Post Traumatic Stress Disorder In Combat Veterans
To effectively treat Post Traumatic Stress Disorder, PTSD in combat Veterans and service members,
therapists use different techniques, which are preceded by addressing any underlying pain associated
with the disorder. In their research, Chard et al. (2011) reported significant modifications to the CPT
protocol for use with patients in a TBI–PTSD residential treatment facility, including increasing the
number of sessions per week, combining group and individual therapy, and augmenting the
treatment with cognitive rehabilitation. However, their research was marred with the use of few
participants which provides doubts regarding the outcome of the proposed treatment procedures.
Moreover, the researchers do not state with certainty as to the ... Show more content on
Helpwriting.net ...
Their research, however, does not provide many references to support the study. Levi, Bar‐Haim,
Kreiss and Fruchter (2016) provide effective psychotherapy approaches for treating combat veterans
with chronic post–traumatic stress disorder, which they show their efficacy with a great deal of
support. The research is more comprehensive than most studies as it provides an assessment of the
psychiatric status at baseline, post–treatment and 8–12 months follow–up using the Clinician–
Administered PTSD Scale, the PTSD Questionnaire, the Montgomery and Asberg Depression
Rating Scale and the Psychotherapy Outcome Assessment and Monitoring System–Trauma Version
assessment questionnaire. However, the researchers did not conduct randomized controlled trials to
determine treatment efficacy. Litz et al., (2009) added to the research on the treatment of PTSD by
stimulating a critical examination of moral injury. The study makes use of the available literature
and offers a working conceptual framework and a set of intervention strategies designed to repair
moral injury, which is a strength also evident in Peterson et al. (2011). Lunney, Schnurr and Cook,
(2014) compared the severity of PTSD symptoms in treatment–seeking older and younger U.S.
veterans with PTSD. The study uses a wide number of participants, which provides credibility to the
research and can be relied upon on information regarding the effective treatment of PTSD. The
researchers
... Get more on HelpWriting.net ...

The Social Discourse Of Bipolar Disorder
The social discourse of bipolar disorder is often punctuated by the classic manic episodes
manifesting as symptoms such as distractibility, pressured speech, decreased need for sleep,
euphoric mood, grandiosity, and problems with impulse control [17]. These classic periods of high
energy are often intertwined in a cyclical fashion with periods of depressive symptoms, much of the
time meeting criteria for major depressive disorder, as well as periods with no symptoms [17]. The
frequency by which a patient moves through these states varies greatly from weeks to months to as
little as a few days, namely "rapid–cycling" [17]. In addition to manic episodes, hypomanic
episodes, characterized by similar symptoms but less severe symptoms than manic episodes, qualify
the disease as bipolar II disorder instead of bipolar I which needs the criteria of manic episodes
alternating with major depressive episodes [17]. Another subtype of bipolar disorder, cyclothymia,
is characterized by depressive episodes that do not meet criteria for a major depressive episode but
does consist of cycling with previously described hypomanic episodes [11]. While the stigma of
manic episodes plagues patients with bipolar disorder, often the depressive episodes are what cause
the most distress and impairment in daily functioning of patients with bipolar disorder [12]. The
burden of bipolar disorder, which has an estimated prevalence of 4% worldwide, permeates
throughout all aspects of society from the

Inferential Test Paper
1. What inferential tests were used in the analysis of data? How are the the tests appropriate for the
research questions? Inferential tests used in this study are : A) Chi square with continuity correction
and odd ratio (OR) with confidence interval (CI) to test the relation between the presence of suicidal
thoughts and age, gender, educational level, day of assessment, clinical symptoms and signs of
stroke , type of stroke, location of stroke, ischemic stroke subtype, associated conditions, cognitive
impairment, acute depression, and functional outcome at discharge that was assessed using modified
Rankin scale. B) A stepwise logistic regression was used to identify the predictors of suicidal
thoughts in acute stroke. C) A sensitivity analysis ... Show more content on Helpwriting.net ...
As far as R–square is concerned, I am not sure that R–square=0.39% is typo, because they should
not have the sign % after R–square. However, if we take that R–square=0.39, which is 39%
independent predictive factors for suicidal thoughts (according to the authors). R–squared is used
"to estimate the proportion of variability in the dependent variable accounted for by the predictors (
Polit & Beck, 2012, p.460), I am not sure how they used R–square. I believe that acute stroke and/or
the variables such as age, previous stroke, comorbidities and others presented in the Table 1 are
independent variables but suicidal thoughts should be considered as dependent

Observable Behavior Paper
concrete observable behaviors. In study the questionnaire was completed by the same nurse both at
pretest and posttest.
The study showed improvement in quality of life of the people living with dementia diseases after
the intervention. The design used in the study is appropriate because it helps in minimizing the
influence of covariates as the participants serves as their own controls. The study had maintained
confidentiality of the participant and ethical consideration. The sample size of the study is very
small so generalization cannot be done. The data were based on observation so it may be biased.
Likewise, the study is very expensive as it need train professionals and dogs.
The study suggests the use of animals for patients with dementia ... Show more content on
Helpwriting.net ...
Creative therapy sessions, included dance, drama, music and movement activities, which were
implemented over an eight–week period, a minimum of three times a week. Observational outcomes
of creative self–expression, communication, pleasure and enjoyment, and general engagement were
recorded. As a sample of the study, all patients attending one of the two community units – unit A or
unit B, both of which provide day treatment and inpatient care – were invited to take part in dance,
drama, music and movement activities. Consent for involvement in the project and the use of
photographs was obtained from patients or their family members. The data collection tool was
developed by the project lead and the clinical governance support team, and was not piloted. To
maintain anonymity all participants using the tool was assigned an identification number that
remained with them throughout the eight–week evaluation period. The data collection tool was
designed to record information on attendance, activities including warm–up and session closing
strategies and outcomes of the creative therapy sessions in relation to creative self–expression,
communication, pleasure and enjoyment, and general engagement. The member of staff running the
activity recorded the degree of improvement seen in the participant during each session. No
improvement was

