자연주의적 탐구조사(Naturalistic Inquiry)

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Using Multivariate Statistics

Principles and Practice of Structural Equation Modeling (2nd ed.)

OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat depression, but the rates, timing, and baseline predictors of remission in “real world” patients are not established. The authors’ primary objectives in this study were to evaluate the effectiveness of citalopram, an SSRI, using measurement-based care in actual practice, and to identify predictors of symptom remission in outpatients with major depressive disorder. METHOD: This clinical study included outpatients with major depressive disorder who were treated in 23 psychiatric and 18 primary care “real world” settings. The patients received flexible doses of citalopram prescribed by clinicians for up to 14 weeks. The clinicians were assisted by a clinical research coordinator in the application of measurement-based care, which included the routine measurement of symptoms and side effects at each treatment visit and the use of a treatment manual that described when and how to modify medication doses based on these measures....

/pdf/evaluation-of-outcomes-with-citalopram-for-depression-using-53pglcs9e0.pdf

Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice

Of 2525 soldiers, 124 (4.9%) reported injuries with loss of consciousness, 260 (10.3%) reported injuries with altered mental status, and 435 (17.2%) reported other injuries during deployment. Of those reporting loss of consciousness, 43.9% met criteria for post-traumatic stress disorder (PTSD), as compared with 27.3% of those reporting altered mental status, 16.2% with other injuries, and 9.1% with no injury. Soldiers with mild traumatic brain injury, primarily those who had loss of consciousness, were significantly more likely to report poor general health, missed workdays, medical visits, and a high number of somatic and postconcussive symptoms than were soldiers with other injuries. However, after adjustment for PTSD and depression, mild traumatic brain injury was no longer significantly associated with these physical health outcomes or symptoms, except for headache. Conclusions Mild traumatic brain injury (i.e., concussion) occurring among soldiers deployed in Iraq is strongly associated with PTSD and physical health problems 3 to 4 months after the soldiers return home. PTSD and depression are important mediators of the relationship between mild traumatic brain injury and physical health problems.

/pdf/mild-traumatic-brain-injury-in-u-s-soldiers-returning-from-48oxdlt2hs.pdf

Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq

The cerebellum has traditionally been seen primarily to coordinate voluntary movement, but evidence is accumulating that it may play a role in cognition and behavior as well. This is a selective review of studies assessing potential cognitive deficits and personality changes associated with cerebellar disease. Preliminary studies of the role of the cerebellum in schizophrenia, dementia, and other psychiatric disorders are also discussed. Efforts to understand the neurological substrates of behavior should consider the role of the cerebellum.

/pdf/the-role-of-the-cerebellum-in-cognition-and-behavior-a-32jcefuctd.pdf

The role of the cerebellum in cognition and behavior: A selective review

The Clinical Significance of Major Depression Following Mild Traumatic Brain Injury

Traumatic brain injury (TBI) and major depression are neuropsychiatric conditions that have been associated with cognitive dysfunction. The aim of this study was to explore the relationship between major depression and cognitive impairment following mild and moderate TBI. Seventy-four TBI patients were assessed for the presence of major depression using the Structured Clinical Interview for the DSM-IV and completed a neurocognitive assessment battery. Subjects with major depression (28.4%), compared to those without, were found to have significantly lower scores on measures of working memory, processing speed, verbal memory and executive function. Potential mechanisms and implications for treatment are discussed.

https://neuro.psychiatryonline.org/doi/pdfplus/10.1176/jnp.17.1.61

Cognitive Impairment Associated With Major Depression Following Mild and Moderate Traumatic Brain Injury

https://brainxchange.ca/Public/Files/Long-Term-Care/Nonpharm_Neuropsychiatric_LTC-Feb13.aspx

Efficacy and feasibility of nonpharmacological interventions for neuropsychiatric symptoms of dementia in long term care: a systematic review.

Objective:Depression in patients with Alzheimer's disease (AD) is common (15% to 63%) and is associated with significant morbidity and increased mortality. Our objective was to quantitatively summa...

https://journals.sagepub.com/doi/pdf/10.1177/070674370705200407

Mark J. Rapoport

Papers

The role of the cerebellum in cognition and behavior: A selective review

The Clinical Significance of Major Depression Following Mild Traumatic Brain Injury

Cognitive Impairment Associated With Major Depression Following Mild and Moderate Traumatic Brain Injury

Efficacy and feasibility of nonpharmacological interventions for neuropsychiatric symptoms of dementia in long term care: a systematic review.

Efficacy and safety of antidepressants for treatment of depression in Alzheimer's disease: a metaanalysis.