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Insights on postpartum mood: Why childbirth is associated with depression and mixed feelings?
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Abstracts / Journal of Psychosomatic Research 76 (2014) 495–520
Having cystic fibrosis predicted significantly higher depression scores than having cancer, diabetes type I or asthma and significantly higher anxiety scores than having diabetes type I. Furthermore, adolescents with diabetes type I reported less depression symptoms than adolescents with cancer or chronic renal failure. The severity of the disease significantly moderated the relationship between type of disease and emotional problems. The effects of type of disease on reporting anxiety or depression symptoms were significant in adolescents with low to medium levels of disease severity but not in those with high levels of severity. Duration of the disease was not a significant predictor of emotional problems and did not act as a significant moderator. Conclusion: The results suggest that type of disease is an important predictor of anxiety and depression symptoms in chronically ill adolescents. Nevertheless, type of disease looses importance at high levels of disease severity. doi:10.1016/j.jpsychores.2014.03.065
51 - Depressive symptoms in obese diabetes patients. Pilot study A.S. Mocana,c, D.E. Dumitrasb, S.S. Iancua, A. Babanc a Department of Diabetes, Nutrition and Metabolic Diseases, County Emergency Hospital Cluj, Romania, bDepartment of Economic Sciences, USAMV Cluj, Romania, cDepartment of Health Psychology, UBB Cluj, Romania Aim: Diabetes is a growing disease and day to day living with diabetes can be overwhelming. An essential recommendation for diabetes patients is to perform physical activity (PA) in order to achieve the metabolic goals. Our aim was to investigate the association of Body Mass Index (BMI) levels with emotional and somatic depressive symptoms in obese diabetes patients. Method: 175 inpatients with type 1 or type 2 diabetes were investigated: for depressive symptoms Beck Depression Inventory was used, PA and diet adherence were self-reported, HbA1c and demographic data were collected from patients' charts. Patients' PA was categorized into three subgroups (sedentary, moderate and intense). Depression score was calculated taking into account emotional and somatic symptoms. Results: 55.4% of all patients had low to severe depressive symptoms, 68.1% were overweight and obese, 42.3% performed moderate PA. Means of BMI level for PA groups were: sedentary m = 28.45, moderate m = 28.36, intense m = 26.53. BMI level was associated with emotional symptoms subscale of depression only in moderate PA diabetes patients (R2 = .399, p = .003, B = −0.371). There was no association between BMI and somatic depression in any of the PA subgroups. Conclusion: BMI is inversely associated with emotional depressive symptoms in obese diabetes patients performing moderate PA. A possible explanation can be that the subgroup of patients with moderate PA have unrealistic expectation for their diabetes and weight outcome, even if they are adherent to recommended PA. Feelings of uselessness and diabetes frustration can contribute to elevated emotional depression symptoms. doi:10.1016/j.jpsychores.2014.03.066
52 - The treatment of resistant, chronic, headaches and facial pain patients in a comprehensive multidisciplinary, mind–body clinic A. Mosek, A. Alexandrovitz, A. Aylon, H. Baum, M. Dano, J. Farchi, E. Farkash, Y. Gliksman, J. Heyd, H. Zipi, Y. Lerner, I. Levi, R. Mitelpunkt, S. Orly Nir, D. Yoel The Headache and Facial Pain Clinic, and the Clinic of Physical Empowerment, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Background and aims: Medically unexplained symptoms including chronic non-remitting pain may comprise up to 25% of a tertiary neurological clinic population. The resistant pain causes severe disability to the patients, and a challenge to the physician facing patients who had “tried already everything”. We hereby report our experience treating these patients in a multidisciplinary clinic with a mind–body approach. Methods: Resistant headache or facial pain was defined as non-remitting pain for at least 1 year; not attributed to another disorder, with a history of multiple consultations; failure of adequate treatments; accompanied with physical disability and impairment of working and social abilities. A multidisciplinary team establishes the treatment, consisting of drug treatment and at least 2 of the following: physical treatment (clinical massage or acupuncture), hypnosis or biofeedback and psychotherapy (short or long term) or group therapy. Results: Out of 3700 patients (66% women; average age 45 years) seen at the headache clinic during the last 42 months, 180 (4.9%) were referred to the multidisciplinary clinic (75% women; average age 50 years). Chronic tension type headache comprised 66% of the complaints, the rest being chronic migraine (21%), atypical facial pain (9%) and chronic cervical pain (4%). Changes were noted after 4-8 weeks of treatment, manifesting as N50% pain reduction in 30% of the patients, or improvement in the general well-being in 30% of the patients. Conclusions: Multidisciplinary mind–body approach is helpful treating patients with non-remitting headache, considered previously ‘beyond help’. Enlarging treatment modalities may improve treatment outcome in these patients. doi:10.1016/j.jpsychores.2014.03.067
53 - Insights on postpartum mood: Why childbirth is associated with depression and mixed feelings? A. Mure an-Madar, A. Băban Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania Purpose: The aim of the present study was to investigate the role of cognitive vulnerability in the development of postpartum depression and its relation to postpartum mood in general. Methods: Pregnant women were recruited antenatally (Time 1), and followed postpartum (Time 2). By online assessment, 133 women provided records at both times. Self-report instruments were used to assess dysfunctional attitudes and depressive symptomatology antenatally. Additional questionnaires for automatic thoughts and emotional distress were completed postpartum. Results: Data analysis showed there were significant differences in depressive symptomatology over time, t(132) = 8.28, p b 0.05, with higher depressive symptomatology levels at Time 2. As expected, no significant differences were found in dysfunctional attitudes, t(132) = 0.53, p N 0.05. Dysfunctional attitudes were related not only to postpartum depressive symptomatology (r = 0.42, p b 0.01), but also to functional negative emotions (r = 0.30, p b 0.01) and to positive emotions (r = 0.33, p b 0.01). Overall, postpartum dysfunctional attitudes and automatic thoughts explained 47% of postpartum depressive symptomatology, F(2,132) = 58.78, p b .001. Antenatal depressive symptomatology alone predicted 58% of postpartum depressive symptomatology, F(1,132) = 180.51, p b .001. Conclusion: There appears to be a continuum of depressive symptomatology throughout the perinatal period, with higher postpartum rates. There is evidence for an underlying, cognitive vulnerability for postpartum depression, stable over the peripartum. This cognitive factors have an influence on the global postpartum mood. doi:10.1016/j.jpsychores.2014.03.068
Abstracts / Journal of Psychosomatic Research 76 (2014) 495–520
Having cystic fibrosis predicted significantly higher depression scores than having cancer, diabetes type I or asthma and significantly higher anxiety scores than having diabetes type I. Furthermore, adolescents with diabetes type I reported less depression symptoms than adolescents with cancer or chronic renal failure. The severity of the disease significantly moderated the relationship between type of disease and emotional problems. The effects of type of disease on reporting anxiety or depression symptoms were significant in adolescents with low to medium levels of disease severity but not in those with high levels of severity. Duration of the disease was not a significant predictor of emotional problems and did not act as a significant moderator. Conclusion: The results suggest that type of disease is an important predictor of anxiety and depression symptoms in chronically ill adolescents. Nevertheless, type of disease looses importance at high levels of disease severity. doi:10.1016/j.jpsychores.2014.03.065
51 - Depressive symptoms in obese diabetes patients. Pilot study A.S. Mocana,c, D.E. Dumitrasb, S.S. Iancua, A. Babanc a Department of Diabetes, Nutrition and Metabolic Diseases, County Emergency Hospital Cluj, Romania, bDepartment of Economic Sciences, USAMV Cluj, Romania, cDepartment of Health Psychology, UBB Cluj, Romania Aim: Diabetes is a growing disease and day to day living with diabetes can be overwhelming. An essential recommendation for diabetes patients is to perform physical activity (PA) in order to achieve the metabolic goals. Our aim was to investigate the association of Body Mass Index (BMI) levels with emotional and somatic depressive symptoms in obese diabetes patients. Method: 175 inpatients with type 1 or type 2 diabetes were investigated: for depressive symptoms Beck Depression Inventory was used, PA and diet adherence were self-reported, HbA1c and demographic data were collected from patients' charts. Patients' PA was categorized into three subgroups (sedentary, moderate and intense). Depression score was calculated taking into account emotional and somatic symptoms. Results: 55.4% of all patients had low to severe depressive symptoms, 68.1% were overweight and obese, 42.3% performed moderate