Asberg Depression Case Study
This assignment is based on a 32 year old Hispanic male that is suffering from severe depression in
accordance to the Montgomery –Asberg Depression Rating Scale. Depression is identified as a
mood disorder that can have a detrimental impact on an individual's life if not abruptly treated.
Symptoms of depression is noticeable by peers when the individual have loud outbursts, irritability,
sleep disturbance, trouble concentrating, or reduced appetite. According to Pae et al. (2008),
"Significant unmet medical need remains in the treatment of depressive and anxiety disorders. Only
about 25–35% of patients with major depressive disorder (MDD) and s quality of life. For this
reason, clinicians must be aware of these side effects, and are advised ... Show more content on
Helpwriting.net ...
An ethical concern is that older people are more susceptible to adverse reaction when prescribed
antidepressants. "Little is known about more serious adverse effects of antidepressants, particularly
in older people, in whom adverse drug events may be more common in the treatment of depression
compared with younger groups because of higher levels of comorbidity, age related physiological
changes, and polypharmacy" Coupland (2011). Provider must keep this ethical consideration in
mind when prescribing antidepressants to other people. Another ethical concern is that Hispanics
usually consult traditional healers. In this case, it is important to inform clients that all herbs and
medications taken should be shared with the provider to prevent adverse reactions. There are
pharmacokinetic and pharmacodynamics considerations in the elderly population. "Reduced
elimination and prolonged half–life are most commonly observed pharmacokinetic changes in older
patients whereas altered sensitivity to drugs and change in receptor affinity are major
pharmacodynamic changes. These potential changes should be considered in designing dosage
regimen to elderly population during clinical and pharmaceutical development as well as
prescription" Mukker et al. (2016). Elderly patients should be started on a lower dose when
prescribing

Comparison Between Beck Depression And Chronic Heart Failure
In my Journal Article they are seeing if depression is linked to Chronic Heart Failure and whether or
not the Beck Depression Inventory Test Is a reliable test to administer. Results have been said that
the Beck Depression Inventory Test is a reliable instrument to assess depression in not only an
individual but also in a patient with Chronic Heart Failure. Depression is something that can be a
great risk factor when dealing with patients that have Chronic Heart Failure. Types of symptoms
that have been said to be assimilated with depression and Chronic Heart Failure are: insomnia,
anorexia, sexual impairment, and fatigue. It has been said that ranges can be between thirty one
and–fifty one percent in these types of patients. A person with

Effect Of Vrikshasanas On Depression
ABSTRACT Topic: Effect of (vrikshasana) on depression patients. Aim: To measure the depression
levels Before and after vrikshasana yogasanas. Objective: To determine whether Yogasanas can
cause changes in depression level. INTRODUCTION : yoga is a physical,mental and spiritual
practices or disciplines which is originated in ancient India.There is a broad variety of yoga schools,
practices,goals and also for people to come out of their depression. People with more stress and
depression can undergo certain asanas for themselves to calm down and be in a normal posture.
Thus the effect of Vrikshasana may have an positive impact on depression people. MATERIALS
AND METHODS: 30 patients was chosen from yoga centre to study the depressive ... Show more
content on Helpwriting.net ...
Majority of study gives a positive effect of exercise on depression.[6]. Among the diagnoses that are
seen in CAM seekers, depression is most prevalent.[7] Reviews endorse a role for yoga among the
CAMs as an effective treatment in depressive disorder patients. [8].Yoga is a generic discipline that
is available as a recognized curriculum in standard college courses (example, a bachelor and post–
graduate degree in yoga). There is hence an option to use practices elucidated in traditional texts as
a generic yoga module in the treatment of selected ailments,depression being one[9]. This study is to
verify whether vrikshasana helps on depression people to come out of their heavy depression and to
avoid side effects due to long–period addiction of dosage so such alternate method can be

Clinician-Rated Test Essay
All clinician–rated test should have three types of reliability: internal reliability, retest reliability,
and interrater reliability (Bagby, Ryder, Schuller, & Marshall, 2004). Research regarding who the
HRSD was normed on is unavailable. However, Cusin et al. (2012) recently reported on the HRSD
psychometrics properties. Interrater reliability of the total scores for the HRSD is considered to be a
strong relationship ranging from 0.80–0.98, with Cronbach alpha estimates of ≥0.70 which is an
adequate score. Interrater reliability examines the relationship between scores provided by different
raters observing the same phenomenon and Cronbach's alpha, is the average of all possible split–
half reliabilities (Shultz, Whitney, & Zickar, ... Show more content on Helpwriting.net ...
One issue with test retest reliability is that longer intervals are likely to impose psychological
change, thus changing true scores (Furr, & Bacharach, 2013). Therefore, the interval amount of time
can have an impact on the client's score. Cusins et al. (2012), research does not indicate the interval
time, but their retest reliability score of 0.81 is indicative of a strong relationship.
The factor structure of the Hamilton depression scale comprises of part of validity 1) content, 2)
convergent, 3) discriminant, 4) factorial, and 5) predictive validity. Cusins et al. (2012), did not go
in depth regarding the assessment validity, but did indicate that the HRDS has been reported of
having a validity from the ranges of range from 0.65 to 0.90, which is considered to be a strong
relationship. A study by Bagby et al. (2004) did refer to the different types of validity in the HRSD.
The term validity refers to if an assessment properly measures what it supposed to measure (Shultz,
Whitney, & Zickar, 2013). Content validity is performed by a rational inspection of the completed
test by subject matter experts (Furr, & Bacharach, 2013). According to Bagby et al. (2004), the
HRSD has poor content validity. The rationale for this is because although the symptoms listed on
the HRSD are features associated with depression, the assessment does not match the official DSM
diagnostic criteria. Since the development of the HRSD, the definition of depression has

