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Biomedical subjects

Heather L Stuart

Publications and source records attributed to Heather L Stuart.

3 recordsLinked to original sources

Epidemiology of major depression in a predominantly rural health region.

BACKGROUND: Several large-scale cross-sectional studies have evaluated the prevalence of major depression in Canadian populations. Few studies have employed prospective methods, which are necessary to evaluate incidence, and few have focused on predominantly rural areas. METHODS: Subjects who had participated in a cross-sectional general health survey were invited to participate in a second wave of data collection 6 months later. These subjects were recontacted using a telephone interview. A brief diagnostic instrument for major depression was used in both waves,and a variety of other variables relevant to the epidemiology of major depression were measured. RESULTS: Of 801 subjects initially enrolled, 666 (83.1 %) consented to be recontacted, and 501 (75.2 %) of these were successfully reached. The incidence of major depression was 3.8%. The incidence was higher in women, although this difference did not attain statistical significance. Having a past history of depression and having a high level of perceived stress were predictors of risk. An exploratory comparison with data collected using similar methods in a nearby urban centre determined that the rural prevalence was lower than urban, and that a variety of factors (street drugs, deficits in social support, unemployment, recent life events) may contribute have to this difference. CONCLUSIONS: The 6-month cumulative incidence of depressive disorder was much higher than that reported by most previous studies. This may be a result of the diagnostic instrument employed, which captures a broader spectrum of depressive morbidity than the instruments used in most previous studies. Also, as the study did not exclude subjects with previous depressive episodes during their lifetime, the incidence rate reflects risks of major depressive episodes rather than major depressive disorders.

Adult↗

Mental disorders and reasons for using complementary therapy.

OBJECTIVE: To compare patients with and without mental disorders who seek services from a complementary therapy practitioner with regard to quality of life, reasons for seeking complementary therapies, complaints, and physical conditions. METHOD: We studied new patients who attended a complementary therapy clinic offering acupuncture treatment between July 1, 1993, and March 31, 1995. We collected data from a self-administered questionnaire and from a physician-conducted psychiatric assessment. RESULTS: Of the 826 new patients at the clinic, 578 (70%) presented with a mental disorder. Patients with a mental disorder perceived their quality of life as poorer and reported greater levels of stress than did those without a mental disorder. However, the groups did not differ in their self-reported reasons for seeking complementary therapies, in their complaints, or in their physical conditions. Among patients with a mental disorder, the major reasons for choosing complementary therapies were personal preference, interest, or belief in complementary therapies (44.3%) and perceiving complementary therapies as a last resort (30.7%). Most patients with a mental disorder saw a complementary practitioner for musculoskeletal and connective-tissue disorders (44.1%), fatigue (26.6%), and headache (15.2%). The most frequent physical illnesses among patients with a mental disorder were diseases of the musculoskeletal system and connective tissue (42.6%). CONCLUSION: Like their counterparts without a mental disorder, individuals with a mental disorder use complementary therapies because of personal beliefs. The wide use of complementary therapies among individuals with a mental disorder may be ascribed to a poor quality of life and high levels of distress.

Acupuncture Therapy↗

Association between physical illness and suicide among the elderly.

BACKGROUND: Only a few small studies have explored the association between various physical illnesses and suicide in the elderly and they have produced inconsistent results. Thus, we undertook this larger study to more definitively assess the association between elderly suicide and physical illness. METHODS: This case-control study compared the proportion with physical illnesses among 822 cases who committed suicide with that among 944 controls who died due to motor vehicle accident at age 55 years or over in Alberta, Canada. RESULTS: Compared to the motor vehicle accident deaths, the elderly who committed suicide were more likely to have cancer, ischemic heart disease, chronic pulmonary disease, peptic ulcer, prostatic disorder, depression and other psychiatric illnesses. There was no significant difference in the proportion of cerebrovascular disease and diabetes mellitus between the case and control groups before adjustment of demographic and clinical characteristics. After adjustment of these variables, the elderly with any of the following illnesses were more likely to die by suicide than those without the illness: cancer (adjusted odds ratio [95% confidence interval]: 1.73 [1.16-2.58]), prostatic disorder (excluding prostatic cancer, 1.70 [1.16-2.49]), chronic pulmonary disease among the married (1.86 [1.22-2.83]), depression (6.70 [4.72-9.50]) or other psychiatric illness (2.16 [1.68-2.76]). There was no evidence that ischemic heart disease, cerebrovascular disease, peptic ulcer and diabetes mellitus might be associated with suicide in the elderly. CONCLUSIONS: Cancer, prostatic disorder, chronic pulmonary disease among the married and psychiatric illness appear to be associated with suicide among the elderly.

Aged↗