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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several recent, large epidemiologic and family studies suggest important temporal changes in the rates of major depression: an increase in the rates in the cohorts born after World War II; a decrease in the age of onset with an increase in the late teenaged and early adult years; an increase between 1960 and 1975 in the rates of depression for all ages; a persistent gender effect, with the risk of depression consistently two to three times higher among women than men across all adult ages; a persistent family effect, with the risk about two to three times higher in first-degree relatives as compared with controls; and the suggestion of a narrowing of the differential risk to men and women due to a greater increase in risk of depression among young men. These trends, drawn from studies using comparable methods and modern diagnostic criteria, are evident in the United States, Sweden, Germany, Canada, and New Zealand, but not in comparable studies conducted in Korea and Puerto Rico and of Mexican-Americans living in the United States. These cohort changes cannot be fully attributed to artifacts of reporting, recall, mortality, or labeling and have implications for understanding the etiology of depression and for clinical practice.
JAMA 1989 Apr 21
PMID:Increasing rates of depression. 266 82

Widespread illicit anabolic steroid use has recently been reported. A review of available evidence suggests that elevations of serum levels of steroid hormones, including anabolic steroids, have profound psychological effects. Long-term, high-dose anabolic steroid use may lead to a preoccupation with drug use, difficulty stopping despite psychological side effects, and drug craving. Reductions in serum levels of steroid hormones appear to result in acute hyperadrenergic withdrawal symptoms that respond to steroid replacement or to agents that also ameliorate withdrawal symptoms in alcohol and opioid dependence. A delayed depression syndrome when serum steroid levels drop precipitously has been reported that appears similar to that observed in withdrawing cocaine-dependent individuals. We conclude that a proportion of anabolic steroid abusers may develop a previously unrecognized sex steroid hormone-dependence disorder and that treatment should be based on research into steroid effects on opioid and aminergic neurotransmission systems and relapse prevention.
JAMA 1989 Dec 08
PMID:Hooked on hormones? An anabolic steroid addiction hypothesis. 215 73

We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11,242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning.
JAMA 1989 Aug 18
PMID:The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. 229 18

The Medical Outcomes Study was designed to (1) determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and (2) develop more practical tools for the routine monitoring of patient outcomes in medical practice. Outcomes included clinical end points; physical, social, and role functioning in everyday living; patients' perceptions of their general health and well-being; and satisfaction with treatment. Populations of clinicians (n = 523) were randomly sampled from different health care settings in Boston, Mass; Chicago, Ill; and Los Angeles, Calif. In the cross-sectional study, adult patients (n = 22,462) evaluated their health status and treatment. A sample of these patients (n = 2349) with diabetes, hypertension, coronary heart disease, and/or depression were selected for the longitudinal study. Their hospitalizations and other treatments were monitored and they periodically reported outcomes of care. At the beginning and end of the longitudinal study, Medical Outcomes Study staff performed physical examinations and laboratory tests. Results will be reported serially, primarily in The Journal.
JAMA 1989 Aug 18
PMID:The Medical Outcomes Study. An application of methods for monitoring the results of medical care. 275 93

The relative risks for cancer morbidity and mortality associated with depressive symptoms were examined using data from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. The Center for Epidemiologic Studies Depression scale and the depression subscale from the General Well-being Schedule were used as predictors in this 10-year follow-up study of a nationally representative sample. No significant risk for cancer morbidity or mortality was associated with depressive symptoms with or without adjustment for age, sex, marital status, smoking, family history of cancer, hypertension, and serum cholesterol level. These data were also reanalyzed for subjects aged 55 years or older who were retraced by a second follow-up. Neither measure of depressive symptoms was a significant risk for cancer death during the 15-year follow-up interval. These results call into question the causal connection between depressive symptoms and cancer morbidity and mortality.
JAMA 1989 Sep 01
PMID:Depression as a risk for cancer morbidity and mortality in a nationally representative sample. 232 31

The Vietnam Experience Study was a multidimensional assessment of the health of Vietnam veterans. From a random sample of enlisted men who entered the US Army from 1965 to 1971, 7924 Vietnam and 7364 non-Vietnam veterans participated in a telephone interview; a random subsample of 2490 Vietnam and 1972 non-Vietnam veterans also underwent a comprehensive health examination, including a psychological evaluation. At the time of the study, the two groups of veterans were similar in terms of level of education, employment, income, marital status, and satisfaction with personal relationships. Certain psychological problems, however, were significantly more prevalent among Vietnam veterans than among non-Vietnam veterans. These included depression (4.5% of Vietnam veterans vs 2.3% of non-Vietnam veterans), anxiety (4.9% vs 3.2%), and alcohol abuse or dependence (13.7% vs 9.2%). About 15% of Vietnam veterans experienced combat-related posttraumatic stress disorder at some time during or after military service, and 2.2% had the disorder during the month before the examination.
JAMA 1988 May 13
PMID:Health status of Vietnam veterans. I. Psychosocial characteristics. The Centers for Disease Control Vietnam Experience Study. 283 30