Margaret Mohrmann
The article "The Practice of the Ministry of Medicine" by Dr. Margaret Mohrmann was written to
share real life stories of patients struggling with diseases. The article "Spiritual struggle and
affective symptoms among geriatric mood disordered patients" by David H. Rosmarin, Mary C.
Malloy and Brent P. Forester was written to explain the medical approach on spiritual care for
patients. Therefore, these articles show the difference between emotional and unemotional language
while discussing healing a person. The format of "The Practice of the Ministry of Medicine" is
nonscientific. Mohrmann writes in the 1st person with using the words I and we. For example, "one
of the things I believe I have learned is how to take history, or more precisely how to hear a story."
(page 1) The title shows vigorous meaning with the use of the word "Ministry." This shows the
connection between healing by medicine and healing by faith. With her personal experiences,
Mohrmann shows that patients need both doctors and faith. Example is "I've already stressed the
importance of recognizing our patients' lives and medical histories as stories, so I won't belabor of a
tragedy of as story." (page 3) The article ... Show more content on Helpwriting.net ...
Rosmarin, Mary C. Malloy and Brent P. Forester was written for educational purposes. The format
of the article is scientific. The title states what the subject was studied and why this subject was
studied. The authors use literal language by lacking imagination. For example, "These findings
appear to contrast with previous research, which has suggested that general religious belief and
practice can buffer against depressive symptoms among older adults in both community and clinical
settings." The use of medical jargon makes this paper hard to read for people who are not in the
medical field. For example, "Our MANOVA test also identified a significant association between
symptom factors and spiritual struggle but not positive religious

Characteristics Of Major Depressive Disorder
Major depressive disorder characterized by depressed mood and/or loss of interest affects 7% of all
Americans. In addition to its primary characteristics, people diagnosed with MDD present with at
least five of the following characteristics for the majority of the day every day for 2 weeks: altered
psychomotor activity, loss of interest, problems concentrating or making decisions, altered sleep
patterns, weight loss or gain, fatigue, recurrent thoughts of death, and feelings of worthlessness or
excessive/inappropriate guilt. In order to meet the standards for clinical diagnosis, the patient's
symptoms must prevent normal functioning (social, occupational, or otherwise) and cannot be
explained alternatively by a medical condition or ... Show more content on Helpwriting.net ...
One possibility is the decrease in diagnosis of MDD by primary care physicians due to somatic
rather than psychological presenting symptoms.
Functional consequences of MDD vary but typically depend on the severity of the symptoms.
Symptoms vary from no noticeable outward changes to total functional incapacity. Suicide attempts
are higher in females, but completion rates are higher in males. Other risk factors for suicide include
living alone, feelings of helplessness and borderline personality disorder.
Treatments
Based on a systematic review of 44 clinical trials dating from January 1, 1990 to January 13, 2015,
an effective evidence–based first–step intervention for managing mild to severe MDD is second
generation antidepressants. Approximately 60 % of patients respond; however 70% do not remit. Of
the several different families of antidepressants like selective serotonin reuptake inhibitors (SSRIs),
tricyclic antidepressants (TCAs), norepinephrine reuptake inhibitors (NRIs), and monoamine
oxidase inhibitors (MAOIs), SSRIs are the most commonly prescribed. SSRIs, initially discovered
as more tolerable forms of TCAs and MAOIs, based on the monoaminergic hypothesis, the theory
that depression results from low levels of serotonin in the brain, work by inhibiting serotonin
reuptake receptors present on presynaptic neurons producing an increase of serotonin in the brain.

Journal Club Critique Form
Journal Club Critique Form – Randomized Control Trial Study Design
Student Name: Bhavna.R.Phulwani Group 4
Article Citation : SAMBUNARIS ANGELO, BOSE ANJANA, GOMMOLL CARL, et al .A Phase
III ,Double Blind, Placebo Controlled , Flexible Dose , study of Levomilnacipran Extended Release
in Patients with Major Depressive Disorder. Journal of Clinical Psychopharmacology . Volume 34 ,
November 1, February 2014.
RELEVANCE OF THE STUDY:
Major Depressive disorder or MDD ,also known as depression is a common ,debilitating disorder
affecting almost 16 million adults in the US every year(as found in the reference ranging in severity
from mild to severe.It is a leading cause of global disease burden and it is projected that it will be
only second to HIV/AIDS syndrome by 2030.It is characterized by symptoms such as fatigue, lack
of motivation, decreased concentration and lassitude, which complicate the depressive state by
impairing social and occupational functioning. Some of these defining symptoms are thought to
occur due to reduced noradrenergic activity which exacerbates the depressed mood state. Feelings of
sadness and other symptoms interfere with a person's ability to work, sleep, study, eat, and enjoy
once–pleasurable activities.
The discovery of the new molecular entity, Levomilnacipran brings out a new horizon in the
treatment of Major Depressive Disorder, due to its unique properties. Levomilnacipran is the active
enantiomer of the racemic drug milnacipran (Savella®)

Maternal Depression
Introduction
Maternal depression is a comprehensive term for a range of depressive conditions affecting
postpartum and pregnant women ("Identifying and Treating," 2010). Earlier this year, a group of
researchers studied the effect that maternal depression has on the body, focusing on changes in DNA
methylation in maternal T–lymphocytes of cord blood and adult hippocampi. DNA methylation is
an epigenetic mechanism where methyl groups are added at CpG sites. Scientists are continuously
identifying new effects that the disorder has on the human body, thus making it scientifically
relevant to the realm of psychobiology. 10 to 20% of mothers will be diagnosed with maternal
depression during their lifetimes (Center on the Developing Child at Harvard ... Show more content
on Helpwriting.net ...
used three different tests: the Mini–International Neuropsychiatric Interview, the Edinburgh
Postnatal Depression Scale and the Montgomery–Asberg Depression Rating Scale. These are
psychiatric–based multiple choice tests and do not consider outside factors in the patient's life or the
subjectivity associated with such an assessment (Sheehan,1998; Cox,1987; Psychiat 1979).
Provided the complexity of depression as a mental disorder, the limitations from these assessments
could be overcome through the use of brain scans ("NIH Research Matters", 2013). The women
were split up into three groups: past depression, current depression and no history of depression. A
quantitatively biological assay such as an MRI could divide these groups in a more objective and
pronounced

