2 Myth or Fact: Does PA lower one s feeling of being depressed?
3 Mental Health, Mental Illness, Mental health: and Mental Disorders State of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity. USHDDS, 1994, p. 4 Mental illness: Refers collectively to all diagnosable mental disorders (continued)
4 Mental Health, Mental Illness, and Mental Disorders (continued) Mental disorder: Health conditions that are characterized by altered thinking, mood, or behavior... associated with distress and/or impaired functioning. USHDDS, 1994, p. 4
5 Mental Health Problems Signs and symptoms of insufficient intensity or duration to meet criteria for mental disorders Symptoms are sufficient enough to potentially warrant active efforts in health promotion, prevention, and treatment
6 Continuum of Mental Illness, Mental Health Problems, and Mental Health
7 Prevalence Disability adjusted life years (DALYs) Estimate of the years of healthy life lost to premature death and years lived with a disability Using DALYs, mental illnesses rank second only to cardiovascular problems in disease burden in industrialized nations It has been estimated (e.g., CDC, 1998) that percent of U.S. adults suffer from some form of mental health problem.
8 More on Prevalence Mood disorders (e.g., major depression, bipolar disorders) rank within the top 10 causes of disability worldwide. National Comorbidity Survey (Kessler et al., 1994) estimated that in a given year 23.4 percent of U.S. adult population will have a diagnosable mental disorder Follow-up study in 2005 mirrored these results
9 Costs Overall costs: $53 billion per year in 2000 Breakdown of costs: 31 percent spent on direct treatment and rehabilitation, 7 percent on mortality, and 62 percent for absenteeism and reduced work productivity Other costs: Increased risk for other diseases Decreased quality of life for individual and families
10 Depression Defined Disorders that influence mood regulation beyond the usual variations between sadness and happiness/excitement Persistent low mood and inability to find enjoyment in activities Lack of motivation to begin or continue activities Feelings of worthlessness
11 Symptoms That May Accompany Depression Feelings of sadness/elation Feelings of guilt/worthlessness Disturbances of appetite Disturbances in sleep patterns Lack of energy Difficulty concentrating Loss of interest in all/most activities Problems with memory Thoughts of suicide Hallucinations
12 Non-clinical Depression Listlessness, feelings of gloom Clinical Depression Depression Loss of interest, lowered mood, at least 2 weeks At least 5 of the following: Loss of appetite, weight gain or loss, sleep disturbance, decreased energy, psychomotor retardation, sense of worthlessness, guilt, concentration problems, thoughts of suicide
13 Treatment Many individuals are reluctant to seek treatment because of stigma associated with mental illness When depression is treated: Pharmacotherapy; psychotherapy Noncompliance is frequent Can be expensive and have unwanted sideeffects Physical activity could help both prevent and treat depression
14 Research on Preventive Effects of Exercise Research shows a connection between growing lack of physical activity and increasing prevalence of mental health problems. A consistent finding indicates that the least active individuals have the greatest incidence of mental health problems. Regular physical activity can be useful in preventing mental health disorders or in reducing their risk of occurrence.
15 Preventive Effects Cross-sectional study by Stephens (1988) reported that physically inactive were more than 3 times more likely to have depressive symptoms that those who regularly exercise. A 2 year study of Adolescents found that physically active adolescents had lower levels of depression (Motl, et al, 2004).
16 Measurement Standard classification criteria Diagnostic and Statistical Manual of Mental Disorders (4 th edition, revised; DSM-IV-TR) Research Diagnostic Criteria (RDC) International Classification of Diseases (ICD-10) Self-report measures Questionnaires (e.g., Center for Epidemiologic Studies Depression Scale; CES-D)
17 Common Questionnairie Measurement of Depression Profile of mood states subscale of depression Center for Epidemiologic Studies Depression scale (CES-D) - Score of 16 or more indicates that the individual experienced some level of depression over the past week.
18 Center for Epidemiologic Studies Depression Scale (CES-D) Sample Items Source: National Institute of Mental Health.
19 Research on Treatment of Nonclinical Depression Findings of North, McCullagh, and Tran (1990): Exercise resulted in decreased depression. Some factors moderated exercise treatment effects while others did not. Exercise was as effective as, and sometimes more effective than, traditional therapies.
