Late-life depression and the family physician

Late-life depression (LLD) is a common disorder seen in clinical practice. Depression in this population group is often left undetected and untreated. The majority of elderly individuals who seek help present to the primary health care setting. The family physician is ideally placed to screen for symptoms of LLD, given that they often have longitudinal knowledge of the patient's history, premorbid personality, functioning and overall health status. An understanding of risk factors, differential diagnoses, appropriate opportunistic screening toolsand decision-making around management plans can assist the family physician in the early detection and treatment of these patients. In doing so, this may lead to a decrease in mortality and morbidity and enhance the patient's quality of life.Keywords: Late life; depression; older; geriatric mental health; major depressive disorder; antidepressants; cognitive impairment; dementia.

Psychosocial determinants of depression and maladaptive behaviour in adolescence: two tested models

Objective: Self-esteem has been identified as a strong predictor of depression and maladaptive behaviours in adolescents. Two relational models (A and B) were tested on the antecedent and consequent variables of self-esteem.Methods: A representative sample of 610 Spanish adolescents (52% boys) ranging in age from 11 to 16 years of age (mean age = 13.38 years, SD = 1.70 years) was used. The participants completed a battery of instruments measuring self-esteem, self-concept, importance of self-concept domains, depression symptoms, and problem behaviour. Covariance structure analysis (path analysis) from LISREL 8.54 was employed.Results: Model B presented a better fit (χ2difference (A­B) = 160.29, p < 0.001). Perceived social support (parents and classmates), and perceptions of competence in domains deemed important were positively related to self-esteem. While both self-esteem and social support (parents and classmates) were negatively related to depression symptoms, only social support (parents and teacher) appeared negatively related to behavioural problems.Conclusions: While self-esteem constitutes a strong correlate of affective symptoms in Spanish adolescents, it is unrelated to maladaptive behaviour. Social support emerged as an important protective factor. Concrete proposals for future research and prevention are discussed

Depressive symptoms disrupt leftward cradling

Objective: Leftward cradling bias is thought to facilitate optimal interaction between mother and infant. There is mixed evidence indicating this bias may be disrupted by depression. This study investigated the relationship between depressive symptoms and preferred cradling side (i.e., cradling bias) in nulliparous women.Method: Six hundred and nineteen females, aged 18 to 25 years, were asked to imagine cradling an infant to soothe it. This instruction was given on four separate occasions. Participants also completed the Beck Depression Inventory-II. All data were collected via an online survey.Results: As the number of depressive symptoms increased, leftward cradling decreased. Although this relationship was not statistically significant, a pattern emerged: As depressive symptoms increased, so too did the likelihood of cradling to the right. Furthermore, those scoring highest on depressive symptoms were more likely to cradle inconsistently to the left, consistently to the right, or show no bias, when compared to those scoring lower on depressive symptoms.Conclusions: Theory suggests that leftward cradling is facilitated by right hemisphere processes involved in relating to others. A relationship between affective symptoms such as depressive symptoms and reduced leftward cradling bias supports this argument. It is argued that leftward cradling facilitates optimal interactions between cradler and infant. Consequently, disruptions of leftward cradling have implications for child development

Depression in doctors: A bitter pill to swallow

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Rural-urban differences in the prevalence and predictors of depression among adolescents in South Africa

Background. Mental health is part of overall health, but there is dearth of research on the rural­urban differences of depression among adolescents in South Africa (SA). Objectives. To present an analysis of rural­urban differences in the prevalence of depression and to assess the sociodemographic predictors of depression among adolescents in SA. Methods. Data were obtained from the National Income Dynamics Study (NIDS), wave 4 of 2014, which was conducted on a nationally representative sample of 3 751 respondents (15 - 19 years). Univariate analysis was used to describe the study population while bivariate analysis was used to test for significant differences in the depression status of the population. Finally, binary logistic regression was used to estimate the predictors of depression. Results. Urban adolescents (14.64%) were more depressed than their rural counterparts (9.40%). Gender, income levels and province of residence also showed significant differences in both rural and urban areas. The significant predictors of depression in both rural and urban areas were race, age, income and province of residence. Conclusion. Counselling and rehabilitation programmes should be targeted more at urban, more educated and higher-earning adolescents, especially in provinces with a relatively higher prevalence of depression