiratory Disease Questionnaire. Patients were placed into four depression-physical illness outcome trajectories: (T#1) depression better, illness better; (T#2) depression better, illness same; (T#3) depression same, illness better; and (T#4) depression same, illness same. Bivariate and multivariate predictors were examined. Minor depression was identified in 587 patients. Of these, 487 were evaluated at 6 weeks and 444 at 12 weeks. By 6 weeks, 39.4% of patients improved both on depression and physical illness (T#1), and 27.3% improved on neither (T#4). By 12 weeks, 49.6% had improved on both and 20.5% on neither. Race, admitting hospital, past psychiatric history, family psychiatric history, comorbid physical illnesses, and antidepressant drug treatment independently predicted outcome trajectory. Improvements in depression and physical illness track closely together in elderly inpatients with heart failure or pulmonary disease. Baseline patient characteristics predict which outcome trajectory they are likely to follow after hospital discharge, and may be useful in diagnosis and management.

Aged↗
PubMed2006

Belief in life after death and mental health: findings from a national survey.

The present study examined the association between belief in life after death and six measures of psychiatric symptomology in a national sample of 1403 adult Americans. A statistically significant inverse relationship was found between belief in life after death and symptom severity on all six symptom clusters that were examined (i.e., anxiety, depression, obsession-compulsion, paranoia, phobia, and somatization) after controlling for demographic and other variables (e.g., stress and social support) that are known to influence mental health. No significant association was found between the frequency of attending religious services and any of the mental health measures. The results are discussed in terms of the potentially salubrious effects of religious belief systems on mental health. These findings suggest that it may be more valuable to focus on religious beliefs than on religious practices and behaviors in research on religion and mental health.

Anxiety Disorders↗
PubMed2006

Major depression and physical illness trajectories in heart failure and pulmonary disease.

The purpose of this study was to examine conjoint trajectories of depression-physical illness in elderly medical inpatients with heart failure and/or chronic pulmonary disease and major depression (MDD), and to identify baseline predictors of trajectory. Consecutive medically hospitalized patients over age 50 with heart failure and/or chronic pulmonary disease were screened for MDD using the Structured Clinical Interview for Depression. Patients were re-evaluated at 6, 12, 18, and 24 weeks. Four depression-physical illness conjoint trajectories were examined: depression better, illness better; depression better, illness same; depression same, illness better; and depression same, illness same. Baseline predictors of trajectory were examined. MDD was identified in 413 patients; 352 had at least one follow-up. By 6 weeks, 22.3% improved on both depression and illness and 38.1% improved on neither. By 24 weeks, 45.0% had improved on both and 24.8% on neither. Short-term baseline predictors of trajectory (6 weeks) differed from long-term (12-24 weeks); past psychiatric history, overall medical illness severity, and education were short-term predictors, whereas past psychiatric history, depression treatments, and physical functioning were long-term. Improvements in MDD and physical illness track closely together. Characteristics during baseline hospitalization predict outcome trajectory after discharge, and may be useful in understanding etiology and directing treatment.

Adaptation, Psychological↗
PubMed2006

Caregiver intervention research: an opportunity for collaboration between caregiving investigators and African-american faith communities.

The African-American community in the United States is rapidly aging. Because friends and family who care for these elderly individuals often do so at the expense of their own physical and psychological well-being, there has been extensive interest in the development of interventions to reduce caregiver burden and morbidity. Few interventions, however, have targeted African-American caregivers. Given the importance of religion for many African-American caregivers, we believe that faith communities could be valuable allies to research investigators. The primary objectives of this paper, therefore, are to: 1) summarize the literature on religion and African-American caregivers; 2) provide a rationale for why caregiving investigators and African-American faith communities should collaborate; and 3) present directions for future research. We present evidence to support our assertion that, not only could collaboration result in interventions that improve the well-being of African-American caregivers, collaboration would also benefit both caregiving investigators and faith communities.

Black or African American↗