20 Treatment Effect on Non-clinical Depression 85% of 1,750 physicians prescribed exercise for patients suffering from depression (Ryan, 1983). Exercise resulted in decreased depression, yielding a moderate sizable effect size. There is no difference in the mode of exercise in reduction of non-clinical depression. Longer the physical activity program goes the greater the benefit The effects of exercise intensity and duration on reducing depression is unknown. Benefits of exercise on reducing depression occurs across age and gender.
21 Research on Treatment of Clinical Depression Martinsen, Medhus, and Sandvik (1985): In a study of hospitalized psychiatric patients, patients rated exercise as the most important part of comprehensive treatment plan. Martinsen, Hoffart, and Solberg (1989): Showed that both aerobic and nonaerobic exercise resulted in significant psychological improvements. Singh, Clements, and Fiatarone (1997): Found that people who trained harder had greater reductions in depression.
22 More on the Treatment of Clinical Depression Blumenthal and colleagues (1999): Showed that an exercise treatment was as effective as a pharmacotherapy treatment and a combination drug/exercise treatment; follow-up studies showed the exercise group was more likely to be fully or partially recovered. Tkachuk and Martin (1999): Found that exercise might reduce the level of medication needed, length of time it is needed, and perhaps even the need for medication at all.
23 Treatment Effect of Exercise on Clinical Depression The overall effect size of PA on clinical depression was highly moderate (.72). Exercise program 9-12 weeks showed double the depression reduction of programs that only lasting 8 weeks or less. Light intensity exercise had a moderate effect size where as moderate intensity exercise has a high effect size on reducing clinicial depression. Exercise above a comfortable pace yields greater depressionreducing effects. Hospitalized depressed patients involved in a 9 week exercise program had significant reductions in depressive symptoms. Aerobic and non-aerobic exercise resulted in similar significant improvements in clinically depressed patients. Similar depression reduction across age and gender Best for Moderate to severe clinically depressed patients (ES =.88) as compared to mild to moderate depressed (ES =.34) patients.
24 Consensus Statements about Exercise and Depression Exercise can be associated with a decreased level of mild to moderate depression. Exercise may be an adjunct to the professional treatment of severe depression. Source: Adapted from Morgan & Goldston (1987).
25 Explanation why exercise reduces feeling of being depressed? 1. Expectancy hypothesis Individuals expect to feel better so they report feeling better(giant placebo effect?) Doesn t t seem likely given physiology evidence PA benefits are beyond just expectancy 2. Monoamine hypothesis Exercise is a stimulus that increases level of neurotransmitters (I.e., dopamine, norepinephrine, serotionin) Neurotransmitters facilitate neural impulses across synapses.
26 Explanations 3. Endorphin Hypothesis Endorphin act to reduce pain and contribute to feelings of euphoria Exercise increases endorphin levels Associated with runners high Beta-endorphins increases well after PA has been discontinued Only proven in animals not humans
27 Practical Recommendations Exercise done on a regular basis can be useful in treating depression as well as in protecting against depression. Research consistently shows that 30 minutes of aerobic exercise three times a week will significantly reduce depression (Johnsgard, 1989, p. 280). Type of exercise doesn t seem to matter.
28 Guidelines for the Use of Exercise Therapy Obtain information from the individual as to what activities he or she likes/dislikes. Exercise with the individual, to provide support and to model correct behavior. Make the exercise adaptable to the individual s lifestyle. Use the individual s home environment. Monitor exercise dosage and modify as necessary. Help the individual realize that setbacks do occur, and devise strategies to deal with them.
29 Exercise vs. Traditional Treatments Exercise decreases depression better than not having any treatment. Exercise is as effective as traditional treatments (i.e., relaxation, psychotherapy, some medication). Exercise with psychotherapy yields best depression-reducing effects. Exercise is cost effective. Exercise also increases physical health, as an added benefit.
