Dataset Information

Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients.

ABSTRACT: Several studies have recognized that depression is a multidimensional construct, although the scales that are currently available have been shown to be limited in terms of the ability to investigate the multidimensionality of depression. The objective of this study is to integrate information from instruments that measure depression from different perspectives-a self-report symptomatic scale, a clinician-rated scale, and a clinician-rated scale of depressive signs-in order to investigate the multiple dimensions underlying the depressive construct.A sample of 399 patients from a mood disorders outpatient unit was investigated with the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS), and the Core Assessment of Psychomotor Change (CORE). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate underlying dimensions of depression, including item level analysis with factor loadings and item thresholds.A solution of six depression dimensions has shown good-fit to the data, with no cross-loading items, and good interpretability. Item-level analysis revealed that the multidimensional depressive construct might be organized into a continuum of severity in the following ascending order: sexual, cognitive, insomnia, appetite, non-interactiveness/motor retardation, and agitation.An integration of both signs and symptoms, as well as the perspectives of clinicians and patients, might be a good clinical and research alternative for the investigation of multidimensional issues within the depressive syndrome. As predicted by theoretical models of depression, the melancholic aspects of depression (non-interactiveness/motor retardation and agitation) lie at the severe end of the depressive continuum.

SUBMITTER: Vares EA

PROVIDER: S-EPMC4552383 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients.

Vares Edgar Arrua EA Salum Giovanni Abrahão GA Spanemberg Lucas L Caldieraro Marco Antônio MA Fleck Marcelo P MP

PloS one 20150827 8

<h4>Background</h4>Several studies have recognized that depression is a multidimensional construct, although the scales that are currently available have been shown to be limited in terms of the ability to investigate the multidimensionality of depression. The objective of this study is to integrate information from instruments that measure depression from different perspectives-a self-report symptomatic scale, a clinician-rated scale, and a clinician-rated scale of depressive signs-in order to ...[more]

PMID: 26313556

Similar Datasets

Project description:Improving the patient experience of primary care is a stated focus of efforts to transform primary care practices into "Patient-centered Medical Homes" (PCMH) in the United States, yet understanding and promoting what defines a positive experience from the patient's perspective has been de-emphasized relative to the development of technological and communication infrastructure at the PCMH. The objective of this qualitative study was to compare primary care clinicians' and their patients' perceptions of the patients' experiences, expectations and preferences as they try to achieve care for depression.We interviewed 6 primary care clinicians along with 30 of their patients with a history of depressive disorder attending 4 small to medium-sized primary care practices from rural and urban settings.Three processes on the way to satisfactory depression care emerged: 1. a journey, often from fractured to connected care; 2. a search for a personal understanding of their depression; 3. creation of unique therapeutic spaces for treating current depression and preventing future episodes. Relative to patients' observations regarding stigma's effects on accepting a depression diagnosis and seeking treatment, clinicians tended to underestimate the presence and effects of stigma. Patients preferred clinicians who were empathetic listeners, while clinicians worried that discussing depression could open "Pandora's box" of lengthy discussions and set them irrecoverably behind in their clinic schedules. Clinicians and patients agreed that somatic manifestations of mental distress impeded the patients' ability to understand their suffering as depression. Clinicians reported supporting several treatment modalities beyond guideline-based approaches for depression, yet also displayed surface-level understanding of the often multifaceted support webs their patient described.Improving processes and outcomes in primary care may demand heightened ability to understand and measure the patients' experiences, expectations and preferences as they receive primary care. Future research would investigate a potential mismatch between clinicians' and patients' perceptions of the effects of stigma on achieving care for depression, and on whether time spent discussing depression during the clinical visit improves outcomes. Improving care and outcomes for chronic disorders such as depression may require primary care clinicians to understand and support their patients' unique 'therapeutic spaces.'

Dataset Information

Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients.

Publications

Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets