Biomedical subjects

Judith A Skala

Publications and source records attributed to Judith A Skala.

5 recordsLinked to original sources

PubMed2006

Coronary heart disease and depression: a review of recent mechanistic research.

OBJECTIVE: Both behavioural and physiological factors have been proposed as mechanisms that may explain the negative effect of depression on coronary heart disease (CHD). Our aim is to review some of the most important findings since our prior review. METHOD: We searched MEDLINE, PsycINFO, and other sources for recent studies of candidate mechanisms, with an emphasis on publications since 2002. RESULTS: Physiological pathways have received far greater attention than behavioural ones in the emerging literature. Recent studies have identified shared genetic determinants, inflammation, blood clotting, and vascular mechanisms as plausible explanatory mechanisms. CONCLUSIONS: Future research should focus on relations between behavioural and physiological mechanisms and on the effects of pharmacologic and psychotherapeutic treatments for depression on candidate mechanisms.

Acute Disease↗

PubMedDate not supplied

The Depression Interview and Structured Hamilton (DISH): rationale, development, characteristics, and clinical validity.

OBJECTIVE: The Depression Interview and Structured Hamilton (DISH) is a semistructured interview developed for the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study, a multicenter clinical trial of treatment for depression and low perceived social support after acute myocardial infarction. The DISH is designed to diagnose depression in medically ill patients and to assess its severity on an embedded version of Williams' Structured Interview Guide for the Hamilton Depression scale (SIGH-D). This article describes the development and characteristics of the DISH and presents a validity study and data on its use in ENRICHD. METHODS: In the validity study, the DISH and the Structured Clinical Interview for DSM-IV (SCID) were administered in randomized order to 57 patients. Trained interviewers administered the DISH, and clinicians administered the SCID. In ENRICHD, trained research nurses administered the DISH and recorded a diagnosis. Clinicians reviewed 42% of the interviews and recorded their own diagnosis. The Beck Depression Inventory (BDI) was administered in both studies. RESULTS: In the validity study, the SCID diagnosis agreed with the DISH on 88% of the interviews (weighted kappa = 0.86). In ENRICHD, the clinicians agreed with 93% of the research nurses' diagnoses. The BDI and the Hamilton depression scores derived from the DISH in the two studies correlated 0.76 (p < .0001) in the validity study and 0.64 (p < .0001) in ENRICHD. CONCLUSIONS: These findings support the validity of the DISH as a semistructured interview to assess depression in medically ill patients. The DISH is efficient in yielding both a DSM-IV depression diagnosis and a 17-item Hamilton depression score.

Analysis of Variance↗

PubMedDate not supplied

Prevalence of depression in hospitalized patients with congestive heart failure.

OBJECTIVE: Prevalence estimates of depression in hospitalized patients with congestive heart failure (CHF) differ considerably across studies. This article reports the prevalence of depression in a larger sample of hospitalized patients with CHF and identifies demographic, medical, psychosocial, and methodological factors that may affect prevalence estimates. METHODS: A modified version of the Diagnostic Interview Schedule was administered to a series of 682 hospitalized patients with CHF to determine the prevalence of DSM-IV major and minor depression; 613 patients also completed the Beck Depression Inventory. Medical, demographic, and social data were obtained from hospital chart review, echocardiography, and patient interview. RESULTS: In the sample as a whole, 20% of the patients met the DSM-IV criteria for a current major depressive episode, 16% for a minor depressive episode, and 51% scored above the cutoff for depression on the Beck Depression Inventory (>or=10). However, the prevalence of major depression differed significantly between strata defined by the functional severity of heart failure, age, gender, employment status, dependence in activities of daily living, and past history of major depression. For example, the prevalence ranged from as low as 8% among patients in New York Heart Association class I failure to as high as 40% among patients in class IV. CONCLUSIONS: The prevalence of depression in hospitalized patients with CHF is similar to rates found in post-myocardial infarction patients. However, it is considerably higher in certain subgroups, such as patients with class III or IV heart failure. Further research is needed on the prognostic importance and treatment of comorbid depression in CHF.

Activities of Daily Living↗

PubMedDate not supplied

Death takes a raincheck.

OBJECTIVE: To review the research literature on temporal variation in mortality rates around symbolically important occasions. METHODS: Qualitative literature review. RESULTS: Since the early 1970s, at least 18 studies have investigated whether death rates increase or decrease before, during, or after symbolically important occasions such as holidays and birthdays. Some studies but not others have found modest evidence of temporal effects. Methodological issues have raised questions about most of the positive findings. None of the studies provides any direct evidence that a psychophysiological mechanism enables people to postpone or hasten their own death. CONCLUSION: Research over the past 3 decades has failed to provide convincing evidence that psychological phenomena such as "giving up" or "holding on" can influence the timing of death.

Aged↗

PubMedDate not supplied

Depression and smoking in coronary heart disease.

OBJECTIVE: This review examines the relationship between depression and smoking in coronary heart disease (CHD). It summarizes relevant findings from general population and smoking cessation studies and discusses the few studies that have investigated whether smoking confounds, mediates, or moderates the effect of depression on cardiac morbidity and mortality. METHODS: Qualitative review of research literature. RESULTS: Although many studies of the prognostic importance of depression in CHD have adjusted for smoking, there is no convincing evidence that smoking actually confounds the relationship between depression and CHD. There is also no evidence that smoking moderates this relationship. There is, however, limited evidence that smoking may partially mediate the effect of depression on morbidity and mortality in CHD. CONCLUSION: We need more research on the relationship between depression and smoking in CHD to develop a more complete model of the mechanisms linking depression to cardiac morbidity and mortality.

Coronary Disease↗