Characterizing the relation between depressive symptoms and Parkinson\u27s disease in a sample of Swedish twins

Depression commonly co-occurs with Parkinson\u27s disease (PD). Psychosocial stressors and biochemical changes associated with PD have both been implicated in the etiology of depression in PD. The purpose of the current study was to examine whether genetic or environmental influences contribute to the increased risk for depressive symptoms among individuals with PD in a population of twins. Among individuals with PD, 24% endorsed a moderate-severe level of depressive symptoms, and 64% endorsed at least a mild level of depressive symptoms. Case-control results indicated that PD is a significant risk factor for both mild (OR = 3.11, CI = 1.82-5.31) and moderate-severe (OR = 3.23, CI = 1.77-5.89) depressive symptoms, adjusting for age, sex, and prior history of major depression. Odds ratios were not significantly attenuated in the co-twin control analysis compared to the case control analysis for either mild or moderate-severe depressive symptoms, suggesting that genetic influences are unlikely to account for the increased risk of depressive symptoms among PD patients. Further support for environmental rather than genetic influences on the PD-depression relation was revealed by examining the risk of depressive symptoms among co-twins of PD patients versus co-twins of non-PD controls. Controlling for age, sex, and prior history of depression, PD in the co-twin was not a risk factor for mild or moderate-severe depressive symptoms in twins without PD. These findings indicate that environmental influences likely play an important role in the etiology of depressive symptoms in individuals with Parkinson\u27s disease. Alternatively, brain changes associated with PD may heighten biological vulnerability to depressive symptoms

Applying stages of change theory to an acute pain situation: Development of the Childbirth Stages of Change Questionnaire (CSOCQ)

Various self-management methods and pharmacological agents are available to relieve childbirth pain. Decisions about pain management during labor have medical, psychological, and sociological ramifications, yet research investigating the selection of childbirth pain management strategies is scarce. The purpose of the current study was to develop a self-report instrument, the Childbirth Stages of Change Questionnaire (CSOCQ), to assess a pregnant woman\u27s readiness to self-manage childbirth pain. Items representative of five levels of readiness were generated by experts. Next, 3 pregnant women evaluated items for content validity. A pilot CSOCQ was administered to 536 undergraduate women. Factor analysis and item-reliabilities were conducted to evaluate psychometric properties of the pilot scale. Analyses supported a four-factor measure consistent with the Stages of Change model. A revised CSOCQ was presented to 21 pregnant women, and preliminary item analyses indicated acceptable reliability. Additional research should clarify the validity and clinical utility of the CSOCQ