Failure to segregate emotional processing from cognitive and sensorimotor processing in major depression.

Most functional neuroimaging studies of major depressive disorder (MDD) employ univariate methods of statistical analysis to localize abnormalities of neural activity. Less has been done to investigate functional relations between these regions, or with regions not usually implicated in depression. Examination of intraneuronal and interneural network relations is important for the advancement of emerging network models for MDD. Principal component analysis (PCA), a multivariate statistical method, was used to examine differences in functional connectivity between 10 unmedicated patients with MDD and 12 healthy subjects engaged in a positive word viewing task. In healthy subjects, principal component (PC) 1 (33% variance) revealed functional connectivity of task-specific sensory, linguistic, and motor regions, along with functional anticorrelations in the default mode network; PC2 (10% variance) displayed functional connectivity of areas involved in emotional processing. This segregation of functions did not occur in the depressed group, where regions involved in emotional functions appeared in PC1 (34% variance) co-varying with those involved in linguistic, motor, and default mode network processing. The lack of segregation of emotional processing from cognitive and sensorimotor functions may represent a systems level neural substrate for a core phenomenon of depression: the interconnection of affective disturbance with experience, cognition, and behavior.

A qualitative analysis of social concerns of women with ovarian cancer.

A diagnosis of ovarian cancer requires a woman to reevaluate her interactions with family, friends, and employers, and cope with unexpected and unwanted changes in areas spanning from financial stability to sexuality and fertility. Social well-being is the aspect of a patient's overall quality of life that encompasses these topics, as it has evolved to represent activities related to roles and relationships at work and at home. The purpose of this study was to explore the social well-being of women with ovarian cancer to better define their needs for the health care community. Data consisted of all correspondence (n = 21,806) sent to 'Conversations!: The newsletter for those fighting ovarian cancer' by women with ovarian cancer from 1994 to 2000. Using ethnographic, qualitative research methods, statements related to the impact of disease were bracketed and coded within physical, psychological, social, and spiritual domains according to the City of Hope Quality of Life Ovarian Cancer Instrument. Comments reflecting social well-being were categorized in sub-themes and reviewed for content. Statements related to social support were most common (n = 251) reflecting the need for support from family, friends, and other women with ovarian cancer. Distress regarding the genetic association of the disease comprised a major theme (n = 73). Family relationships were also discussed (n = 146) in light of the stress of changing roles and relationships at home. Issues related to employment and returning to work (n = 74) focused on both the difficulties in taking time off work to receive treat-ment and sense of achievement felt upon returning to work and regaining normalcy. The themes identified in this study challenge healthcare professionals to provide increased disease-specific support, as well as concomitant sup-port for husbands/partners and children of patients. Additional information on genetic testing and counseling for women at-risk due to a family history of ovarian cancer is also needed.

Family perspectives of ovarian cancer.

PURPOSE: This qualitative study explored quality of life (QOL) in family caregivers of ovarian cancer patients to better define their needs for support. DESCRIPTION OF STUDY: One thousand one hundred pieces of correspondence written by family caregivers of ovarian cancer patients were contributed to the City of Hope investigators by the founder and editor of Conversations!: The International Newsletter for Those Fighting Ovarian Cancer. The investigators analyzed meaningful comments in the letters using content analysis methods. RESULTS: Comments by family caregivers reflected little concern for their own physical well-being and, instead, focused on the psychological, social, and spiritual aspects of their experiences. Correspondence on the psychological effects of caregiving demonstrated poor QOL stemming from feelings of lack of control and helplessness. Social data showed that family caregivers lacked support, were given to feelings of isolation, and experienced considerable anxiety regarding the genetic nature of the disease. Spiritual well-being was particularly important to caregivers, as they drew strength from their faith and were able to find positive meaning in their experiences. CLINICAL IMPLICATIONS: The study findings revealed that caregivers require additional support from the healthcare community, especially to address disease-specific needs in patients with ovarian cancer. The correspondence demonstrates a need in family caregivers to connect with others fighting the same disease. This study also identifies the need for support for at-risk women, as well as a continuing need for palliative-care services.