Seclusion of a patient who has been admitted to an institution for psychiatric care is one of the possible interventions from a range of treatment and care strategies. Seclusion is used in different kinds of institutions, for example, in psychiatric hospitals, institutions for mentally handicapped persons, and judicial institutions. Seclusion is a controversial issue in the care of psychiatric inpatients, having provoked moral debate for several decades. Seclusion is associated with neglect and abuse; thus, the issue provokes emotional reactions on both sides of the debate. According to Mattson and Sacks.

War has being defined as an armed conflict between the states or countries to attain their purpose or defend their rights resulting in autonomous destruction of a state’s economy and subjecting people to physical and mental disturbance. There have been long debates on the post-war effects on the mental health of the people disturbing them socially, economically and cognitively.

Childbirth marks a critical time period in a woman’s life and is accompanied by a myriad of mental, physical, and social adjustments. Postpartum Depression (PPD) screening is by far the most established method of evaluating maternal wellness and the most current recommendation from the American Congress of Obstetricians and Gynecologists (ACOG) states that depression screening may be beneficial, despite its detractors and evidence that it does not ultimately affect outcomes or facilitate treatment engagement.

Background: Despite a long history of debate regarding subtypes of depression, there have been no attempts to examine subtypes of Postnatal Depression (PND) on the basis of symptom profiles.

Method: 413 mothers admitted to a residential program for unsettled infant behaviour completed a structured clinical interview for current and lifetime depressive and anxiety disorder diagnosis, self-report symptom measures and a range of self-report questionnaires relating to known depression risk/vulnerability factors. From this larger sample, a ‘depressed’ subsample (n = 159) was selected on the basis of interview and symptom-based questionnaire data.

Results: Five symptom-based factors were identified (‘cognitive features of depression’, ‘physiological features of anxiety’, ‘emotional / affective features of depression’, ‘cognitive features of anxiety’ and ‘fatigue’). Three clusters differing in terms of depressive symptom severity were identified, with the severest cluster also being characterized by elevated levels of anxiety. There were no differences between the clusters with respect to the type of symptoms reported or vulnerability / risk factors.

Conclusion: This study found no evidence of qualitatively distinct symptom-based subtypes of PND, therefore adding to the growing body of evidence suggesting that depression is a uni-dimensional construct.

Depression is a disorder characterized by the predominance of anhedonia and empty. On account of being a disorder with high prevalence and being a major cause of disability, this study was proposed that aimed to evaluate the effectiveness of pharmaceutical care through the pharmacotherapeutic follow-up and its correlation with quality of life. The patients were followed for eight months through telephone contacts and presidential meetings. The pharmacist evaluated depressive symptoms, adherence, quality of life and the need for pharmaceutical intervention. The instruments used were: Dader method, PHQ - 9, Beck Anxiety Inventory, Morisky Test et al. and Quality of life - SF-36. The data were analyzed in Bioestat 5.0 software using the Wilcoxon test, comparing the depressive symptoms, anxiety and quality of life before and after the Pharmacotherapeutic follow-up; and Pearson Correlation to determine if there is a correlation between depressive symptoms and quality of life. It obtained a statistically significant reduction in depressive symptoms (p-value: <0.0001) and anxious (p-value: <0.0001). There was a statistically significant improvement (p <0.05) in quality of life, demonstrated in all dimensions of SF-36. By performing the correlation between depressive symptoms and quality of life, it was observed that as depressive symptoms decrease the quality of life improves [r Pearson) = 0.6911, p = 0.0007]. They were carried out several pharmaceutical interventions to increase adherence, reduce treatment, abandonment and provide health education to patients. These interventions were carried out in the form of oral communication between pharmacist-patient and pharmacist-patient-doctor. The Pharmaceutical Care was effective in reducing depressive and anxiety symptoms and improve the quality of life of patients with depression.

Background: There are a couple of independent studies examining the effectiveness of telephone based therapy for the treatment of depression. However, up-to-date systematic reviews are lacking.