Combined nitrate/beta-blocker/nifedipine therapy is commonly used to treat refractory angina pectoris. We have observed "paradoxical" myocardial ischemia in ten patients with refractory angina (seven receiving combined beta-blocker and nitrate therapy, and three receiving nitrate treatment alone) in whom nifedipine (mean dosage, 92 mg/day; range, 60 to 120 mg/day) induced a decrease in blood pressure, angina pectoris (10/10 patients), and ischemic ECG changes (7/10 patients). These ten patients, all of whom regularly reported angina within 20 to 30 minutes of nifedipine ingestion, were prospectively studied before and after usual nifedipine dose administration, while blood pressures, heart rate, and ECGs were recorded. Mean systolic BP fell from 109 to 94 mm Hg after nifedipine (P less than .001, paired t test); mean heart rate increased from 64 to 68 beats per minute (P less than .05); seven patients developed transient ECG changes (five with ST-T wave depression and two with ST-T wave elevation) during the hypotensive period. Nifedipine may provoke angina and myocardial ischemia in certain patients with refractory angina pectoris receiving concomitant beta-blocker and nitrate therapy.
JAMA 1985 Feb 22
PMID:Nifedipine-induced hypotension and myocardial ischemia in refractory angina pectoris. 285 6

Little information exists on the epidemiology of central nervous system side effects in patients taking antihypertensive medications. We examined prevalence rates of tricyclic antidepressant (TCA) use among a random sample (N = 143,253) of Medicaid recipients. The TCA use was compared for patients taking any of seven antihypertensive agents and for those prescribed insulin or oral hypoglycemic agents. Use of TCA was significantly higher in patients taking beta-blockers (23% over two years) than for patients taking hydralazine or hypoglycemics (both 15%) or methyldopa or reserpine (both 10%). Prevalence rate ratios revealed a risk of being prescribed a TCA of 1.5 (95% confidence interval, 1.4 to 1.7) for patients receiving beta-blockers relative to patients receiving hydralazine or hypoglycemics. beta-Blocker use may be an important cause of iatrogenic depression among hypertensive patients.
JAMA 1986 Jan 17
PMID:Increased antidepressant use in patients prescribed beta-blockers. 286 35

Cigarette smoking has been causally linked to coronary heart disease. To investigate the effect of smoking on the activity of ischemic heart disease, 65 patients with chronic stable manifestations of coronary disease and a positive exercise tolerance test underwent continuous ambulatory monitoring to quantify the amount of ischemic ST segment depression during daily life. Twenty-four smokers were compared with 41 nonsmokers for frequency and duration of electrocardiographic signs of ischemia during 24 hours. A total of 4,968 hours of ambulatory monitoring were analyzed. The frequency of episodes was three times as often (median) and the duration of ischemia was 12 times longer (median duration, 24 vs 2 min/24 h) in smokers than nonsmokers. This finding remained statistically significant when a number of potentially confounding factors were controlled by means of logistic regression. This study shows that patients with coronary artery disease who smoke have significantly and substantially more active myocardial ischemia during daily life than patients who do not.
JAMA 1989 Jan 20
PMID:Effect of smoking on the activity of ischemic heart disease. 290 79

Six adolescents, 12 to 15 years old, with insulin-dependent diabetes mellitus were discovered to be secretively taking extra insulin, not with the intent of improving metabolic control. Large discrepancies between reported and observed insulin requirements were noted. Psychosocial problems antedated the discovery of surreptitious insulin administration in all. Psychological testing and psychiatric evaluation revealed a variety of psychiatric conditions; depression was common. In two patients surreptitious insulin administration was believed to represent suicidal behavior. In others, it appeared to represent symptom substitution when use of other health-threatening behaviors such as recurrent ketoacidosis was made increasingly difficult through appropriate intervention. Surreptitious insulin administration may be one symptom of serious underlying psychiatric dysfunction in adolescents with insulin-dependent diabetes.
JAMA 1986 Dec 19
PMID:Surreptitious insulin administration in adolescents with insulin-dependent diabetes mellitus. 309 38


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