Depression is the most common of the affective disorders (disorders of mood rather than disturbances of thought or cognition); it may range from a very mild condition, bordering on normality, to severe (psychotic) depression accompanied by hallucinations and delusions. Worldwide, depression is a major cause of disability and premature death. Unipolar depression is commonly (about 75% of cases) non-familial, clearly associated with stressful life-events and accompanied by symptoms of anxiety and agitation; this type is sometimes termed reactive depression. Other patients (about 25%, sometimes termed endogenous depression) show a familial pattern, unrelated to external stresses, and with a somewhat different symptomatology. This distinction is made clinically, but there is little evidence that antidepressant drugs show significant selectivity between these conditions.

Mindfulness derives from Buddhist practice and is fundamentally concerned with the development of present moment awareness. It is arguably one of the fastest growing areas of mental health research with the last decade witnessing a tenfold increase in the number of published scientific papers concerning the applications of mindfulness in mental health contexts. Given the demonstrable growth of interest into the clinical utility of mindfulness, this paper provides a: (i)timely and evidence-based appraisal of current trends and issues in psychopathology-related mindfulness research, and (ii) discussion of whether the empirical evidence for mindfulness-based interventions actually merits their growing popularity and utilization amongst mental health stakeholders. It is concluded that mindfulness-based interventions have the potential to play an important role in psychiatric treatment settings as well as in applied psychological settings more generally. However, due to the rapidity at which mindfulness has been taken out of its traditional Buddhist setting, and what is possibly evidence of media and/or scientific hype concerning the effectiveness of mindfulness, it is recommended that future research seeks to: (i) consolidate and replicate research findings, (ii) assess the maintenance of outcomes over longer time periods, (iii) investigate potential adverse effects, and (iv) fully control for potential performance bias in mindfulness-based intervention studies. It is further recommended that future research seeks to investigate the Buddhist position that sustainable improvements to mental and spiritual health typically require consistent daily mindfulness practice over a period of many years (i.e., they do not arise after attending eight two-hour classes with some self-practice in between).

Background: Mexican-American children have the highest rates of childhood obesity of any ethnic group. Because Mexican-American mothers follow the advice of abuelas (respected grandmothers in the Mexican-American community) more than that of health care providers, this pilot study evaluated the efficacy of using abuelas to deliver a motivational interviewing intervention to encourage Mexican-American mothers to limit their childrens low-nutritive simple carbohydrate intake. Specific questions were whether or not 1) abuelas could deliver a motivational interviewing intervention, 2) abuelas could recruit and retain participants, and 3) mothers altered their attitudes/beliefs, perceived norms, perceived behavioral control (self-efficacy), intent and behavior of limiting their childrens low-nutritive simple carbohydrate intake. Methods: Two abuelas were recruited and trained to deliver a motivational interviewing intervention. The abuelas recruited 6 mothers to participate in the study. Assessments and interventions occurred at baseline and 1 month. Attitude/beliefs, perceived norm and perceived behavioral control (self-efficacy) were measured using sub-scales of the Healthy Diet Survey, intent was measured using an Intent Questionnaire, and behavioral change was assessed using a short-form food frequency questionnaire. A Wilcoxon test (a=0.05) was used to evaluate changes in responses between baseline and 1 month. Results: The abuelas were successfully trained in motivational interviewing and reliably delivered the intervention. The abuelas recruited 6 mothers and all 6 participated through the entire study. All mothers felt it was important to limit their childrens low-nutritive simple carbohydrate intake (M=9.83, SD=.408) and scored their readiness to change as highly or extremely likely. Confidence in their ability to limit their childrens low-nutritive simple carbohydrate intake increased (z=-2.041, p=.041) between baseline (M=6.33, SD=1.97) and 1 month (M=9.67, SD=.82) for 5 of the mothers. The sixth scored her confidence as 10 (the maximum) at both assessments. Responses to the food frequency questionnaire suggest a trend towards limiting their childrens low-nutritive simple carbohydrate intake. Conclusions: This study demonstrated that recruitment, retention, and program delivery using abuelas were successful and the results suggest a trend towards mothers limiting their childrens low-nutritive simple carbohydrates.

Objective: Several studies have examined the correlation of either Post-Traumatic Stress Disorder (PTSD) or depression to chronic pain and disability and yielded varying and sometimes contradicting results. The objective of this study was to investigate this correlation and the possible additive effect of PTSD and depression on pain and functional disability. Methods: All patients evaluated in the Chronic Pain Clinic completed a pre-assessment questionnaire that included Visual Analogue Scale (VAS) scores for pain, Brief Pain Inventory (BPI), and pain interference with daily functioning. We also assessed level of depression and presence of PTSD. We then performed statistical analyses using Pearsons correlation to compare the correlations in PTSD group versus non-PTSD group. Results: We examined 182 patients presenting to the Durham VA Medical Center Chronic Pain clinic. The correlation between depression and pain severity in patients with PTSD is 0.43 (p < 0.0048) while the correlate in those without PTSD is 0.45 (p < 0.0001). The correlation between depression and pain interference with daily functioning in patients with PTSD is 0.62 (p < 0.0001) versus those without PTSD is 0.66 (p < 0.0001). Conclusion: This study suggests significant correlation between pain and depression, both in patients with and without PTSD. PTSD did not have an additive effect on that correlation of depression with pain. Depression correlated stronger with pain interference than with pain severity. Abbreviations: PTSD: Post-Traumatic Stress Disorder; BPI: Brief Pain Inventory; VAS: Visual Analogue Scale; PHQ-9: Patient Health Questionnaire; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders; OIF: Operation Iraqi Freedom; OEF: Operation Enduring Freedom; PHQ: Patient Health Questionnaire.

We report the case of a 63 year-old man who presented with sudden-onset, severe headache. Work-up revealed a hemorrhagic pituitary macroadenoma. He then suffered sudden-onset aphasia and right hemiparesis. Further evaluation revealed left ICA occlusion. Emergent transsphenoidal resection of the tumor produced recanalization of the occluded ICA, but his neurological symptoms persisted. ICA occlusion following pituitary tumor apoplexy is a rare event that must be recognized early for optimal patient outcomes. We report the first case with demonstration of carotid recanalization after tumor resection, review the incidence of ICA occlusion due to pituitary tumors, describe the possible mechanisms, and recommend optimal treatment strategies.