Generalized Anxiety Disorder ( Gad ) Essay
Literature Review
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is a disorder in which an individual may feel persistent,
excessive, and worry about everyday things that may not even happen. Individuals with this disorder
may feel worry, excessive anxiety, and have thoughts of the worst even when there is no need for
concern. A person experiencing GAD may expect a disaster. They may worry about their finances,
money, health, family, work, or any issue that may come to mind. This disorder may be present
when a person worrying increases on more days than one for at least six months. GAD can interfere
with work, school, family, and even social activities. GAD can be diagnosed in adults when they
experience at least three of the symptoms. These symptoms include restlessness or feeling on the
edge, fatigue, difficulty focusing or mind going blank, irritability, muscle tension, pain in back or
headaches, and sleep disturbance (ADAA, n.d.).
According to the Mayo Clinic, genetics may play a role as well as other factors, but is not fully
known. Some of the risk factors for GAD is personality, genetics, and sex. With personality, a
person who is shy, have negative thoughts, or who avoids dangerous situations may be more prone
to generalized anxiety disorder than others are. GAD may run in the family, thus being a genetic
factor. Also, women are more prone to have GAD than men. The common two treatments for GAD
include medication and psychotherapy. Psychotherapy

African Americans With Psychotic Disorders
Over the years, the scientific literature has shown that African–American patients are more likely
than other racial groups to receive a diagnosis of schizophrenia. Determining the reasons for this
disparity has been a challenging problem for researchers. The debate is centered on the question of
whether or not African–Americans are truly more susceptible to schizophrenia than these other
groups; conversely, the idea that African–Americans are simply being diagnosed at higher rates has
persisted.
Strakowski et al. (1996) showed that African–Americans with psychotic disorders are more likely
than Caucasian patients to report first–rank symptoms of schizophrenia to their treating clinician.
These "first–rank symptoms" refer to auditory ... Show more content on Helpwriting.net ...
For the expert–consensus diagnoses, clinicians looked at the structured interviews and medical
records of the patients. Strakowski determined that there are minimal differences in first–rank
symptoms between African–American and Caucasian patients when clinicians are blinded by
ethnicity/race. There were 79 patients that met DSM–IV criteria for an affective disorder, 40
identifying themselves as Caucasian or White and 39 identifying themselves as African–American.
The expert–consensus diagnoses revealed the presence of first–rank symptoms in 55% of the White
patients and 62% of the African–American patients. However, despite these minimal differences, it
was found that during the structural interviews, African–American patients were more likely to be
diagnosed with a schizophrenia spectrum disorder than their white counterparts (Strakowski et al.,
1996). Therefore, the overdiagnosis of schizophrenia cannot be attributed to the presence of these
first–rank symptoms.
It is highly important to explore whether or not clinician overdiagnosis of schizophrenia extends to
other minority groups. A later study by Gara et al. (2012) expanded on Strakowski's work. Six
hundred ten subjects (including a group of self–identified Latinos) exhibiting affective symptoms
were recruited at 6 different sites, which would allow for more generalizability in the

Special People/Special Needs
University of Phoenix
Cultural Diversity
BSHS 421
Special People/Special Needs
Mental illness is a special need within itself; couple that with being a minority, specifically an
African American, and the problem increases. The following paper will display examples and data
portraying the difficulty that African Americans face when seeking mental health services,
particularly for schizophrenia. Also included will be assessment techniques, intervention strategies
and treatment planning.
According to the NAMI Multicultural Action Center (Medline Plus, 2004), "African Americans in
the United States are less likely to receive diagnoses and treatment for their mental illnesses than
Caucasian Americans." This can be due to many factors, ... Show more content on Helpwriting.net
...
Psychosocial intervention uses behavioral modification, coaching, and modeling among others.
When performing psychosocial intervention there are other interventions used such as group
therapy, vocational training, social skills training and leisure management skills. Social skills
training involve the individual learning the symptoms of the disease. Learning the symptoms is
important because this can help with a relapse and a checklist is usually given to the individual and
their family members. Daily living skills are also learned during this time. Daily living skills consist
of bathing, cleaning, and decision making of important matters. Vocational training is important and
there are steps that need to be taken. The steps are deciding what kind of work is suitable for the
individual, having and help them apply for the job, and having and helping them follow up on the
job. The development of intellectual skills such as lapse of attention, concentration, reason and
problem solving can affect the individual's performance of the job. The setting the individual lives
can help then with intervention and therapy. There are many different living settings that are used
based on the level of functioning and capability. Day–care is where the individuals go during
working hours to get vocational training and intervention strategies. Residential rehabilitation
consists of a short stay. Some factors of having to live in a residential program

How Kava Is An Herb Of The Western Pacific Islands
Kava is an herb found in the western pacific islands. Kava is a sacred plant that had been used in
multiple varieties of ways, particularly ceremonially and medicinally, in the western pacific for
centuries. Kava is used to "relieve anxiety, restlessness, sleeplessness, and stress–related symptoms
such as muscle tension or spasm. Kava may also relieve pain". Kava comes in many forms, the
traditional one being tea, but also "as a dietary supplement in powder and tincture (extract in
alcohol) forms".
Does it work? Well, according to WebMD (not the greatest source, but it is the source for many
Americans on basic health information so I am using it in my paper as a baseline for American
understanding of kava) kava is known to have, "a calming ... Show more content on Helpwriting.net
...
In the United States though, kava is fully legal in every capacity.
The most serious concern about kava is the effect kava has on those who take it and then try to
operate a motor vehicle. One study published in the Journal, Public Library of Science investigated
the, "the association between kava use and the risk of four–wheeled motor vehicle crashes in Fiji".
This study was a, "population–based case–control study. Data was collected by structured
interviewer administered questionnaires of self–reported participant data on demographic
characteristics and a range of risk factors including kava use and potential confounders". This study
found that, "overall, 23% and 4% of drivers of case and control vehicles, respectively, reported
consuming kava in the 12 hours prior to the crash or road survey. After controlling for assessed
confounders, driving following kava use was associated with a four–fold increase in the odds of
crash involvement (Odds ratio: 4.70; 95% CI: 1.90–11.63). The related population attributable risk
was 18.37% (95% CI: 13.77–22.72). Acknowledging limited statistical power, we did not find a
significant interaction in this association with concurrent alcohol use". This study concluded that,
"in a setting where recreational kava consumption is common, driving following the use of kava
was associated with a significant excess of serious–injury involved road crashes. The precautionary
principle would suggest road safety strategies should explicitly

