Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Suboptimal medication adherence is one of the major reasons for treatment failure among patients with acne vulgaris. Motivating patients to adhere to treatment, especially during the maintenance phase, remains a challenge. Although the literature on medication adherence in the acne vulgaris patient population is sparse, the available literature on patients with dermatologic and nondermatologic disorders suggests that a multifactorial approach, combining nonpharmacologic interventions and effective, well tolerated, and simplified drug regimens, appears to be associated with the greatest success. Furthermore, it is important to evaluate the patient for underlying affective disorders (e.g., depression) that can undermine adherence. The dermatologist can play a major role in enhancing patient adherence by prescribing adherence-enhancing therapeutic regimens and by forming a therapeutic alliance with patients.
 ...
PMID:How do you foster medication adherence for better acne vulgaris management? 1467 72

Androgenic-anabolic steroids (AAS) are synthetic derivatives of the male hormone testosterone. They can exert strong effects on the human body that may be beneficial for athletic performance. A review of the literature revealed that most laboratory studies did not investigate the actual doses of AAS currently abused in the field. Therefore, those studies may not reflect the actual (adverse) effects of steroids. The available scientific literature describes that short-term administration of these drugs by athletes can increase strength and bodyweight. Strength gains of about 5-20% of the initial strength and increments of 2-5 kg bodyweight, that may be attributed to an increase of the lean body mass, have been observed. A reduction of fat mass does not seem to occur. Although AAS administration may affect erythropoiesis and blood haemoglobin concentrations, no effect on endurance performance was observed. Little data about the effects of AAS on metabolic responses during exercise training and recovery are available and, therefore, do not allow firm conclusions. The main untoward effects of short- and long-term AAS abuse that male athletes most often self-report are an increase in sexual drive, the occurrence of acne vulgaris, increased body hair and increment of aggressive behaviour. AAS administration will disturb the regular endogenous production of testosterone and gonadotrophins that may persist for months after drug withdrawal. Cardiovascular risk factors may undergo deleterious alterations, including elevation of blood pressure and depression of serum high-density lipoprotein (HDL)-, HDL2- and HDL3-cholesterol levels. In echocardiographic studies in male athletes, AAS did not seem to affect cardiac structure and function, although in animal studies these drugs have been observed to exert hazardous effects on heart structure and function. In studies of athletes, AAS were not found to damage the liver. Psyche and behaviour seem to be strongly affected by AAS. Generally, AAS seem to induce increments of aggression and hostility. Mood disturbances (e.g. depression, [hypo-]mania, psychotic features) are likely to be dose and drug dependent. AAS dependence or withdrawal effects (such as depression) seem to occur only in a small number of AAS users. Dissatisfaction with the body and low self-esteem may lead to the so-called 'reverse anorexia syndrome' that predisposes to the start of AAS use. Many other adverse effects have been associated with AAS misuse, including disturbance of endocrine and immune function, alterations of sebaceous system and skin, changes of haemostatic system and urogenital tract. One has to keep in mind that the scientific data may underestimate the actual untoward effects because of the relatively low doses administered in those studies, since they do not approximate doses used by illicit steroid users. The mechanism of action of AAS may differ between compounds because of variations in the steroid molecule and affinity to androgen receptors. Several pathways of action have been recognised. The enzyme 5-alpha-reductase seems to play an important role by converting AAS into dihydrotestosterone (androstanolone) that acts in the cell nucleus of target organs, such as male accessory glands, skin and prostate. Other mechanisms comprises mediation by the enzyme aromatase that converts AAS in female sex hormones (estradiol and estrone), antagonistic action to estrogens and a competitive antagonism to the glucocorticoid receptors. Furthermore, AAS stimulate erythropoietin synthesis and red cell production as well as bone formation but counteract bone breakdown. The effects on the cardiovascular system are proposed to be mediated by the occurrence of AAS-induced atherosclerosis (due to unfavourable influence on serum lipids and lipoproteins), thrombosis, vasospasm or direct injury to vessel walls, or may be ascribed to a combination of the different mechanisms. AAS-induced increment of muscle tissue can be attributed to hypertrophy and the formation of new muscle fibres, in which key roles are played by satellite cell number and ultrastructure, androgen receptors and myonuclei.
 ...
PMID:Effects of androgenic-anabolic steroids in athletes. 1524 88

