Utilization of liaison psychiatric services in a general hospital in Jamaica [abstract]

OBJECTIVE: To identify the pattern and characteristics of Liaison Psychiatry refferals in the University Hospital of the West Indies over a six-month period. METHOD: A prospective cohort analysis was conducted on patients referred to the Liaison Psychiatry service between November 28, 2000 and May 28, 2001. Clinical and sociodemographic data were gathered by individual interviews and mental status examination and a DSM IV diagnosis made. RESULTS: Fifty-nine patients were referred with 28 (47.5 percent) males, and with a mean ñ Standard Deviation age of 39.42 ñ 15.92 years. Significantly more patients were referred from the medical wards (37, 62.5 percent) than from the surgical wards (14, 23.7 percent) or the gynaecological wards (8, 13.6 percent) (x2= 16.803, 2df, p<0.005). The main reason for referral was "strange behaviour" (31, 52.5 percent) and depression (13, 22 percent). There was no statistically significant difference between the referring wards and the reason for referral or diagnostic pattern. An equal number of patients were diagnosed with a psychotic disorder and unipolar depressive disorder (33.9 percent each). CONCLUSION: The medical wards of the University Hospital of the West Indies are the main agents of referral to the Liaison Psychiatric service with the majority of patients presenting with the majority of patients unipolar depressive or psychotic disorders. (AU)

Maternal moods predict breast-feeding in Barbados

This study was designed to identify psychosocial variables affecting early infant feeding practices in Barbados. The sample included 93 healthy women and infants born at the Queen Elizabeth Hospital who were extensively evaluated 7 weeks, 3 months, and 6 months after birth. Maternal moods were assessed with the Zung Depression and Anxiety Scales and the General Adjustment and Morale Scale. Feeding practices were evaluated using a questionnaire developed for this population. The prevalence of mild depression in this population was 16 percent at 7 weeks and increased to 19 percent at 6 months, whereas there were very few cases of moderate-to-severe depression. Disadvantaged environmental conditions, including less information-seeking by the mother, lower family income, and poor maternal health, were closely associated with increased symptoms of depression and anxiety in all women. However, significant predictive relationships between mood and feeding practices remained even when the effects of the home environment were controlled. Specifically, depressive symptoms at 7 weeks postpartum predicted a reduced preference for breastfeeding at current and later infant ages. Conversely, feeding practices did not predict maternal moods at later ages. These findings have important implications for public policy dealing with programs promoting breastfeeding. Early interventions designed to treat mild postnatal depression should be instituted early in the postpartum period to improve the chances for successful breastfeeding.(Au)

Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs

OBJECTIVE: The purpose of this study was to compare syndromes of parent-reported problems for children in 12 cultures. METHOD: Child Behavior Checklists were analyzed for 13,697 children and adolescents, ages 6 through 17 years, from general population samples in Australia, Belgium, China, Germany, Greece, Israel, Jamaica, the Netherlands, Puerto Rico, Sweden, Thailand and the United States. RESULTS: Comparisons of nine cultures for subjects ages 6 through 17 gave medium effect sizes for cross-cultural variations in withdrawn and social problems and small effect sizes for somatic complaints, anxious/depressed, thought problems, attention problems, delinquent behavior, and aggressive behavior. Scores of Puerto Rican subjects were the highest, whereas Swedish subjects had the lowest scores on almost all syndromes. With great cross-cultural consistency, girls obtained higher scores than boys on somatic complaints and anxious/depressed but lower scores on attention problems, delinquent behavior, and aggressive behavior. Although remarkably consistent across cultures, the developmental trends differed according to syndrome. Comparison of the 12 cultures across ages 6 through 11 supported these results. CONCLUSIONS: Empirically based assessment in terms of Child Behavior Checklist syndromes permits comparisons of problems reported for children from diverse cultures (Au)

Depression in the elderly

This was a cross-sectional study of elderly persons living in the institutional, rural, and urban settings. It was conducted to determine prevalence of depression and to determine the factors which may act as protective mechanisms against depression. Elderly males and females were chosen haphazardly from senior citizens clubs in Kingston and St. Andrew. The Golden Age Home in Kingston was the institution used for the selection of elderly, using the accidental chunk method. The study revealed that the highest prevalence of depression was in the institutional setting followed by urban and then rural areas. Young elderly were at greater risk of developing depression as were those with no income. The elderly who were not depressed were more likely to have adequate levels of privacy and live with children with whom they had satisfying relationships. These findings disclosed that there is a significant level of depression among elderly, and certain members of the elderly population should be clearly monitored for signs of depression. As well, programmes need to developed to cope with the emotional and economic needs of the elderly. (AU)