Oaea Case Study
Omegas have been thought to play a role in perinatal depression by affecting depression
neurotransmitters and receptors in the brain. Furthermore, analysis has shown that n–3 PUFA levels
are decreased in depressed individuals in contrast to individuals not depressed. A double blind,
randomized, placebo controlled study was conducted for 6 weeks. The participants had to meet the
DSM–IV criteria for major depression and be within the timeline of third trimester to six months
postnatal. The participants were required to score greater or equal to 13 on the EPDS, or greater than
14 on the Hamilton Depression Ration scale HDRS or greater than 25 on the Montgomery Asberg
Depression Rating Scale. The study had 13 randomly assigned to the ... Show more content on
Helpwriting.net ...
To participate in this study the individuals had to have a HAM–D score of 26 or higher at the
beginning of the study. The results of the trial showed a statistically significant reduction in the
HAM–D score. Specifically, a 21–mean reduction in the average HAM–D score in the Brexanolone
group in comparison to the 8.8 –mean reduction in the placebo group. This indicates Brexanolone is
an effective method in treating post–partum depression. This metaanalysis analyzed four different
treatments in the management of PPD. Treatment one and two consisted of Fluoxetine or placebo
medication. The third and fourth treatment included Fluoxetine or placebo medications coupled with
one or six sessions of CBT. By the end of the study the researchers observed that there was a
reduction in depression in all groups. Specifically, the Fluoxetine group showed greater
improvement than the placebo group. Furthermore, the six CBT therapy sessions proved to be more
beneficial than the one CBT therapy session. It was also observed that women in the Fluoxetine and
CBT group did not show significantly greater improvement than individuals who received just the
Fluoxetine alone. Although results were observed to be greater in the Fluoxetine group, CBT was
shown to be beneficial whether coupled with or without pharmacological assistance. In sum, the
results of the study were found to be inconclusive. This is due to that the participants were only
experiencing mild PPD. Therefore, a wider

Comparing Two Treatments For Bipolar Disorder
Comparing Two Treatments for Bipolar Disorder Bipolar disorder is a mental health issue that
affects millions of people worldwide. It is typically treated with a combination of mood stabilizers
and antidepressants. It can take a patient and their doctor a long time to find the right combination
of medications to effectively treat their bipolar disorder. Some individuals do not find much comfort
in any level of the traditional medications and continue to struggle with their depression. Recently,
scientists have been looking into newer ways to help treat bipolar disorder. Two of these new
treatments for helping people suffering from bipolar depression are the use of ketamine and
olanzapine. Ionescu et al. (2015) examined the use of ketamine to treat bipolar depression.
Ketamine is an anesthetic drug. Lately, there has been a lot of research into possible treatment of
several psychological disorders using sub–anesthetic levels of ketamine. Recent research has shown
ketamine to be effective at treating depression in patients with treatment resistant bipolar I and
bipolar II. Ionescu et al. (2015) examined if the antidepressant effects of ketamine in bipolar
patients, was lessened if they had comorbid anxiety. This study was part of a larger, double blind,
placebo controlled study, which examined the safety of using ketamine with mood stabilizers. The
participants in this study were split into two groups, those with comorbid anxiety, and those without.
All participants received

Benefits Of Medicinal Herbs And Nutritional Supplements
Curcumin: Researchers have been studying on different herbs and nutritional supplements which led
to the proposal for managing clinical disorders like depression .For example ashwagandha treats
anxiety and brahmi is being used for the cognitive problems while colostrinin for dementia4 and
ginseng has been successful in treating the sexual dysfunction .(1–4) Curcumin, is one of the
ingredients present in turmeric. It is also an unconventional treatment that has been studied in the
management of depression.Turmeric is a spice originally from the rhizome of the plant Curcuma
longa.Turmeric contains differentnumber of bioactive substances, like polyphenols,
sesquiterpenes,diterpenes, triterpenoids, sterols, and alkaloids.(5,6) ... Show more content on
Helpwriting.net ...
Depression is one of the most common health issues and it affects twenty one percent of total
population in the world. (9,10).The major and primary cause of depression has been found to be
imbalance in the physiology of monoaminergic neurotransmission through serotonin (11) .However
, present studies put forward that most of the depression cases are correlated with systemic and
biological imbalances.(12)As a result this lead to the study of how to deal with the imbalances. For
example studying the effect of anti–inflammatory on immuno–inflammations (13) and effect of
antioxidants on increasing antioxidant defences and lower free radical damage. (14,15).Despite the
fact these pharmaceutical agents have antidepressant effect on monoaminergics,evidences support
that they can also alter immuno–inflammation, decrease oxidative stress, intensify neurotrophic
actions and influence HPA activity (16–18). Even though there are wide variety of drugs available
for treating depression, the search for safer drugs leads to the path of research in Curcumin. This
compound has a potential effect in treating depression without any adverse side effects.
(19)According to Xu et al curcumin is the ingredient of curcuma longa and has proven antioxidant
effect and neuroprotective effect. (20,21). Chinese medicine has been found to use the curcumin in

Abnormal Psychology: Bipolar Disorder
Bipolar Disorder
Mental illness has plagued human kind for as long as we have been on this earth. The science of
psychology has made great strides in past century. The stigma of being mentally ill has begun to fall
away and people are finally starting to get the help that they need to recover. Bipolar disorder is one
illness that we have come to more fully understand. Through assistance from a psychiatrist, family
and medication a patient with bipolar disorder can enter remission and live a normal life. Bipolar
disorder, also known as manic–depressive disorder (MDD), affects people of all races, colors, and
economic backgrounds. Approximately two million Americans aged 18 and older are affected by
this disorder. ... Show more content on Helpwriting.net ...
Also, the patient 's thyroid status should be assessed. A University of North Carolina study has
proved that depression is three times more likely for those with hypothyroidism than those with
normal thyroid function (Dranov).
Psychiatrists must do a full psychiatric evaluation in order to diagnose a patient with bipolar
disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) IV is used for
diagnosis; the DSM–IV criteria for bipolar disorder must be met in order to diagnose a patient.
Tools such as scales are very helpful in aiding of the diagnosis of the patient. Scales are a series of
questions relating to the disorder in question and according to the score, clinicians can either
confirm or rule out a diagnosis. Typical scales for bipolar disorder are: Young Mania Rating Scale
(YMRS), Montgomery–Asberg Depression rating scale (MADRS), and The Global Assessment of
Functioning scale (GAF) (Psychiatry). When scales are repeated during the course of treatment,
efficacy of medication can be assessed. As MDD patients are historically under–reporters of
symptoms, it may be helpful for a close loved one to accompany the patient to treatment. Patients
may also not recognize the extent of their behavior and it helps to have a secondary report (Butler).
Treatment options
Medication is the first line of defense in treating bipolar disorder. Traditionally, lithium was the drug
of choice for bipolar patients. Though lithium is still used

