Gender differences in depression among veterans with spinal cord injury.

PURPOSE: Little is known about gender differences in depression among veterans with spinal cord injury (SCI). Accordingly, the main objectives of this study were (a) to examine demographic and clinical characteristics of veterans with SCI; (b) to investigate gender differences in lifetime depression and depressive symptom severity, including probable major depressive disorder (MDD); and (c) to identify contributory factors (e.g., pain, life satisfaction) for gender differences in depression. METHOD: An exploratory secondary analysis was performed on a cross-sectional data set (N = 1,047) from a longitudinal study of health and employment among veterans with SCI. Community-dwelling veterans (N = 135) included women (n = 45) case-matched 1:2 to men (n = 90) based on age, injury level, and time since injury. Group comparisons and regression analyses were used to explore gender differences. RESULTS: Veterans with SCI had significantly higher rates of lifetime depression as compared with the general population. Women, as compared with men, had higher rates of lifetime depression diagnosis and endorsed more depressive symptoms, as measured by the Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR). Among women, satisfaction with life was a significant predictor of QIDS-SR scores. A similar pattern was seen among men, with the addition of bodily pain as a significant predictor. CONCLUSIONS: Given the relationship between depressive symptoms and life satisfaction for women, follow-up depression screenings among veterans with SCI should include quality of life assessments. Additionally, assessment of somatic symptoms, such as pain, in relation to depressive symptomatology is recommended, particularly among men. (PsycINFO Database Record

Neurocognitive outcomes among children who experienced seizures during treatment for acute lymphoblastic leukemia.

BACKGROUND: Limited information is available regarding neurocognitive outcomes of children who experience seizures during treatment for acute lymphoblastic leukemia (ALL). Accordingly, the main objectives of this study were to determine the incidence and risk factors for treatment-related seizures among children with ALL, and the neurocognitive outcomes associated with treatment-related seizures. PROCEDURE: Prospective neuropsychological assessment and magnetic resonance imaging (MRI) were planned for all 498 patients with newly diagnosed ALL enrolled on the St. Jude Total Therapy XV (TOTXV) protocol at three time points. The study database was reviewed retrospectively to identify those with treatment-related seizure. To assess neurocognitive changes associated with seizure, each patient with treatment-related seizure was matched with two cohort patients without seizure for age at treatment, gender, race, and treatment intensity. RESULTS: Nineteen patients developed seizure, with a 2-year cumulative risk of 3.82 ± 0.86% (SE). No risk factors were identified to be associated with the development of seizure, with a possible exception of intensive chemotherapy used on the standard/high-risk arm as compared to the low-risk arm. Neuropsychological performance of the seizure group, as compared to normative scores and nonseizure control cohort, indicated problems in attention, working memory, and processing speed. Cognitive deficits persisted 2 years after therapy, with additional declines in intellectual function observed. MRI indicated early neurotoxicity among the seizure group, as evidenced by greater leukoencephalopathy on initial examinations. CONCLUSION: Treatment-related seizures were associated with leukoencephalopathy and decreased neuropsychological performance. Prospective studies are needed to detect changes in neurocognitive status associated with long-term functional impairment.