Brief report of affective state and depression status after traumatic brain injury.
ABSTRACT Objective: To examine the relationship between affective state (positive and negative affect) and depression status among adults with chronic traumatic brain injury (TBI). Research Method: This is a cross-sectional cohort study of community-dwelling adults with chronic TBI (n = 64) that assesses the relationship between affective state (positive and negative affect), using the Positive and Negative Affect Schedule (PANAS), and depression status, categorized as no depression, history of depressive episode, and current depressive episode, using the Primary Care Evaluation of Mental Disorders (PRIME-MD). Results: Affective state differed significantly across depression status groups for both positive affect (F (2, 61) = 5.10, p = .009) and negative affect (F ( 2, 61) = 8.19, p = .001). Participants with no depression reported higher positive affect (M = 35.67, SD = 9.08) than those with a current depressive episode (M = 27.64, SD = 8.59, p = .007) and lower negative affect (M = 14.52, SD = 5.08) than those with a history of a depressive episode (M = 20.21, SD = 5.08, p = .006) and those with a current depressive episode (M = 22.29, SD = 6.21, p = .001). Conclusions: Poor affective state, including both low positive affect and high negative affect, is associated with depression diagnosis. High negative affect is present, even in the absence of a current depressive episode, after TBI. These data highlight the need to assess affective state in addition to screening for mood disorders among adults with chronic TBI. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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ABSTRACT: The consequences of major depression for disability, impaired well-being and service utilization have been studied primarily in younger adults. In all age groups the consequences of minor depression are virtually unknown. In later life, the increased co-morbidity with physical illness may modify the consequences of depression, warranting special study of the elderly. With rising numbers of elderly people, excess service utilization by depressed elderly represents an increasingly important issue. Based on a large, random community-based sample of older inhabitants of the Netherlands (55-85 years), the associations of major and minor depression with various indicators of disability, well-being and service utilization were assessed, controlling for potential confounding factors. Depression was diagnosed using a two-stage screening design. Diagnosis took place in all subjects with high depressive symptom levels and a random sample of those with low depressive symptom levels. The study sample consists of all participants to diagnostic interviews (N = 646). As in younger adults, associations of both major and minor depression with disability and well-being remained significant after controlling for chronic disease and functional limitations. Adequate treatment is often not administered, even in subjects with major depression. As the vast majority of those depressed were recently seen by their general practitioners, treatment could have been provided in most cases. Bivariate analyses show that major and minor depression are associated with an excess use of non-mental health services, underscoring the importance of recognition. In multivariate analyses the evidence of excess service utilization was less compelling. Both major and minor depression are consequential for well-being and disability, supporting efforts to improve the recognition and treatment in primary care. However, controlled trials are necessary to assess the impact this may have on service utilization.Psychological Medicine 12/1997; 27(6):1397-409. · 5.43 Impact Factor
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ABSTRACT: The extent of mood disorders following traumatic brain injury (TBI), and the possible risk factors, are investigated. New data are presented from a prospective study of consecutive hospital admissions. Six months post-TBI, 99 adults completed a standardized assessment of emotional state, the Wimbledon Self-Report Scale. Cognitive performance and the impact of the injury on everyday functioning were also assessed. The rate of clinically significant mood disorders (caseness) was 38%. Of the demographic or injury characteristics, only pre-injury occupational status predicted post-injury caseness. Those unoccupied pre-injury were more likely to report mood disturbance post-injury. In contrast, post-injury occupational status was not related to caseness either for the whole group or the subgroup of those previously occupied, despite the adverse effects on occupational functioning for a significant proportion of subjects. Associations were found between emotional state and cognitive and everyday functioning 6 months post-injury. Psychosocial disabilities appeared more strongly associated to mood disorders than did physical disabilities. A significant level of unmet need has been highlighted, and possible risk factors identified, which may inform the purchase and provision of TBI rehabilitation services. Follow-up data on these subjects are available and will be reported separately.Brain Injury 03/1998; 12(3):177-90. · 1.86 Impact Factor
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ABSTRACT: We review psychometric and other evidence relevant to mixed anxiety-depression. Properties of anxiety and depression measures, including the convergent and discriminant validity of self- and clinical ratings, and interrater reliability, are examined in patient and normal samples. Results suggest that anxiety and depression can be reliably and validly assessed; moreover, although these disorders share a substantial component of general affective distress, they can be differentiated on the basis of factors specific to each syndrome. We also review evidence for these specific factors, examining the influence of context and scale content on ratings, factor analytic studies, and the role of low positive affect in depression. With these data, we argue for a tripartite structure consisting of general distress, physiological hyperarousal (specific anxiety), and anhedonia (specific depression), and we propose a diagnosis of mixed anxiety-depression.Journal of Abnormal Psychology 09/1991; 100(3):316-36. · 4.86 Impact Factor