Montgomery Asberg Depression Rating Scale For Depression,...
Convergent validity refers to two measures that should be theoretically related (Furr, & Bacharach,
2013). Bagby et (2004) used thirteen scales to compare the validity. Some of the scale used were the
Montgomery Asberg Depression Rating Scale (MADRS), Major Depression Inventory, Minnesota
Multiphasic Personality Inventory, Raskin Depression Scale, Clinical Global Impression Scale,
Carroll Rating Scale for Depression, and the Global Assessment Scale. Convergent validity is
considered to be adequate when a scale shows Pearson's r values of at least 0.50 in correlations with
other measures (Bagby et al.,2004). Bagby et al., (2004) alluded that the HRSD showed adequate
convergent reliability, because it met the correlations with the majority of the scales. One of the
scales that the HRSD failed to meet the correlation with is the Structured Clinical Interview for
DSM–IV (.37). This is important to note because the DSM–IV is the standard for definitions and
diagnoses of mental disorders (Bagby et al., 2004). Failing to meet the Structured Clinical Interview
for DSM–IV is consistent with the rationale for failing to meet content validity.
Discriminate validity test to ensure that measurements that are not supposed to be related to the
measure are in fact not actually related (Shultz, Whitney, & Zickar, 2013). On the basis of the
Global Severity Scale, Bagby et al. (2004) concluded that the HRSD was able to discriminate
psychiatric patients classified as mildly, moderately, and

Symptoms And Treatment Of Depression
Severe depression can have a devastating effects on not only individuals, but also on their families
and communities. Depressive disorders when severe or prolonged enough can cause some patients
to seek to harm themselves, or worse; to seek to end their lives. While over the last century there
have been significant strides in the treatment of depression, there still is much work to be done. May
medication that treat depression take a long time for patient to reach therapeutic dosages, mean that
patients often have to wait weeks on longer for their symptoms to improve. Because of the
significant time for these medication to begin to cause patients depression to enter remission, there
is a critical time frame in which patients need help or ... Show more content on Helpwriting.net ...
This research is needed because of the dangers that depressive disorders and other mental illnesses
pose to patients. Kudlow, McIntyre and Lam, (2014) state the patients with major depressive
disorder often do not respond to their first antidepressant medication and may clinicians may wait to
change medications for up to eight weeks in order to assess for delayed effect. This significant
amount of time required for traditional medications to cause a response may be putting patients at
risk and ketamine may provide more effective short term response and remission; buying patients
time for traditional medications to work.
Peer reviewed academic articles that studied the effects and suitability of ketamine were used to
determine the hypothesis of this study. The research included in this study only included adult
patients with depressive disorders. Individual studies range in their inclusion criteria for patients,
with some excluding patients with specific comorbid mental diseases. For instance, Lee, Della
Selva, Liu and Himelhoch (2015) excluded participates that were undergoing electroshock therapy,
this study will include research with a variety of patient exclusion in the hopes to widen the depth of
depressive spectrum disorders. These research articles were gather from the Grand Canyon
University library databases as well as Science–Directs.com data bases, with criteria limited to peer
viewed academic

Medical And Surgical Treatment Of Vitiligo
Vitiligo is a skin disease where an individual loses their pigmentation when the pigment producing
cells are attacked and destroyed (AOCD, n.d.). Vitiligo is also known to be an auto–immune
disorder where certain white blood cells direct the destruction of the melanocyte (AOCD, n.d.).
Melanocytes are cells that give us our skin and hair color (AAOD, n.d.). Vitiligo affects any
individual no matter their ethnic origin or sex. Individuals often notice that they have the skin
disease before they reached the age of 20 which is often notice on individuals with darker skin.
Common areas that vitiligo would normally start would be on an individual's hands, feet, or face
(AOCD, n.d.).
Currently, there's no cure for vitiligo but there are ... Show more content on Helpwriting.net ...
Articles that involved foreign language and children were excluded from the search.
Search Strategy The systematic review was searched independently by one reviewer to find articles
related to vitiligo and depression. There was no primary focus for a particular country. There was
one particular database used to conduct the search which was google scholar. fig.1
Author(s) Country Objectives Methods Results
Al–Harbi, M (2012) Europe To study and classify depressive symptoms Self–administered
questionnaires 54 % were found to be depressed. Depression was more prevalent in single patients.
Branch and Layegh (2010) Iran Evaluate the degree of depression in vitiligo patients Beck
Depression Questionnaire 70 % was the prevalence rate of depression in individuals with vitiligo.
Chan et al. (2012) Asia Explore the level of depression in a group of vitiligo patients A descriptive
study 17.2% had been identified as depressed.
Maleki et al (2005) Iran Evaluate the prevalence and severity if depression in vitiligo patients
Hamilton Depression Rating Scale Out of the 52 participants 24(46%) were depressed.
Zaki and Elbatrawy (2009) Egypt To detect the level of depression in patients with vitiligo Hamilton
Depression Rating Scale Depression was found in 33 % of the patients. Table 2.
Results The results for