MOLINA HEALTHCARE OF CALIFORNIA MAJOR DEPRESSION IN ADULTS IN PRIMARY CARE HEALTH CARE GUIDELINE (ICSI) Health Care Guideline Twelfth Edition May 2009. The guideline was reviewed and adopted by the Molina
What is bipolar disorder? There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
Depressive Symptoms? Administer depression screening tool: PSC Depression Assessment & Treatment Yes Positive screen Safety Screen (see Appendix): Administer every visit Neglect/Abuse? Thoughts of hurting
Psychiatric Disorders Learning about the brain from diagnosis to treatment Tedi Asher Harvard Medical School Talk overview Part I: Defining psychiatric disorders Part II: Biological underpinnings of depression
Major Depressive Disorder Major Depressive Disorder (MDD) Guideline Diagnostic omenclature for Clinical Depressive Conditions Conditions Diagnostic Criteria Duration Major Depression 5 of the following
1 DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE ASSESSMENT/PROBLEM RECOGNITION 1. Did the staff and physician seek and document risk factors for depression and any history of depression? 2. Did staff
Depression & Multiple Sclerosis Managing Specific Issues Feeling blue The words depressed and depression are used so casually in everyday conversation that their meaning has become murky. True depression
Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Overview Depression is significantly higher among elderly adults receiving home healthcare, particularly among
Department of Epidemiology & Public Health Lunchtime seminar, 18 th Feb 2014 Self-management strategies for mild to moderate depression The internet-based ifightdepression tool Dr Celine Larkin National
Depression What is depression? Depression is one of the common human emotional states. It is common to experience feelings of sadness and tiredness in response to life events, such as losses or disappointments.
Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,
Elizabeth A. Crocco, MD Assistant Clinical Professor Chief, Division of Geriatric Psychiatry Department of Psychiatry and Behavioral Sciences Miller School of Medicine/University of Miami Question 1 You
The Canadian Mental Health Association (CMHA) is a nation-wide, charitable organization that promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness.
Mood and anxiety disorders in patients with a brain tumor Isabel Schuermeyer, MD Director, Psycho-Oncology Cleveland Clinic Taussig Cancer Institute Jazz Classrooms I & II Overview What has the research
Treating Depression to Remission in the Primary Care Setting James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health 2007 United Behavioral Health 1 2007 United Behavioral Health Goals
Caring for depression Aetna Health Connections SM Disease Management Program Get information. Get help. Get better. 21.05.300.1 B (6/08) Get back to being you How this guide can help you Having an ongoing
The Family Library DEPRESSION What is depression? Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too. Also called
CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014 2014 MVP Health Care, Inc. CHAPTER 5 CHAPTER SPECIFIC CATEGORY CODE BLOCKS F01-F09 Mental disorders due to known physiological
Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression
Clinical Audit: Prescribing antipsychotic medication for people with dementia Trust, team and patient information Q1. Patient's DIS number... Q2. Patient s residence: Home Residential Home Nursing Home
Diagnosis and Treatment of Bipolar Disorder Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016 Points to Cover What is the defining characteristic of Bipolar Disorder? Bipolar I vs. Bipolar II
Depression Screening in Primary Care Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN MetroHealth System Our Vision Make Greater Cleveland a healthier place to live and a better place to do business. 2
Schizoaffective disorder Dr.Varunee Mekareeya,M.D.,FRCPsychT Schizoaffective disorder is a psychiatric disorder that affects about 0.5 to 0.8 percent of the population. It is characterized by disordered
Understanding Mental Illness Healing Friends Training Module 1 Objectives To know the myths about mental illness To know the causes of mental illness To have a basic knowledge of common mental illnesses
Obsessive-Compulsive Disorder Clinical Practice Guideline Summary for Primary Care CLINICAL ASSESSMENT AND DIAGNOSIS (ADULTS) Obsessive-Compulsive Disorder (OCD) is categorized by recurrent obsessions,
1 of 6 6/3/2014 10:15 AM Return to Web version Depression Overview What is depression? When doctors talk about depression, they mean the medical illness called major depression. Someone who has major depression
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
