Women and somatization: unrecognized depression.

Depression is the mental health disorder most commonly seen in the primary health care setting. Estimates of the prevalence of people who are depressed but are seeking treatment for physical disorders in the primary care setting range from 12% to 55% of total patients. We conducted a study to determine the number of women with high depressive symptoms who were seeking treatment for physical disorders and compared this group with women with no depressive symptoms who were also seeking physical health care. The women with high depressive symptoms (n = 122) and the women with no depressive symptoms (n = 115) were similar in age, economic status, occupation status, and lifestyle. The depressed women reported significantly more physical complaints, increased disability, increased functional limitations, and increased use of health care services than did the nondepressed women. They disclosed a variety of physical complaints in all organ systems, had had more life events, and had a diminished belief in their ability to control their environments. The results of this study support the view that large numbers of women with depression that is unrecognized present themselves to the health care system for physical complaints. Health care providers need to extend their view of women as whole beings, instead of as a somatic complaint.

Women and depression.

As Western society increases in complexity and becomes more reliant on technology, women who thrive as integrators in interactional modes will face new dilemmas. Many women will view these changes as challenges, but for many other women, who view these changes as threats, the response will be depression. We lay a foundation to an understanding of depression in women, evaluating the current concept of depression and pointing out its limitations. We then review the traditional theories of women's increased vulnerability to depressive disorders, which have failed to explain adequately this phenomenon. A more recent theory of women's depression, based on the self-in-relation theory of women's development, is offered as an alternative.

Light, social zeitgebers, and the sleep-wake cycle in the entrainment of human circadian rhythms.

The availability of sufficient zeitgebers is essential for entrainment of circadian rhythms. Bright light is an important human zeitgeber. However, social cues acting through the sleep-wake cycle may also be important in the entrainment of human rhythms. Current research suggests that humans receive inadequate and sporadic exposure to bright light. Social cues, although less powerful, may be an important form of entrainment for contemporary humans, and also serve to augment the effects of available bright light. Both light and social zeitgebers should be investigated for their roles in the genesis, prevention, and treatment of alterations in health.

Body temperature and diurnal type in women with seasonal affective disorder.

Body temperature rhythms and diurnal type were explored in female controls and women with seasonal affective disorder (SAD) before and after phototherapy. Women with SAD reported being more like evening types than did controls. Morning phototherapy advanced the body temperature rhythms of women with SAD, and shifted their morningness/eveningness scores toward the morning end of the continuum. The implications of these results for our understanding of both SAD and depression in women are discussed.

Circadian rhythms and nursing research: methodological considerations.

The role circadian rhythms play in mental health, sleep, human development and aging, pharmacologic efficacy, immune function, and cardiovascular health makes them a natural focus of nursing research. Integration of chronobiologic concepts into nursing care demands sound empirical support. Nevertheless, issues such as detection of linear trends, the fit of circadian data to a cosinor model and circular distributions, add complexity to the collection, analysis and interpretation of circadian rhythm data. The purpose of this paper is to convey an informed understanding of ways in which to deal with this intricate assembly of issues.

Seasonal affective disorder, Part I: A review of the neural mechanisms for psychosocial nurses.

This article is the first of a two-part series on Seasonal Affective Disorder (SAD). Mental health and nursing researchers are beginning to investigate the implications of seasons on mood and mood states. Delineation of SAD and its treatment by phototherapy is an example. This article reviews the pertinent research regarding the hypothesized neural mechanisms of SAD. Three competing hypothesis are contrasted and compared: the melatonin hypothesis, the phase delay hypothesis, and the photon counting hypothesis. Although no one theory is universally accepted, current data supports the phase delay hypothesis and suggests that morning phototherapy is the most effective treatment.

Seasonal affective disorder, Part II: Phototherapy, an expanded role of the psychosocial nurse.

The integration of neurobiology into the research and practice of psychosocial nursing is an imperative for the decade of the 1990s. This substantial goal probably will be achieved through the completion of smaller endeavors. This article is intended to be one such contribution. The purpose of this article are threefold. First, it will introduce the psychosocial nurse to the characteristics of Seasonal Affective Disorder (SAD). This article also will provide the psychosocial nurse with the putative biological basis of SAD and phototherapy. Finally, specific information regarding the therapeutic application of bright light is provided.