Major Depressive Disorder ( Mdd ) Essay
Major Depressive Disorder (MDD), commonly called depression, is almost twice as prevalent in
women than it is in men (Cyranowski, Frank, Young, & Shear, 2000). Previously it was thought that
this statistic was so because women were more likely to seek help than men were for this disease.
However, this has been widely discounted by the gender difference seen across the world
(Cyranowski, Frank, Young, & Shear, 2000). With the rising cases of MDD, and the higher
likelihood of being diagnosed at younger ages, depression is becoming more accepted and less
stigmatized in society. Causes of the disorder are heavily intertwined between social–causation,
neurological/genetic disposition and psychological–causation. Treatment ranges from group and
single therapy to medication with all sorts of other types in–between. This paper aims to look at the
causes and outcomes of MDD in women and the potential treatments.
Introduction
Major depressive disorder (MDD) affects approximately 18 million people in the United States
alone, and 340 million people worldwide. MDD, as defined in the Diagnostic and Statistical
Manual, 5th ed. (DSM–V), is characterized by "one or more major depressive episodes that are
persistent and abnormally depressed mood states that last at least 2 weeks and include cognitive
symptoms and disturbed physical functions". The DSM–V includes a clinical significance criterion
where "symptoms cause clinically significant distress or impairment in social,

The Efficacy And Metabolic Profile Of Bipolar Disorder
A Systematic Review of the Efficacy and Metabolic Profile of Lurasidone in the Treatment of
Depression in Bipolar Disorder MSc in Psychiatry 2015 Dissertation by Giles Osborne BA BSc
MA(Oxon) Department of Psychiatry, Cardiff Medical School, Cardiff, CF14 4XN Main Body
Word Count 18,885 May 2015 DECLARATION / STATEMENTS PAGE DECLARATION This
work has not previously been accepted in substance for any degree and is not concurrently
submitted in candidature for any degree. Signed––––––––––––––––––––––––––––– (G R Osborne)
Date–––––––––––––––––––––––––––––––––––––––– STATEMENT 1 This thesis is being
submitted in partial fulfilment of the requirements for the degree of MSc (Psychiatry)
Signed–––––––––––––––––––––––––––– (G R ... Show more content on Helpwriting.net ...
Signed––––––––––––––––––––––––––– (G R Osborne)
Date––––––––––––––––––––––––––––––––––– ACKNOWLEDGEMENTS I would like to thank
Mr Jon Ford BSc MSc and Dr Chris Lee MBBS PhD for the proofreading of this paper. I would
particularly like to thank Dr Chris Lee for inspiring me to undertake this MSc. Dedicated to Obi,
even though he may not have the cognitive construct of self. ABBREVIATIONS ADL: Activities of
Daily Living AE: Adverse Event ANCOVA: Analysis of Covariance ANOVA: Analysis of Variance
BDNF: Brain Derived Neurotrophic Factor BMI: Body Mass Index BPD: Bipolar Disorder CGI–
BP: Clinical Global Impressions Scale CGI–BP–C: Clinical Global Impressions Scale – Bipolar–
Change Scale CGI–BP–S: Clinical Global Impressions Scale – Bipolar–Severity Scale CI:
Confidence Interval CVD: Cardiovascular Disease DB: Database df: Degrees of Freedom DSM IV/
5: Diagnostic and Statistical Manual of Mental Disorders versions 4 or 5 EMA: European Medicines
Agency EPSE: Extrapyramidal Side Effects EU: European Union FPG: Fasting Plasma Glucose
FDA: Food and Drug Administration FDC: Fixed Dose Combination GLP: Good Laboratory
Practice HAM–D: Hamilton Depression Rating Scale HR: Hazard Ratio ICD 10: International
Classification of Diseases 10th Revision ICH–GCP: International Conference on Harmonisation
Good Clinical Practices IFG: Impaired Fasting Glucose

Depression And Its Effects On An Individual 's Life Essay
Depression is a mental illness that can have profound impacts on an individual's life. Unfortunately
though, our understanding of this disorder is limited. Contributing to this is the fact that for several
decades, there was only one theory on depression, which was the monoamine theory. This theory
rationalized that depression was due to an absolute or relative deficiency of monoamines and that
antidepressants work by correcting this deficiency (Willner, Scheel–Krüger, & Belzung, 2013).
Only within the last decade or two have there been new proposals on the causes of depression.
These new proposals have helped to increase our understanding of this disorder as well as highlight
flaws in the original theory. Among these is the neurogenesis theory of depression.
This theory was established by BL Jacobs, H van Praag, and FH Gage (2000) through a review of
work that had been performed in the 1990s. Upon evaluation of the previous literature, they found
that drugs that increase serotonin such as d,l–fenfluramine also stimulate hippocampal neurogenesis.
Due to this, they theorized that the birth of new neurons in the hippocampus was an important factor
in the treatment of depression. This was an important revelation. Before their work, depression was
thought to be cured solely by increasing the level of deficient neurotransmitters as evidenced by the
monoamine theory. Although this had some efficacy in treating depression it did not explain why
antidepressant drugs took a while

The Use Of Ketamine As A Narcotic Medication Prescribed As...
Ketamine is a narcotic medication prescribed as an anesthetic agent and an analgesic. The articles
argue for adding broadening Ketamine 's therapeutic boundaries in relation to what is legally
prescribed in the U.S.A. Specifically, broadening to include Ketamine as an anti–depressive
treatment. The difference between these articles lie in what ways Ketamine is perceived as a useful
antidepressant and how those conclusions are formed. I chose this topic because I am a certified
Pharmacy Technician. Medications are naturally an interest for me and any opportunity to learn
more about them may benefit my current experience and future in Science.
Review of the Literature
Summary of Theories:All three articles All articles support use of ketamine as an antidepressant but
support ketamine 's scope to different lengths. Lee, Della Selva, Liu and Himelhoch (2005) state that
in comparison to medications available, Ketamine is fast acting and effective. Furthermore,
Szymkowicz, Finnegan, and Dale agree with this notion but to further expand, they state Ketamine
as beneficial for suicidal patients. Lastly, Price, Iosifescu, Murrough, Chang, Al Jurdi, Iqbal,
Soleimani, Charney, Foulkes and Mathew underline a necessary characteristic for positive results,
that is, patients should be under 65 years of age.
Summary of Findings and Recommendations:
Lee et al.'s meta–analysis found 60 minute infusion of ketamine would cause large effects on
BPAD(Bipolar Affective Disorder) and MDD(