Objective: To evaluate the effectiveness of telephone-based therapy in the management of patients suffering from depression compared with the usual care.

Methods: A systematic review and meta-analysis of randomized controlled trials was conducted that compared telephone-based therapy with usual care for depression. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL (up to August 28, 2012) to identify eligible studies. The primary outcome was depression level at the end of the intervention. We pooled the mean depression level data from the studies using standardized mean difference using the random-effects model.

Results: A total of 11 studies met the inclusion criteria. Nine of these studies was considered for the pooled analysis. Comparison of depression levels in the immediate post-intervention period from the seven studies included in the pooled analysis was in favour of telephone-based therapy (standardized mean difference = -0.43; 95% CI: -0.74-0.12). In the remaining two studies, telephone-based therapy resulted in a statistically significant improvement in clinical outcomes and patient satisfaction. A longer duration of intervention and the presence of known medical comorbidity was positively associated with the effectiveness of telephone-based therapy. The overall effect was stable when studies with extreme characteristics were excluded. Intervention results were found to be sustained throughout the follow-up period.

Conclusion: Telephone-based therapy could be more effective than face-to face therapy in reducing the symptoms of depression. However, further research is required to establish the applicability and costeffectiveness of telephone-based therapy for routine depression management in health systems.

Study background: Tricyclic antidepressants are widely prescribed in the treatment of depression, although the mechanism of their therapeutic effects is poorly understood. Novel hypotheses suggest that antidepressants might act on synaptic plasticity and cytoskeletal remodeling. The aim of the present study was to evaluate in animals exposed to acute and chronic behavioural despair paradigms of depression, the treatment with amitriptyline, a widely used tricyclic antidepressant, on axon Growth-Associated Protein 43 (GAP43), a synaptic protein, in the mouse hippocampus.

Methods: The effect produced by peripheral administration of amitriptyline on hippocampal GAP43 expression was investigated by immunoblotting and immunofluorescence experiments.

Results: Animals exposed to the Tail Suspension Test (TST), a highly predictive model of antidepressant activity following acute treatment, did not show any variation in the GAP43 contents 6 and 24 h after testing. Acute administration of amitriptyline (10 mg/kg i.p.) increased hippocampal levels of GAP43. Conversely to TST, animals exposed to Unpredictable Chronic Mild Stress (UCMS), an animal model of depression, showed diminished GAP43 immunostaining in the hippocampal CA3 region. Chronic administration of amitriptyline not only counteracted the immobility induced by exposure to UCMS paradigm evaluated by the TST, but also reversed the decrease of the synaptic protein.

Conclusion: These findings suggest that depressive states might be associated to a reduction of synaptic protein expression. These synaptic changes might be involved in the mechanism of tricyclic antidepressant drugs and may contribute to their psychotherapeutic actions.

A promising area of research on depression is its interactions with the immune system, taking place within the field of psychoneuroimmunology. Indications of brain-immune system interactions exist at different levels of organizations: in animal studies, stressful events can disorganize the immune response and increase susceptibility or even mortality to experimentally induced tumours.

The impact of a “24-7” schedule in our general physiology, as well as our cognitive capacities, is a growing social concern. A disrupted circadian rhythm is inherent to many occupations in today’s society, namely airline pilots and crew-members, military and law enforcement personnel, medical staff or any rotating shift worker. This makes it a socially pervasive phenomenon, taking a toll on mental and general health. The comprehension of these mechanisms has been delayed by the difficulty to dissociate the effect of sleep abnormalities from circadian clock dysfunction and the lack of indisputable biological markers to define and diagnose a circadian disorder.

Employers may purchase evidence-based depression care management products to improve work outcomes of their depressed employees. Because employers have imperfect information about mental health products, they may rely on peers to evaluate benefits and costs of the products. We examined the impact of peer influence on employer appraisal of depression care products in a randomized controlled trial of marketing intervention for a high quality depression care product. Using a general form of the autocorrelation model in social network analysis, findings showed significant peer influences on how employers changed their appraisal of a depression care product.