PA. Means of BMI level for PA groups were: sedentary m = 28.45, moderate m = 28.36, intense m = 26.53. BMI level was associated with emotional symptoms subscale of depression only in moderate PA diabetes patients (R2 = .399, p = .003, B = −0.371). There was no association between BMI and somatic depression in any of the PA subgroups. Conclusion: BMI is inversely associated with emotional depressive symptoms in obese diabetes patients performing moderate PA. A possible explanation can be that the subgroup of patients with moderate PA have unrealistic expectation for their diabetes and weight outcome, even if they are adherent to recommended PA. Feelings of uselessness and diabetes frustration can contribute to elevated emotional depression symptoms. doi:10.1016/j.jpsychores.2014.03.066
52 - The treatment of resistant, chronic, headaches and facial pain patients in a comprehensive multidisciplinary, mind–body clinic A. Mosek, A. Alexandrovitz, A. Aylon, H. Baum, M. Dano, J. Farchi, E. Farkash, Y. Gliksman, J. Heyd, H. Zipi, Y. Lerner, I. Levi, R. Mitelpunkt, S. Orly Nir, D. Yoel The Headache and Facial Pain Clinic, and the Clinic of Physical Empowerment, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Background and aims: Medically unexplained symptoms including chronic non-remitting pain may comprise up to 25% of a tertiary neurological clinic population. The resistant pain causes severe disability to the patients, and a challenge to the physician facing patients who had “tried already everything”. We hereby report our experience treating these patients in a multidisciplinary clinic with a mind–body approach. Methods: Resistant headache or facial pain was defined as non-remitting pain for at least 1 year; not attributed to another disorder, with a history of multiple consultations; failure of adequate treatments; accompanied with physical disability and impairment of working and social abilities. A multidisciplinary team establishes the treatment, consisting of drug treatment and at least 2 of the following: physical treatment (clinical massage or acupuncture), hypnosis or biofeedback and psychotherapy (short or long term) or group therapy. Results: Out of 3700 patients (66% women; average age 45 years) seen at the headache clinic during the last 42 months, 180 (4.9%) were referred to the multidisciplinary clinic (75% women; average age 50 years). Chronic tension type headache comprised 66% of the complaints, the rest being chronic migraine (21%), atypical facial pain (9%) and chronic cervical pain (4%). Changes were noted after 4-8 weeks of treatment, manifesting as N50% pain reduction in 30% of the patients, or improvement in the general well-being in 30% of the patients. Conclusions: Multidisciplinary mind–body approach is helpful treating patients with non-remitting headache, considered previously ‘beyond help’. Enlarging treatment modalities may improve treatment outcome in these patients. doi:10.1016/j.jpsychores.2014.03.067
53 - Insights on postpartum mood: Why childbirth is associated with depression and mixed feelings? A. Mure an-Madar, A. Băban Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania Purpose: The aim of the present study was to investigate the role of cognitive vulnerability in the development of postpartum depression and its relation to postpartum mood in general. Methods: Pregnant women were recruited antenatally (Time 1), and followed postpartum (Time 2). By online assessment, 133 women provided records at both times. Self-report instruments were used to assess dysfunctional attitudes and depressive symptomatology antenatally. Additional questionnaires for automatic thoughts and emotional distress were completed postpartum. Results: Data analysis showed there were significant differences in depressive symptomatology over time, t(132) = 8.28, p b 0.05, with higher depressive symptomatology levels at Time 2. As expected, no significant differences were found in dysfunctional attitudes, t(132) = 0.53, p N 0.05. Dysfunctional attitudes were related not only to postpartum depressive symptomatology (r = 0.42, p b 0.01), but also to functional negative emotions (r = 0.30, p b 0.01) and to positive emotions (r = 0.33, p b 0.01). Overall, postpartum dysfunctional attitudes and automatic thoughts explained 47% of postpartum depressive symptomatology, F(2,132) = 58.78, p b .001. Antenatal depressive symptomatology alone predicted 58% of postpartum depressive symptomatology, F(1,132) = 180.51, p b .001. Conclusion: There appears to be a continuum of depressive symptomatology throughout the perinatal period, with higher postpartum rates. There is evidence for an underlying, cognitive vulnerability for postpartum depression, stable over the peripartum. This cognitive factors have an influence on the global postpartum mood. doi:10.1016/j.jpsychores.2014.03.068