Randomized controlled trial of interpersonal psychotherapy versus enhanced treatment as usual for women with co-occurring depression and pelvic pain.

Objective: Our study assessed the effectiveness of Interpersonal Psychotherapy (IPT) tailored for biomedical patients with depression and pain. IPT was compared to enhanced treatment as usual (E-TAU) among women with co-occurring depression and chronic pain presenting for care at a women's health or family medicine practice. We hypothesized that women presenting to urban medical practices with depression and chronic pain would benefit from IPT tailored to address their needs to a greater degree than from E-TAU.

Interpersonal Psychotherapy for Co-occurring Depression and Chronic Pain.

Up to 37% of individuals experience chronic pain during their lifetimes. Approximately one-fourth of primary care patients with chronic pain also meet criteria for major depression. Many of these individuals fail to receive psychotherapy or other treatment for their depression; moreover when they do, physical pain is often not addressed directly.

Interpersonal psychotherapy for women with comorbid depression and chronic pain.

Chronic pain is prevalent among patients with depression and a risk factor for poor depression treatment outcomes. No known psychotherapy approaches have been developed to target the needs of patients with comorbid depression and chronic pain. This study's goals were to evaluate feasibility, acceptability, and initial effects of interpersonal psychotherapy adapted for women with depression and chronic pain.

Pain and depression in gynecology patients.

Background: The prevalence and consequences of comorbid pain and depression in gynecology patients are understudied.

Objective: The purpose of the study was to determine the prevalence of pain, depression, and their co-occurrence among gynecology patients, and to examine how pain and depression are associated with additional comorbid mental disorders.

Method: Self-reported pain, depressive symptoms, other mental-disorder symptoms, functional status, interpersonal distress, and abuse were assessed in 1,647 gynecology patients by use of the Patient Health Questionnaire and the Medical Outcomes Study (SF-20).

Pain as a predictor of depression treatment outcomes in women with childhood sexual abuse.

Objectives: Childhood sexual abuse (CSA) increases risk for both depression and pain in women. Pain is associated with worse depression treatment response. The contribution of pain to depression treatment outcomes in women with histories of CSA is unknown.

Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression.

Objective: The objective of this study was to determine if psychosocial stress and anxiety were associated with depression severity in primary care patients with chronic musculoskeletal pain.

Methods: A cross-sectional sample of 500 primary care patients with musculoskeletal pain (250 with depression and 250 without depression) was assessed for anxiety, psychosocial stress, depression severity and demographics. The depressed and nondepressed participants were compared using t test and chi(2) analyses.

Pain and depressive symptoms among financially disadvantaged women's health patients.

Objectives: Women are at greater risk than men for both pain and depression, yet little is known about the frequency and implications of comorbid pain and depression among women in women's health settings. This study aimed to determine the frequency of comorbid depressive symptoms and pain among a sample of gynecology outpatients and to evaluate the associations of comorbid pain and depressive symptoms with physical, emotional, and social functioning and abuse experiences.

Methods: A total of 242 low-income, primarily African American women presenting at an urban women's health clinic for routine gynecological care consented to participate.

Contributions of physical and sexual abuse to women's experiences with chronic pelvic pain.

Objective: To examine the roles of physical and sexual abuse in women with chronic pelvic pain using multi-dimensional pain assessment and to compare the chronic pelvic pain experiences of women with physical abuse to those of women with sexual abuse.

Study Design: Structured questionnaires were used to measure self-reported abuse, pain severity, psychological distress, physical functioning, interpersonalfunctioning, and coping in 63 women attending a tertiary care gynecologic clinic for diagnosis and treatment of chronic pelvic pain.

Results: Women with chronic pelvic pain who reported abuse demonstrated significantly more psychological distress than did women who reported no abuse, but there were no differences in pain severity, physical functioning, interpersonal functioning or coping.

Personality traits and symptom reduction in a group treatment for women with histories of childhood sexual abuse.

The influence of personality on symptom reduction has not been examined in research on treatments for women with childhood sexual abuse histories, although personality has demonstrated predictive value in other treatment contexts. This study examined personality variables associated with symptom reduction in group therapy for hospitalized women with histories of sexual abuse. Personality was measured with the NEO-Five-Factor Inventory (NEO-FFI), which yields scores on neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness.

Beta EEG activity and insomnia.

To date there have been seven studies which find that beta EEG is elevated at around sleep onset and during polysomnographic sleep in patients with insomnia. These findings suggest that insomnia may be characterized by central nervous system (CNS) hyperarousal. In this article, the seven studies are critically reviewed, two theoretical perspectives on beta EEG are presented, and the concept of hyperarousal as a three component process is discussed.

Neuropsychological changes and treatment compliance in older adults with sleep apnea.

Introduction: Apnea is a common disorder in older adults and has been shown to affect cognition. Some studies suggest that treatment for apnea improves certain cognitive deficits, but few studies have examined the relationship between compliance and cognitive improvement. We designed a study to answer the following questions about sleep apnea, cognition and treatment in older adults: (1) Which neuropsychological (NP) variables are differentially associated with measures of sleep fragmentation and oxygen desaturation? (2) Does compliant use of CPAP provide a cognitive advantage over noncompliant use? (3) Does NP performance at baseline predict compliance at 3 months?

Method: Twelve participants were recruited for the study.

Neuroimaging of NREM sleep in primary insomnia: a Tc-99-HMPAO single photon emission computed tomography study.

Study Objectives: The objectives of this study were to: 1) demonstrate the feasibility of combining polysomnography and SPECT neuroimaging to study NREM sleep in primary insomnia and 2) evaluate possible functional CNS abnormalities associated with insomnia.

Design: Patients with insomnia and good sleeper controls were studied polysomnographically for three nights with a whole brain SPECT Scan of NREM sleep on Night 3. Groups were screened for medical/psychiatric history, substance use, and matched on age, body mass index, and education.

The effects of an orally administered cholinergic agonist on REM sleep in major depression.

Background: Centrally active cholinergic agents such as arecoline and physostigmine shorten rapid eye movement (REM) latency, reduce REM interval times, or both and do so preferentially in patients with depression. We tested an orally administered cholinergic agonist (donepezil HCL 10 mg [Aricept]) to determine whether this agent also alters REM timing in depressed patients (n = 8) compared with age- and gender-matched control subjects (n = 8).

Methods: All subjects were studied for 3 consecutive nights in the sleep laboratory.

Genetic segregation analysis of recurrent, early-onset major depression: evidence for single major locus transmission.

Coordinated efforts are now underway to identify susceptibility genes for unipolar major depressive disorder (MDD) and related disorders. These studies have focused on recurrent, early-onset MDD (RE-MDD), thought to be the most familial form of this disorder. The goal of this study was to conduct a complex segregation analysis of recurrent MDD and other major mood disorders aggregating in families identified by probands with RE-MDD.

Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia.

Objective: Although four meta-analytic reviews support the efficacy of pharmacotherapy and behavior therapy for the treatment of insomnia, no meta-analysis has evaluated whether these treatment modalities yield comparable outcomes during acute treatment. The authors conducted a quantitative review of the literature on the outcome of the two treatments to compare the short-term efficacy of pharmacotherapy and behavioral therapy in primary insomnia.

Method: They identified studies from 1966 through 2000 using MEDLINE, psycINFO, and bibliographies.