Ga Lowe

Parenting and depressive symptoms among adolescents in four Caribbean societies

BackgroundThe strategies that parents use to guide and discipline their children may influence their emotional health. Relatively little research has been conducted examining the association of parenting practices to depressive symptoms among Caribbean adolescents. This project examines the association of parenting styles to levels of depressive symptoms among adolescents in Jamaica, the Bahamas, St. Kitts and Nevis, and St. Vincent.MethodsAdolescents attending grade ten of academic year 2006/2007 in Jamaica, the Bahamas, St. Vincent, and St. Kitts and Nevis were administered the Parenting Practices Scale along with the BDI-II. Authoritative, Authoritarian, Permissive and Neglectful parenting styles were created using a median split procedure of the monitoring and nurturance subscales of the Parenting Practices Scale. Multiple regression analyses were used to examine the relationships of parenting styles to depressive symptoms.ResultsA wide cross-section of tenth grade students in each nation was sampled (n = 1955; 278 from Jamaica, 217 from the Bahamas, 737 St. Kitts and Nevis, 716 from St. Vincent; 52.1% females, 45.6% males and 2.3% no gender reported; age 12 to 19 years, mean = 15.3 yrs, sd = .95 yrs). Nearly half (52.1%) of all adolescents reported mild to severe symptoms of depression with 29.1% reporting moderate to severe symptoms of depression. In general, authoritative and permissive parenting styles were both associated with lower levels of depressive symptoms in adolescents. However, the relationship of parenting styles to depression scores was not consistent across countries (p < .05). In contrast to previous research on Caribbean parenting, caregivers in this study used a mixture of different parenting styles with the two most popular styles being authoritative and neglectful parenting.ConclusionsThere appears to be an association between parenting styles and depressive symptoms that is differentially manifested across the islands of Jamaica, the Bahamas, St. Kitts and Nevis and St. Vincent.

Depression in adolescence: new developments

Depression in adolescence is under-recognized although its associated burden of illness is very high. Some frequent associations with depression in this age group are under-achievement, poor lifestyle choices including substance abuse, and a high risk of the persistence of the illness into adulthood There is also an increased risk of mortality related to suicide and harmful lifestyles. For depression in adolescents to be reduced, there needs to be strong collaboration among health professions, adolescents and their caregivers. Non-mental health clinicians must expand their role and become better prepared to recognize, prevent and treat depression in this age-group. Greater public awareness must also be achieved so that adolescents and their caregivers can seek help early.

Locus of control, depression and quality of life among persons with sickle cell disease in Jamaica

This study explored how locus of control (LOC), depression and quality of life (QOL) interplay in patients with sickle cell disease. One hundred and forty-three sickle cell clinic patients with consecutive clinic consultations completed the Multidimensional Health Locus of Control and Short Factor 36 (SF-36) scales as well as the Beck Depression Inventory. Participants in this study had higher scores on the “chance”, “other people” and “internal” domains of LOC than persons with a number of other chronic illnesses in a previous study. Hierarchical regression analyses showed that high scores on the “internal” domain of LOC were associated with better QOL and fewer symptoms of depression. Depressive symptoms were greater in persons with high scores on the “other people” LOC domain and in younger persons. These findings would suggest that it is possible that interventions which enhance internal LOC and discourage “other people” orientations might improve QOL and ameliorate depression among persons with sickle cell disease.

Depressive Symptoms among Fourth Form Students in St. Kitts and Nevis High Schools

There has been limited research on depressive symptoms among high school students in St. Kitts and Nevis. This project examines levels of depressive symptoms among fourth form (grade 10) students attending all high schools in St. Kitts and Nevis. Students enrolled in the fourth form during the 2006/2007 academic year in all high schools were administered the Beck Depression Inventory II (BDI-II). A near census of the students was conducted (n = 744 students; 50.4% females, 47.6% males, and 2% no gender reported; age 13–19 years, mean = 15.5 ± 0.8 years). Six in every ten students (62.1%) reported some symptoms of depression, with 14.8% reporting moderate to severe and 9.7% reporting severe symptoms of depression. Females reported significantly higher BDI-II scores (t(727) = 7.11, p < 0.01) with 70% of females reporting some level of depressive symptoms compared with 52% of their male counterparts (X2(1) = 24.6, p < 0.05). Additionally, 34% of females were in the moderate to severe or severe range of depressive symptoms, while 15% of males were in the same range. Students who were older than expected for their grade (i.e., 17 years or older) reported significantly higher BDI-II scores (F(2,740) = 2.88, p < 0.05) than students who were younger or at the expected age (i.e., 14–16 years). Students whose mothers had a high school or postsecondary education reported significantly lower levels of depressive symptoms than students whose mothers had less than a high school education (F(3, 637), = 4.23, p < 0.05). Symptoms of depression among fourth form students in St. Kitts and Nevis are a prevalent problem that is influenced by students’ age, gender, and social class as indicated by maternal education.

