Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients

Background

Several studies have recognized that depression is a multidimensional construct, although the scales that are currently available have been shown to be limited in terms of the ability to investigate the multidimensionality of depression. The objective of this study is to integrate information from instruments that measure depression from different perspectives–a self-report symptomatic scale, a clinician-rated scale, and a clinician-rated scale of depressive signs–in order to investigate the multiple dimensions underlying the depressive construct.

Methods

A sample of 399 patients from a mood disorders outpatient unit was investigated with the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS), and the Core Assessment of Psychomotor Change (CORE). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate underlying dimensions of depression, including item level analysis with factor loadings and item thresholds.

Results

A solution of six depression dimensions has shown good-fit to the data, with no cross-loading items, and good interpretability. Item-level analysis revealed that the multidimensional depressive construct might be organized into a continuum of severity in the following ascending order: sexual, cognitive, insomnia, appetite, non-interactiveness/motor retardation, and agitation.

Conclusion

An integration of both signs and symptoms, as well as the perspectives of clinicians and patients, might be a good clinical and research alternative for the investigation of multidimensional issues within the depressive syndrome. As predicted by theoretical models of depression, the melancholic aspects of depression (non-interactiveness/motor retardation and agitation) lie at the severe end of the depressive continuum.     

Gathering Hopewell: Society, Ritual, and Ritual Interaction

Gathering Hopewell: Society, Ritual, and Ritual Interaction . Barbara Y. Butler. and D. Troy Case, eds. New York: Kluwer Academic/Plenum Publishers, 2005. 807 pp.     

Ritual and Social Change: Another Javanese Example

This paper was submitted for publication to American Anthropologist and in the usual manner was sent anonymously to three referees. The referees' coymerits are appended     

Alternating Ontologies: Exchange and Ritual in Anganen History

In this article I examine the changing social and historical context of exchange and ritual amongst the Anganen of the Southern Highlands Province of Papua New Guinea, a neglected theme in Highland ethnography. I focus primarily on the history of the incorporation of one spirit cult ritual, rimbu, and its relationship to the other major spirit cult, kabit, and just how these two cults inter-relate with two major categories of exchange—the ceremonial pig kill (yasolu) and the more ‘mundane’ forms of exchange associated with such events as marriage and death. It is the structural parallels, differences and interconnections between these two exchange categories and the two ritual types which have guided much of the historical development of local social structure until colonisation. This has resulted in a substantial, though not necessarily stable, integration of ritual and exchange which has been ‘played out’ over the approximately fifteen-year periods between yasolu pig kills. I argue that it is this set of oppositions that provides the structural basis for different potentialities for male capacity. On occasion these may be so graphically distinct that they may be called differing social ontologies, different baselines for being and action. Different aspects of rimbu were adopted from around the turn of the twentieth century until colonisation some 50 years later when both kabit and rimbu were abandoned under mission pressure. However, to talk about the adoption of rimbu and the changes to Anganen social structure which it helped to produce as ‘pre-colonial’ history is misleading to the extent that much of the impetus for change was bound up in the efflorescence of trade caused by the Australian pearling industry in the Torres Strait. I call this period ‘ante-colonial’ in order to highlight the impact of the Australians and the irony that what the Australians indirectly helped create, rimbu as a central feature to Anganen social life, was destroyed with the direct colonial presence and missionisation.     

The Campus Tour: Ritual and Community in Higher Education

This study examines the messages that a university transmits to prospective students during a particular ritual—the campus tour. Specifically, the article discusses the ways that members of a university communicate their expectations with respect to becoming contributing members of the academic community. Three community discourses serve as the theoretical foundation for the analysis. The conclusion discusses ways that rituals could be examined and modified to create multicultural and democratic communities.     

Painful Memories: Ritual and the Transformation of Community Trauma

This paper explores the question of how ritual can heal community pain or trauma. Drawing together recent insights into the ideological nature of healing with a focus on ritual process, I argue that in cases of social violence and healing, ritual's ability to assuage pain is linked to the ways in which it draws pain into the process of reconstructing memory. The argument is illustrated through an examination of how the Betsimisaraka of east Madagascar used rituals of cattle sacrifice to transform the pain they experienced during an anticolonial rebellion that took place in 1947.     

Ritual Opening and Individual Transformation: Rites of Passage at Esalen

Ritual manipulation of emotion can result in "psychic opening," a state in which the individual's defenses are suddenly lowered. An individual in this state is vulnerable and suggestible, and major shifts in his psychic configurations can occur. When ritualized psychic opening exists as a part of a cultural event-pattern for the purpose of inducing psychobehavioral transformation in individuals, the process can be considered as a type of rite of passage. An encounter/Gestalt workshop at Esalen Institute is discussed as an example of this process. The data show that the group setting itself has many liminal characteristics .     

Women and Migration: Anthropological Perspectives

Women and Migration: Anthropological Perspectives. Jacqueline Knorr and Barbara Meier. eds. Frankfurt: Campus Verlag, 2000. 268 pp.     

Ritual, Risk, and Danger: Chain Prayers in Fiji

Rituals that defuse immediate senses of danger can perpetuate senses of powerlessness. Ambiguous language used in defensive rituals can heighten people's senses of the risks they are confronting and also compel people to perform those rituals again in the future. In this article, I illustrate this argument by examining Fijian Methodist masu sema (chain prayers), which are conducted to defuse the dangers that beset society, including curses from demonic ancestors. I argue that Fijian cultural themes of present-day human powerlessness are generated largely by competition between Methodist and chiefly authorities. "Chain prayers" are attempts to negate the power of dangerous ancestors, but in requesting God's help, ritual participants cast themselves as powerless. Verbal ambiguity in chain prayers gives "demons" lives of their own, compelling their future circulation.     

Ritual and Myth in Odawa Revitalization: Reclaiming a Sovereign Place

Ritual and Myth in Odawa Revitalization: Reclaiming. Sovereign Place. Melissa A. Pflüg. with. foreword by Lee Irwin. Norman: University of Oklahoma Press, 1998. 280 pp.     

Long-Circulating Liposomes: Development and Perspectives

Abstract

Long-circulating liposomes can be prepared by coating liposome surface with a hydrophilic layer of oligosaccharides, glycoproteins, polysaccharides and synthetic polymers in order to make liposomes “invisible” for scavenger cells of the mononuclear phagocyte system. Incorporation of lipid-anchored poly(ethylene glycol) in liposome bilayer allows to prolong its circulation at least tenfold. Various designs of glycolipid- and polymer-based liposomes are presented, possible mechanisms of action are discussed; potential of these liposomes for drug targeting is presented.