Chapter Ten 2011 McGraw-Hill 2011 McGraw-Hill Higher Education. Higher Education. All rights All reserved. rights reserved. What Is Stress? A stressor is any physical or psychological event or condition
Chapter 7 Mood Disorders An Overview of Mood Disorders Gross Deviations in Mood 2 Fundamental states: & Mania : The Low Major Depressive Episode The most commonly diagnosed & most severe depression Depressed
For patients trapped by depression and its treatment side effects... Introducing the new way back to the true you About Depression Introducing NeuroStar TMS Therapy Depression is a serious medical illness
Serious Mental Illness: Symptoms, Treatment and Causes of Relapse Bipolar Disorder, Schizophrenia and Schizoaffective Disorder Symptoms and Prevalence of Bipolar Disorder Bipolar disorder, formerly known
Mohammad Amjad ullah Khan, M.D. Child, Adolescent and Adult Psychiatry Texas A & M University Scott & White Healthcare System Temple and Killeen Sadness of mood for most of the day, nearly every day, and/or
How to Recognize Depression and Its Related Mood and Emotional Disorders Dr. David H. Brendel Depression s Devastating Toll on the Individual Reduces or eliminates pleasure and jo Compromises and destroys
These Guidelines are based in part on the following: American Academy of Child and Adolescent Psychiatry s Practice Parameter for the Assessment and Treatment of Children and Adolescents With Bipolar Disorder,
FACT SHEET 4 What Is? Bipolar disorder, also known as manic depression, affects about 1 percent of the general population. Bipolar disorder is a psychiatric disorder that causes extreme mood swings that
PTSD IN PRIMARY CARE Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington What to expect today? Defining and assessing PTSD Approach for doing differential
Anxiety and depression appropriate terms for cancer survivorship research? Jon Håvard Loge Regional Centre for Excellence in Palliative Care, Dept. of Oncol., Oslo University Hospital/ Dept. of Behavioural
TM Understanding Depression The Road to Feeling Better Helping Yourself Your Treatment Options A Note for Family Members Understanding Depression Depression is a biological illness. It affects more than
Mental Health and Nursing: A Summary of the Issues What s the issue? Before expanding on the key issue, it is important to define the concepts of mental illness and mental health: The Canadian Mental Health
Assessment of depression in adults in primary care Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group 1 The questions and
Resource Guide Antidepressant Medication Management A helpful resource for primary care physicians August 2015 Depression Management Managing your patients with depression This booklet provides an overview
Management of depression in young people in primary care Key recommendations: 1 Management A young person with mild or moderate depression should typically be managed within primary care services A strength-based
EMA/303592/2015 Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole) This is a summary of the risk management plan (RMP) for Aripiprazole Pharmathen, which details the measures
Part 1: Depression Screening in Primary Care Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN MetroHealth System Objectives Part 1: Improve ability to screen and diagnose Depression in Primary Care Increase
An Upstream Approach to Improving Psychological Wellbeing Dr Brian Marien Founder and Director of Positive Health Strategies firstname.lastname@example.org www.positivegroup.org Prevention or cure? Zola,
Identifying and Treating Dual-Diagnosed Substance Use and Mental Health Disorders Presented by: Carrie Terrill, LCDC Overview What is Dual Diagnosis? How Common is Dual Diagnosis? What are Substance Use
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic childhood disorders. Current estimates indicate that 4% to 12% of all school-aged children may be affected.
Bipolar Disorder Clinical Practice Guideline Summary for Primary Care DIAGNOSIS AND CLINICAL ASSESSMENT Bipolar Disorder is categorized by extreme mood cycling; manifested by periods of euphoria, grandiosity,
Depression Signs & Symptoms Contents What Is Depression? What Are The Signs And Symptoms Of Depression? How Do The Signs And Symptoms Of Depression Differ In Different Groups? What Are The Different Types
Guide for family and friends of people affected by bipolar disorders www.douglas.qc.ca This guide is intended for families, friends and other people who are interested in understanding the different aspects
nn Mental Illness Facts and Statistics This section contains a brief overview of facts and statistics about mental illness in Australia as well as information that may be useful in countering common myths.
Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7 Purpose The Patient Health Questionnaire (PHQ) is designed to facilitate the recognition and diagnosis of the most common mental
1) The original DSM was published in a) 1942 b) 1952 c) 1962 d) 1972 DSM-5: A Comprehensive Overview 2) The DSM provides all the following EXCEPT a) Guidelines for the treatment of identified disorders
About Postpartum Depression and other Perinatal Mood Disorders The entire period of pregnancy up to one year after delivery is described as the perinatal period. Many physical and emotional changes occur
E-Resource March, 2015 DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource Depression affects approximately 20% of the general population
Using antidepressants in children and young people bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They
What works for bipolar disorder and how should this be delivered in practice? Daniel Smith email@example.com W4 Improving the diagnosis and management of bipolar disorder: screening, integrated
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
Introduction Amphetamines, which are classified as stimulants, work by using the dopamine reward system of the brain. When these drugs are used, the user s central nervous system is simulated which causes
Serious Mental Illness (SMI) SMI determination is based on the age of the individual, functional impairment, duration of the disorder and the diagnoses. Adults must meet all of the following five criteria:
Talking to a friend or family member affected by depression Supported by Supported by the European Depression Association Brought to you by For people affected by depression, discussing their condition
6.1 Anxiety Depression - Adults Anxiety is a condition characterized by persistent worry or unease and is usually accompanied by fear, panic, irritability, poor sleep, poor concentration and avoidance,
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault firstname.lastname@example.org Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
136 198 2004 2003 14 12 %13.2 17 %7.1 %9.6 3 32 9 Depression in childhood and adolescence is among the commonest and more disabling disorders. It has been reported that childhood depression ranges from
Dr. May Lam Assistant Professor, Department of Psychiatry, The University of Hong Kong Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome a mental state in
Feeling Moody? Is it just a bad mood or is it a disorder? Major Depressive Disorder Prevalence: 7%; 18-29 years old; Female>Male DDx: Manic episodes with irritable mood or mixed episodes, mood disorder
1 MH 12 ALCOHOL RELATED DISORDERS Includes Alcohol Abuse and Alcohol Dependence; Does Not Include Alcohol Use Disorders Background This case definition was developed by the Armed Forces Health Surveillance
Co-Occurring Disorders PACCT 2011 CAROLYN FRANZEN Learning Objectives List common examples of mental health problems associated with substance abuse disorders Describe risk factors that contribute to the
Management of moderate to severe ere (including psychotic) depression in children and young people tiers 2 4 bring together all NICE guidance, quality standards and other NICE information on a specific
PSYCHIATRY FOR PCPs BIPOLAR DISORDER David A Harrison, MD, PhD Assistant Professor Dept of Psychiatry & Behavioral Sciences University of Washington School of Medicine Mood Disorders: Diagnosis & Treatment
Effective Care Management for Behavioral Health Integration Title: Effective Care Management for Behavioral Health Integration A process improvement initiative focused on improving mental health outcomes
Social Stigmatization and Societal Expectations as Factors of Health Inequalities Illustrated by the Example of Depression Psychotherapists report their experiences Lena Hünefeld, M.A. Health Inequalities
`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= Overview: Common Mental What are they? Disorders Why are they important? How do they affect
Bradley C. Riemann, Ph.D. Clinical Director, OCD Center and CBT Services Rogers Memorial Hospital The Use of Exposure and Ritual Prevention with OCD: Key Concepts and New Directions OCD Center Rogers Memorial
Professional Reference Series Depression and Anxiety, Volume 1 Depression and Anxiety Prevention for Older Adults TA C M I S S I O N The mission of the Older Americans Substance Abuse and Mental Health
Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health email@example.com Mental Health Disorders An estimated 57.7 million adults (26.2% of adult population) suffer
Antidepressant Skills @ Work Dealing with Mood Problems in the Workplace Dr. Joti Samra PhD, R.Psych. Adjunct Professor & Research Scientist CARMHA www.carmha.ca Dr. Merv Gilbert PhD, R.Psych. Principal
: a brief overview sufferers experience sound in the absence of an external source. Sounds heard in tinnitus tend to be buzzing, hissing or ringing rather than fully-formed sounds such as speech or music.
Shared Care Guideline for Prescription and monitoring of Naltrexone Hydrochloride in alcohol dependence Author(s)/Originator(s): (please state author name and department) Dr Daly - Consultant Psychiatrist,
Depression and Mental Health: A Psychiatrist s Perspective Peter M. Lake, MD Medical Director Rogers Memorial Hospital Oconomowoc Depression The Intersection of Hope, Medicine and Research Marquette University
1 MH 12 ALCOHOL RELATED DISORDERS Includes Alcohol Abuse and Alcohol Dependence; Does Not Include Alcohol Use Disorders Background This case definition was developed by the Armed Forces Health Surveillance
Depression ENGELSK Depresjon Depression What is depression? Everyone will feel sadness, loneliness, or grief at one time or another, for example at the death of a loved one. This is a natural part of life,
Traumatic brain injury EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury (TBI) is a common neurological condition that can have significant emotional and cognitive consequences.