Validation of the Brief Screen for Depression in a Jamaican cohort

Research on depression in Jamaicans has been limited by the absence of a psychometrically sound measure of depression. This project attempts to rectify this problem by exploring the concurrent and discriminant validity of the Brief Screen for Depression (BSD) using a sample of 244 students attending the University of the West Indies, Mona, Jamaica. Participants were administered the BSD along with the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression scale (CES-D) the University of California at Los Angeles (UCLA) Loneliness Scale - Revised, (UCLA-R) and the Responding Desirably on Attitudes and Opinions scale (RD16). Overall, the BSD was found to have an acceptable level of concurrent validity as evidenced by high correlations with scores on the BDI (0.64) and the CES-D (0.62), and an acceptable level of discriminant validity as demonstrated through moderate correlations with the UCLA Loneliness Scale (0.40). In addition, the BSD was found to possess a moderate degree of sensitivity in identifying individuals who may be experiencing clinically significant symptoms of depression.

A Brief Report on the Association of Academic Tracking With Depressive Symptoms in High School Students in Jamaica

There has been limited research on academic tracking and depressive symptoms among high school students in Jamaica. Students enrolled in Grade 10 of traditional and nontraditional high schools in Jamaica were surveyed (N = 278). Students completed the Beck Depression Inventory—II along with several other measures. Seven in every 10 students reported some symptoms of depression. Results of hierarchical regression analyses controlling for social class found that students attending nontraditional high schools reported significantly higher Beck Depression Inventory—II depression scores than students in traditional high schools. This was particularly true for male students attending nontraditional high schools. The strong emphasis on academic achievement and the tracking of students may have a negative association with Jamaican students’ depressive symptoms.

Associations amongst disease severity, religious coping and depression in a cohort of Jamaicans with sickle-cell disease

The purpose of this study was to investigate the relationship between disease severity (sickle-cell type and hospital, emergency room and clinic emergency visits (CEU)), religious coping (positive and negative) and depression. This was accomplished through secondary analysis of a data set based on a Comprehensive Sickle Cell Standardized Questionnaire compiled by a multidisciplinary team of professionals from Duke University Medical Centre, and administered to persons with sickle-cell disease being treated at the Sickle Cell Unit on the University of the West Indies Campus between November 2008 and January 2009. Disease severity was not a good predictor of depression within the population. On the other hand, depression was found to correlate with positive and negative religious coping, such that increases in the former were associated with decreases in depression scores; while the reverse was noted for the latter (negative religious coping). The results shed light on issues that could possibly impact the treatment plan for such individuals.

Screening for postpartum depression

Postpartum depression, a potentially serious public health problem can be effectively treated. With the implementation of universal screening with a standardized, self-administered screening tool, in conjunction with appropriate education and training of health care providers to increase awareness of this problem and to impart greater diagnostic suspicion, identification of and early intervention for PPD can be facilitated. There is need for increased collaboration between Obstetric and Consultation Liaison Psychiatric Services, with particular emphasis on the prevention of psychiatric morbidity associated with pregnancy, thereby improving the quality of life for and interaction between mother and child. The establishment of a true Liaison Psychiatric Service dedicated to pregnancy and the postpartum period, with a Psychiatrist employed by the Obstetric Services, may be of great value.

Validation of the Kutcher Adolescent Depression Scale in a Caribbean student sample

BACKGROUND Research on depression among Caribbean children has been limited by a lack of valid and reliable measures. We addressed this problem by exploring the internal consistency reliability and the concurrent and discriminant validity of the Kutcher Adolescent Depression Rating Scale (KADS) among a wide cross-section of the student population attending elementary schools in Jamaica and Barbados. METHODS Students enrolled in grade 6 in a cross-section of schools in Jamaica and Barbados were invited to participate in the study. Schools included a balance of government-funded public schools and privately funded preparatory schools. All schools that were invited to participate accepted, and all grade 6 classrooms in each school were sampled. The following instruments were administered to the students during the fall semester of 2015: KADS, Adolescent Depression Rating Scale (ADRS), major depression disorder subscale of the Revised Childrens Anxiety and Depression Scale (RCADS), and state and trait anxiety visual analogue scales. RESULTS In total, 759 children (376 girls [49.5%] and 363 boys [47.8%]; in 20 cases [2.6%], sex was missing) with a mean age of 10.7 (standard deviation 0.66) years (median 11.0 yr) took part in the study. Overall, the KADS had an acceptable degree of reliability (α = 0.76). The instrument had reasonably good concurrent validity, as evidenced by strong correlations with scores on the ADRS (r = 0.62) and the major depression disorder subscale of the RCADS (r = -0.61). It had acceptable discriminant validity, as shown through low correlations with the state and trait anxiety visual analogue scales (r = 0.21 and 0.18, respectively). This pattern of results suggests that a large part (37%) of the variance underlying the KADS assesses depression, and a smaller degree of the variance (3%-4%) measures a conceptually similar but distinct concept. INTERPRETATION The KADS is a reliable and valid measure for assessing depressive symptoms among Jamaican and Barbadian elementary school students. The sample may not be representative of all Caribbean children.

Psychopharmacological Options in the Management of Lupus Cerebritis: A Case Report

The purpose of this paper is to report a case of a 19 year old woman who presented with prominent hyperactive delirium and Systemic Lupus Erythematosus (SLE). The psychiatric drug treatment and rational for its usage are discussed. This case illustrates the importance of differentiating between the psychiatric manifestations of chronic high dose steroid use and a psychosis secondary to brain involvement of SLE. Lupus cerebritis should be included in the provisional diagnosis of the young woman with acute onset of psychosis and should be carefully differentiated from a psychotic disorder especially if the patient has no clear period of premorbid psychiatric pathology or a genetic predisposition for a primary psychotic disorder.