Literature Review On Menopause
Literature Review Mitchel and Barnes (2005) note that menopause or peri–menopause has the effect
of increasing depressive symptoms or initiating the onset of depressive symptoms. A systematic
review of literature on the impact of menopause on the course of bipolar disorder indicate that
postmenopausal women reported worsening mood symptoms particularly depression (Mitchel &
Barnes, 2005). A study by Dalal and Agarwal (2015) on postmenopausal syndrome found that 75%
of women investigated experienced vasomotor symptoms; in some case the symptoms lasted for up
to 10 years. The symptoms included hot flushes, emotional lability, difficulty in concentrating and
insomnia. The highlighted symptoms are similar to bipolar disorder symptoms. Retrospective study
conducted on women with bipolar disorder showed that women experienced intense mood
symptoms during menopausal transition (Ellen, 1996). A study by Dalal and Agwaral (2015) found
that 20% women who had never experienced depression during their life become depressed at one
point during menopause. Whereas it is difficult to isolate the effect of age on the occurrence of
depression among menopaused women, many studies on mood during menopause reveal increased
incidence of depression during peri–menopause and it eventually decreases in later postmenopausal
years (Dalal & Agwarl, 2015). A study conducted by Harvard Study of Moods and Cycles selected
premenopausal women aged between 36 and 44 years without a history

A Summary Of I-Charge
RESULTS
The safety and tolerability of i–Charge are shown in Table.1. i–Charge is seen to be safe and
tolerable. None of the subjects complained about erythema, oedema, vomiting, pruritic, urticaria,
burning micturition, hypopigmentation and hyperpigmentation. I–Charge was observed to be safe
from baseline till the end of the study.
Characteristics of treatment in both trial and placebo groups are described in Table.2 with the level
of compliance and the medication regime during the study period. It is observed that women
subjects constituted 90% in both Treatment and Placebo groups. The average age in Treatment and
Placebo groups were 42 and 41 respectively. 33.33 subjects in treatment and placebo groups were in
sick leave. 7 subjects ... Show more content on Helpwriting.net ...
(p>0.001)
Placebo group: Montgomery–Åsberg Depression Rating Scale (MADRS) with a mean value of
21.72 and SD 6.58 pre–treatment reduced to a mean value of 17.40 with SD 8.28 post treatment.
(p>0.001)
For all the parameters, the results indicate marked improvement in physical health and energy,
mental health and reduction in stress, fatigue, depression in most subjects on i–Charge treatment for
a period of two weeks. No clinically significant adverse reactions were either reported or observed,
during the entire study period and overall compliance to the safety and efficacy was excellent.
Chronic fatigue syndrome (CFS) is a complex and serious illness that is often misunderstood.
Experts have noted that the terminology "chronic fatigue syndrome" can trivialize this illness and
stigmatize persons who experience its symptoms. However, the fatigue in this illness is striking and
quite distinct from the common fatigue everyone experiences. A variety of other names have been
used, including myalgic encephalomyelitis (ME), ME/CFS, chronic fatigue immune dysfunction,
and most recently, systemic exertion intolerance disease. The lack of agreement about nomenclature
need not be an impediment for advancing critically needed research and education.19,20,21
At this time, there are no treatments (pharmacologic) that have been proven effective in large
randomized trials and replicated by other

Evaluation Of A Program Evaluation Essay
PROGRAM EVALUATION
In order to determine the effectiveness of the program and the level of participant satisfaction,
Kingsley Manor will collect and analyze data with the aim of answering the following questions: (1)
Will an onsite wellness program increase the wellness and health related uality of life for older
adults with Diabetes Mellitus Type II? (2) What participant specific characteristics predict increased
or decreased benefit from participation in a wellness program? (3) Do older adults with Diabetes
Mellitus Type II perceive changes in function, health, wellness or quality of life related to
participation in a wellness program? (4) How satisfied are older adults with Diabetes Mellitus Type
II with a wellness program that incorporates educational and exercise sessions?
This study will use the following Operational definitions:
1. Older adult: person aged 65 or older
2. Diabetes Mellitus Type II (DMT2): a chronic disease due to progressive insulin secretory defect
on the background of insulin resistance diagnosed by A1C or plasma glucose criteria (ADA, 2015)
3. Wellness: "an active, lifelong process of becoming aware of choices and making decisions toward
a more balanced and fulfilling life; wellness involves choices about our lives and our priorities that
determine our lifestyles" (as defined by ASU, n.d.)
4. Health: "a state of complete physical, mental and social well–being and not merely the absence of
disease or infirmity" (as defined by WHO, 1946)
5.

Electroconvulsive Therapy: A Literature Review
Major depression affects over 4.8% among males, which exists as a mental disorder that alters their
process to feel, think, and perform daily responsibilities. So, those that remain diagnosed with major
depression are generally treated with medications, psychoanalysis, or a mixture of the two. In
contrast, if treatment options do not reduce depression levels among patients, then the patient could
be recommended for Electroconvulsive therapy (ECT) by a consultant. As well, the purpose of the
literature review is to determine if ECT seems to produce changes in the brain that could potentially
reverse symptoms of specific mental disorders, and if ECT is effective for those that remain
resistant to medications and psychotherapy. However, there ... Show more content on
Helpwriting.net ...
(2004), to determine if ECT increases the probability for cognitive risks among 26 psychiatric
outpatients. As well, a maintenance ECT (M–ECT) was used throughout the study, considering that
M–ECT remains as one of the most efficient ways to avoid relapses and recurrences among patients.
In spite of this, 5 patients withdrew from the ECT therapy, and 1 patient had a relapse during the
ECT sessions, which left 20 patients that completed the longitudinal study. Additionally, a verbal
phonetic fluency and encoding test were utilized to collect the data for the experiment.
Consequently, the researchers concluded that there were no cognitive effects among the 20 patients.
However, they do acknowledge that there existed a small number of limitations to their study; for
instance, insufficient comparison group to match specific psychiatric illnesses, and lack of cognitive
assessment before the ECT

Recommended

Recommended

More Related Content

More from Leslie Sanchez

More from Leslie Sanchez (20)

Recently uploaded

Recently uploaded (20)