Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011551 (depersonalization)
 1,117 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper examines several clinical concerns about the shorter half-life benzodiazepine hypnotics from an epidemiologic perspective. It draws on data from (1) 1979 and 1990 comprehensive probability-based U.S. national household surveys of the medical use of psychotherapeutic medications; (2) a 1990 four-city community-based volunteer call-in survey of the beneficial and adverse effects of hypnotics; and (3) an analogous random-digit dialing telephone survey in the general population. The issues addressed are abuse liability, rebound, depersonalization/derealization, paranoid feelings, accidents/injuries, and the unexamined consequences of the target illness in assessments of benefit-risk. In populations representative of everyday outpatient practice, we found that (1) the abuse liability of benzodiazepine hypnotics with shorter and longer elimination half-lives was generally low and comparable; (2) prevalence rates for rebound were low and not differential for flurazepam, temazepam, triazolam, and OTC sleeping pills; (3) reports of a single or an occasional experience involving depersonalization/derealization or paranoid feelings were fairly frequent in normals, in insomnia patients prior to treatment, and in persons with untreated insomnia; (4) treatment-emergent rates of occurrence for these same symptoms were low and not drug-specific; (5) past-year prevalence rates for serious accidents/injuries were much higher for chronic untreated insomnia than for normal controls and most groups treated with psychotherapeutic medications. A high proportion of past-year users of hypnotics were satisfied with their medication and would take it again.
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PMID:New epidemiologic findings about insomnia and its treatment. 148 78

The dexamethasone suppression test (DST), the thyrotropin releasing hormone (TRH) test, and the ratio of plasma L-tryptophan to competing amino acids (L-TRP/CAA) were studied in relation to the 21 items of the Hamilton Depression Rating Scale (HDRS) in 123 depressed patients categorized according to DSM-III. The relationships between the biological data and the items or item clusters of the HDRS were assessed by multivariate analyses. The psychopathological correlates of increased post-dexamethasone cortisol and decreased thyroid stimulating hormone (TSH) responsivity to TRH were middle and delayed insomnia and weight loss. The symptom correlates of decreased availability of L-TRP to the brain were psychic anxiety, depersonalization, obsessions and paranoid symptoms. Core depressive symptoms, i.e. depression, loss of interest, feelings of guilt and suicidal thoughts, were not related to the biological markers.
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PMID:Symptom profiles of biological markers in depression: a multivariate study. 211 48

The study describes common symptoms of depression and age and sex differences in these symptoms in elderly Finns. The symptoms were assessed on the basis of the 22-item Hamilton Rating Scale for Depression (HRSD), and comparisons were made between the symptoms of those diagnosed as depressed and those diagnosed as not depressed in clinical investigations. The most common symptoms in depressed men were general somatic symptoms, initial insomnia, loss of interest in work and activities, middle insomnia, and depressed mood. In depressed women, the most common symptoms were psychic anxiety, general somatic symptoms, initial insomnia, loss of interest in work and activities, and depressed mood. In both these groups the lowest occurrences were found for compulsory symptoms, paranoid symptoms and depersonalization. The symptomatology was most severe in the oldest age group: depressed mood and many somatic symptoms were more common in depressed older male and female age groups than in younger groups. Sex comparisons showed that many symptoms were more severe in depressed women than in depressed men: depressed mood, feelings of guilt, psychic anxiety, somatic anxiety and diurnal variation of symptoms were more common in depressed women. Retardation was the only symptom that was more common in depressed men. Loss of libido did not belong to the symptomatology of depression in the oldest female age group, but in men and in younger female age group it could in some cases indicate occurrence of depression.
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PMID:Symptoms of depression in old people in Finland. 323 47

The prevalence of hallucinatory depression and symptoms and the social and health status of hallucinatory depressives were studied in a Finnish population aged 60 years or over. The prevalence was 2 per 1,000 for men, 3 per 1,000 for women and 2 per 1,000 for both sexes. Hallucinatory depressions represented 0.9% of all depressions both in men and women, and 7.7% of major depressions in men, 5.7% in women, and 6.3% in both sexes. The hallucinations included visual and hearing hallucinations. Delayed insomnia and depersonalisation were more severe in hallucinatory depressives than in nonhallucinatory major depressives, but initial insomnia was more severe in nonhallucinatory major depressives. Depersonalisation, paranoid symptoms and delayed insomnia were more severe in hallucinatory depressives than in all nonhallucinatory depressives, but initial insomnia was more severe in all nonhallucinatory depressives. The physical health and functional capacity of hallucinatory depressives were good, but they had suffered from social stress factors before the onset of depression. The results gave some evidence that hallucinatory depression in old age is not a clinical entity separate from other forms of major depression.
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PMID:Hallucinatory depression in the elderly: a community study. 326 72

Eighty-six patients suffering from nonpsychotic unipolar major depressive disorder, according to Research Diagnostic Criteria, were rated on a modified Hamilton Rating Scale for Depression (HRS). All completed the self-rating Beck Depression Inventory (BDI). Distal colon motility (dcm) studies, performed in all the patients, differentiated two types: low intestinal tone (low-IT) = 40 subjects, and high intestinal tone (high-IT) = 46 subjects. Low-IT depressed patients showed a statistically significant preponderance in the HRS items 'retardation', 'somatization', 'fatigability', 'hypochondriasis' and 'obsessional symptoms'. The high-IT depressed patients, on the other hand, showed preponderance in the items 'guilt', 'suicide', 'insomnia', 'agitation', 'anxiety psychic', 'loss of insight', 'depersonalization' and 'paranoid symptoms'. A positive correlation (r) was found between HRS- and BDI-mean total scores. In addition, a positive correlation (r) was found between HRS scores and distal colon tone in high-IT patients, although the same was not true for low-IT patients. Our results suggest the existence of two subtypes of depressive syndromes, distinguishable on the basis of distal colon motility profiles.
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PMID:Distal colon motility and clinical parameters in depression. 622 40

