The specific role of relationship life events in the onset of depression during pregnancy and the postpartum

Background The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. Methods A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. Results 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). Conclusions The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum

Consumer and staff perspectives of the implementation frequency and value of recovery and wellbeing oriented practices

Background: Despite advances in our understanding of what mental health systems and services can do to enhance recovery and wellbeing outcomes for people seeking support, there is limited evidence demonstrating that this body of work has translated successfully into mental health service practice. The Collaborative Recovery Model (CRM) is a practice framework that has been designed to support application of recovery and wellbeing oriented principles and practices within mental health service delivery. The aims of this study were to assess consumer and staff perceptions of implementation frequency during service engagement and the value of this approach for assisting recovery within a setting where the CRM approach had been adopted. Methods: The setting was a large Australian community managed mental health organisation. The study involved a cross-sectional analysis of consumer (n = 116) and staff practitioner (n = 62) perspectives. A series of paired sample t-tests assessed for differences between consumer and staff perceptions of the: (i) importance of key practice elements for assisting recovery, and the (ii) frequency that key practice elements are utilised during engagement sessions. Spearman\u27s r correlational analysis explored associations between importance, frequency and helpfulness of sessions. Results: Key practice elements of the model were applied during service interactions at a high level and perceived by the majority of consumers and staff participants as being important or very important for assisting recovery. Significant moderate correlations were found between the extent that practice elements were valued and the level at which they were applied. Higher levels of implementation of CRM practices were associated with higher ratings of perceived session helpfulness. The strongest association was between \u27encouragement to set tasks to complete between support visits\u27 and perceived helpfulness. Conclusions: Consumer and staff responses revealed that the key practice elements of the CRM were frequently implemented during service engagement interactions and were seen as valuable for assisting recovery. The level of agreement between raters suggests firstly, that the key practice elements were apparent and able to be rated as occurring, and secondly that the CRM approach is seen as responsive to consumer needs. The results have implications for translating recovery and wellbeing oriented knowledge into mental health service practice

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

From mental hospitals to alternative community services

(from the chapter) present a brief review of the main features of mental hospitals /// discuss community psychiatry and alternative community services, the rationale for the suggested shift from the hospital-based to the community-based system of care /// present the Italian experience of moving toward a comprehensive, integrated, alternative system of community care without mental hospitals /// South-Verona Community Psychiatry Service (CPS) will be described, and some data and material relevant to clinical practice, derived from our experience in coping with the problems that emerge when treating the whole range of psychiatric patients in the community, will be presented ((c) 1997 APA/PsycINFO, all rights reserved

Psychological performance of anxious patients in tests used in anxiolytic drug trials

Tested sixty anxious inpatients under drug free conditions with a performance battery commonly used for the evaluation of impairment deficits in anxiolytic drug trials to examine the interrelations among the various performance tasks and to gain some preliminary indication of the underlying factor structure. A factor of general performance ability accounted for 40% of the total variance and contributed to the performance of tasks with cognitive as well as motor components. Performance was related to age and intellectual efficacy, while personality variables and state anxiety had a transcurable influence on performance

Psychological performance of normal subjects on tasks commonly used in evaluation of anxiolytic drugs

A battery of performance tasks together with some personality inventories commonly used in drug evaluation studies were administered to 60 normal subjects to study the intercorrelations among measures and to gain some preliminary indications of their factor structure. Speed of psychomotor performance accounted for 30% of the total variance

L'utilizzazione dei test di livello in psicologia clinica

psicologia clinica,test di livello,metodologi

The long-term treatment with benzodiazepines: suggestions for further research

While the effects of short-term benzodiazepine treatment have been extensively studied in several well-designed, controlled, clinical trials, further information is needed on the value and risks of anxiolytic drugs when administered over months to maintain chronic patients. Clinical trials on the effects of long-term benzodiazepine treatment present several methodological problems. The aim of this paper is to discuss these problems in relation to samples, drugs and dosage, duration, measures and experimental design

The demand for extramural psychiatric intervention in a community-based service

Using a psychiatric case register, 549 patients who had extramural contacts with the South Verona, Italy, community psychiatric service in 1983 were selected and followed up for 3 yrs. Out of 12,429 extramural contacts, 16% were unplanned (drop-in) contacts. A linear-logistic model was used to investigate the joint effects of sociodemographic and clinical variables on the frequency of unplanned extramural contacts. The model to fit the data was complex, confirming that many interactions among the variables affect the probability of using the community services on an urgent or unplanned basis. (PsycLIT Database Copyright 1990 American Psychological Assn, all rights reserved

I disturbi emotivi nella medicina di base e la formazione del medico

I disturbi emotivi nella medicina di base e la formazione del medic