Differential Diagnosis and Treatment of Restless Legs Syndrome: A Literature Review.

Restless legs syndrome (RLS) is a chronic neurological disorder affecting a growing number of people. Patients describe an irresistible urge to move their lower limbs in times of immobility. Due to its vague symptoms and similarity to other disorders, it has become increasingly difficult for primary care clinicians to properly diagnose and manage RLS. As a result, patients with RLS are routinely misdiagnosed and continue their lives without proper management. This literature review examines the current understanding of the disorder, provides key points to assist clinicians in differentiating RLS from similar disorders, and explores recently updated evidence-based guidelines for the effective management of RLS.

Rural-urban differences in stigma against depression and agreement with health professionals about treatment.

OBJECTIVES: To determine if levels of personal stigma towards depression and agreement with health professionals about treatment differ between rural-urban populations. METHODS: Data from a telephone survey conducted in Alberta (n = 3047, response rate = 75.2%) was analyzed. Participants responded to a case vignette describing a depressed individual and questionnaires assessing attitudes towards treatments, and personal stigma against depression. The relation between rural-urban status and agreement with health professionals about treatment was assessed using logistic regression. Stigma scores in relation to rural-urban status were analyzed using multivariate linear regression. RESULTS: Urban respondents were more likely than rural participants to agree with health professionals about depression treatments. This was found overall, and in women. After adjustment for income and education, rural-urban status was no longer significant. Urban participants had lower stigma scores in overall analysis. After adjustment for income and education, stigma scores remained higher among rural men. Education was associated with lower stigma scores among both men and women in fully adjusted models. The ability to recognize depression was associated with lower stigma scores. CONCLUSIONS: Differences exist in rural-urban population about treatments for depression and stigma towards depression. The rural-urban differences in stigma and agreement with health professionals about treatment may be largely explained by educational levels.

Causation beliefs and stigma against depression: results from a population-based study.

BACKGROUND: The results of studies on perceived causes and stigma have been varied and inconsistent, with no studies examining this relationship in Canada. The objective of this study was to examine the associations between biological, psychosocial, and medical causal beliefs in depression and stigma against depression. METHODS: We randomly recruited participants in Alberta, aged 18-74 (n=3047, response rate 75.2%), for a cross-sectional telephone survey between February and June 2006, using random digit dialing. Participants were presented with a case vignette describing a depressed individual and responded to a personal stigma and depression causation questionnaire. Stigma scores were analyzed using Wald tests and multivariate logistic regression. RESULTS: Nearly all respondents endorsed a psychosocial (99.1%) or genetic (96.4%) cause of depression. Participants who endorsed genetic cause of depression had a lower mean stigma scores than others. Logistic regression modeling showed that endorsing depression due to "being a nervous person" was associated with increased odds of having stigmatizing attitudes. LIMITATIONS: Recall and social desirability response biases were possible due to reliance on self report. CONCLUSIONS: It is encouraging that 99% of participants endorsed a psychosocial cause of depression. There is no evidence that endorsing a biological cause of depression could increase stigma. To disseminate scientific knowledge in the process of mental health education and promotion, language shall be carefully crafted to avoid unnecessary stigma.

A pilot study of the impact of bovine spongiform encephalopathy on the futures of rural youth and Canadian farming.

There is an abundance of literature examining the economic impact of Canada's bovine spongiform encephalopathy (BSE) outbreak, but few studies examined the impact of such a crisis on health at the individual, family, or community levels. In particular, rural youth represent an under-researched population despite being at risk for a unique set of social and health concerns. In this pilot study, our objectives were to explore how rural youth responded to Canada's BSE crisis and how they perceived themselves, their families, and their communities to have been impacted. Seven youths (n = 7), recruited from within a university setting using a snowball sampling method, were interviewed. They represent a segment of rural, agriculturally based youth who are resilient due to good parental support. Although they reported high stress in their families during the immediate crisis in 2003, they did not report lasting high levels of stress or negative health effects due to BSE. They did report a decline in rural community health, identifying a reduction in community activities and in the participation of families in community activities. Participants identified elements that discourage youth from pursuing farming as a career and expressed concern for the future of family farming. The results are discussed in terms of the ability of agriculturally based youth to make the transition to adulthood. The implications have importance for future research and policy that addresses the structural supports for choice making, the long-term success for rural youth in transitioning to adult status, and the future of agriculture.

Descriptive epidemiology of stigma against depression in a general population sample in Alberta.

BACKGROUND: Mental health illnesses, such as depression, are responsible for a growing disease burden worldwide. Unfortunately, effective treatment is often impeded by stigmatizing attitudes of other individuals, which have been found to lead to a number of negative consequences including reduced help-seeking behavior and increased social distance. Despite the high prevalence of depression in Canada, little research has been conducted to examine stigma against depression in the Canadian general population. Such information is crucial to understanding the current state of stigmatizing attitudes in the Canadian communities, and framing future stigma reduction initiatives. The objectives of this study were to estimate the percentages of various stigmatizing attitudes toward depression in a general population sample and to compare the percentages by demographics and socioeconomic characteristics. METHODS: We conducted a cross-sectional telephone survey in Alberta, Canada, between February and June 2006. Random digit dialing was used to recruit participants who were aged 18-74 years old (n = 3047). Participants were presented a case vignette describing a depressed individual, and responded to a 9-item Personal Stigma questionnaire. The percentages of stigmatizing attitudes were estimated and compared by demographic and socioeconomic variables. RESULTS: Among the participants, 45.9% endorsed that depressed individuals were unpredictable and 21.9% held the view that people with depression were dangerous. Significant differences in stigmatizing attitudes were found by gender, age, education, and immigration status. A greater proportion of men than women held stigmatizing views on each stigma item. No consistent trend emerged by age in stigma against depression. Participants with higher levels of education reported less stigmatizing attitudes than those with less education. Participants who were not born in Canada were more likely to hold stigmatizing attitudes than those who were born in Canada. CONCLUSION: In the general population, stigmatizing attitudes towards depression differ by demographic characteristics. Men, those with less education and immigrants should be the targets of stigma reduction campaigns.