Using split sample discriminant function analysis on a series of 63 consecutive depressed outpatients, the authors identified several items on the Hamilton Depression Rating Scale that were associated with dexamethasone resistance (late and middle insomnia, retardation, somatic and psychic anxiety, and obsessive-compulsive symptoms), and several items that were associated with dexamethasone suppression (genital symptoms, somatic-general symptoms, hypochondriasis, early insomnia, and depersonalization). The accuracy of the classification function was 100% for the index split sample, 84% for the overall sample, and 72% for the other split sample. The implications of these findings are discussed.
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PMID:Depressive symptoms associated with dexamethasone resistance. 658 25

During a four-week open study, amoxapine (AX), a new antidepressant agent, was administered to seven patients with pseudoneurotic schizophrenia, seven with neurosis and another seven with schizophrenia, all having similar symptoms. The improvement ratio was 71.4% in the pseudoneurotic schizophrenia group, 57.1% in the neurosis group and 42.8% in the schizophrenia group. Through the application of rating instruments, improvements were observed in the pseudoneurotic schizophrenia group in such items as psychotic and psychoneurotic symptoms in the assessment through the Springfield Outpatient Symptom and Adjustment Index, somatic concern and blunted affect through the Brief Psychiatric Rating Scale, and depression and depersonalization through the Clinical Rating Scale. On the other hand, overall improvements were less seen in the items of the neurosis group and the schizophrenia group. Effective doses of AX were 30 to 75 mg/day in the three groups. Side effects were observed in four cases which included insomnia, tachycardia, palpitation and hypomanic state. There were no cases in which AX was discontinued because of the side effects as these symptoms were slight. AX is remarkable and characteristically efficacious in the pseudoneurotic schizophrenia, and this effectiveness is presumed due to its antidepressant and antipsychotic actions.
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PMID:Effects of amoxapine, a new antidepressant, on pseudoneurotic schizophrenia. 702 96

The therapeutic efficacy, utility and safety of bifemelane hydrochloride were studied in 52 elderly depressive patients. The drug was administered as a tablet containing 50 mg orally three times daily for 8 consecutive weeks. The final global improvement rating and global utility rating were respectively 80.8 and 73.1 percent for all patients. The improvement rates on the Hamilton depression rating scale (HAM-D) were more than 60% for depressed mood, guilt, suicide, middle insomnia, delayed insomnia, psychotic anxiety, gastro-intestinal symptom, hypochondriasis, depersonalization and derealization. The rates regarding global symptoms evaluated by the Psychoneurotic rating scale for doctor's use were more than 60% for tension, agitation, irritability and excitement, phobia, depression, hypochondria and nocturnal delirium in psychotic symptoms, and insomnia in addition to palpitation in somatic symptoms. A significant decrease was also observed in the symptoms covered by the Self-rating depression scale of Zung after treatment with this drug. There were no instances of side-effects, nor any abnormalities in laboratory tests, encountered throughout the trial. Therefore, bifemelane hydrochloride is of value for the treatment of geriatric depression.
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PMID:The effects of bifemelane hydrochloride on depressive illness of the elderly. 749 Jan 69

1. The authors examined the effect of total sleep deprivation (SD) in combination with nortriptyline in 20 patients with major depressive disorder (MDD). Patients underwent a 36-hour SD procedure followed by nortriptyline started on the evening after SD, with ratings for two weeks. 2. Eleven (55%) patients were responders; they showed a rapid and sustained remission after SD, whereas non-responders demonstrated the delayed results expected with nortriptyline. 3. High initial depression scores and absence of depersonalization were associated with response to SD, while being female and middle insomnia were associated with response to the combined regimen. 4. The combination of SD with antidepressants proves to be an effective and safe treatment modality.
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PMID:Sleep deprivation accelerates the response to nortriptyline. 841 98

Aging is a physiological process that shares many behavioral, biochemical and neuroendocrine phenomena with the pathophysiological situation of unresolved stress, as well as with a pharmacologically induced syndrome resulting from chronic benzodiazepine (BZ) consumption. Behavioral findings include symptoms such as drowsiness, ataxia, fatigue, confusion, weakness, dizziness, vertigo, syncope, reversible dementia, depression, impairment of intellectual, psychomotor and sexual function, agitation, auditory and visual hallucinations, paranoid ideation, panic, delirium, depersonalization, sleepwalking, aggressivity, orthostatic hypotension, and insomnia. Neuroendocrine findings include: central depletion of noradrenaline (NA), dopamine, adrenaline (AD), and serotonin (5-HT); reduction in the ratio of circulating NA/AD as well as platelet 5-HT and increase of AD, plasma free 5-HT and cortisol. These disturbances together with the increased platelet aggregability observed in the three groups are typical of unresolved-stress situations. Immunological findings include significant reduction of peripheral T lymphocytes (CD3, CD4, CD8) and the CD4/CD8 ratio, CD16 and gamma-delta cells. On the other hand, the three groups (elderly subjects, subjects faced with unresolved stress, and BZ consumers) show increase of the CD57 lymphocyte subset as well as natural killer cytotoxicity. Alterations of several biological markers have also been found, specifically in the oral glucose tolerance test, the intramuscular clonidine test, and the supine/orthostasis/exercise test. From a clinical point of view, the three groups appear to be more susceptible to the appearance and progression of many acute and chronic diseases (infectious and malignant diseases). As a result, chronic consumption of BZs should be avoided in both the elderly and subjects in unresolved-stress situations.
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PMID:Benzodiazepines: tolerability in elderly patients. 884 97


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