This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Study methodologies, including case-control and cross-sectional surveys, have demonstrated psychological abnormalities including depression, suicidal ideation, anxiety, psychosomatic symptoms, including pain and discomfort, embarrassment and social inhibition. Effective treatment of acne was accompanied by improvement in self-esteem, affect, obsessive-compulsiveness, shame, embarrassment, body image, social assertiveness and self-confidence. Acne is associated with a greater psychological burden than a variety of other disparate chronic disorders. Future studies with a longitudinal cohort design may provide further validation of the causal inference between acne and psychosocial disability provided by the current literature.
 ...
PMID:Psychosocial impact of acne vulgaris: evaluating the evidence. 1533 75

The inflammatory stage of acne vulgaris is usually of greatest concern to the patient. A number of morphologically different inflammatory lesions may form that can be painful and unsightly. In 30% of patients, such lesions lead to scarring(1). Inflammatory acne and acne scarring can have significant psychological effects on the patient, including depression, anxiety, and poor self-image(2). Although inflammatory acne has been well characterized clinically, the mechanisms by which inflammatory lesions arise are still poorly understood. The human skin commensal bacterium, Propionibacterium acnes, has long been associated with inflammatory acne. This organism has been implicated over and above all of the other cutaneous microflora in contributing to the inflammatory response characteristic of acne. However, its precise role in the disease and its interaction with the human immune system remain to be elucidated.
 ...
PMID:Acne: inflammation. 1555 22

Acne, a chronic inflammatory disease of the pilosebaceous units of the face, neck, chest, and back, is the most common skin disorder occurring universally, with an estimated prevalence of 70-87%.(1) It is a pleomorphic disorder characterized by both inflammatory (papules, pustules, nodules) and noninflammatory (comedones, open and closed) lesions. Grading of acne is mandatory to determine the appropriate therapeutic strategy. Mild acne can be purely comedonal or mild papulopustular, with a few papulopustules present as well.(2) Moderate acne is characterized by numerous comedones, few to many pustules, and few small nodules, with no residual scarring.(2) In severe acne papulopustules are numerous, many nodules can be detected, inflammation is marked, and scarring is present.(2) Very severe acne can be recognized by sinus tracts, grouped comedones, many deeply located nodules, and severe inflammation and scarring.(2) Although acne does not affect health overall, its impact on emotional well-being and function can be critical and is often associated with depression, anxiety, and higher-than-average unemployment rates.(3) Effective treatment can dramatically improve a person's quality of life.
 ...
PMID:Guidelines for treating acne. 1555 32

There is currently considerable controversy regarding a proposed causal relationship between the use of isotretinoin and depression and suicide. A search was made of the MEDLINE, EMBASE and PsychINFO databases using the search terms 'isotretinoin', 'depression' and 'suicide'. Despite numerous case reports linking isotretinoin to depression, suicidal ideation and suicide, there is, as yet, no clear proof of an association. While isotretinoin, used to treat acne vulgaris, has not been demonstrated to be associated with depression or suicide, the possibility of a relatively rare idiosyncratic adverse effect remains. GPs have a role in the clinical application of these findings.
 ...
PMID:Isotretinoin, depression and suicide: a review of the evidence. 1572 Sep 36

This article discusses the psychological effect of acne vulgaris. It is shown that acne has significant effect on self-image and impacts quality of life. The impact of acne may be equivalent to that of asthma or epilepsy. Anxiety and depression and a reduction in social functioning are a consequence of this condition. Effective treatment results in improvement of quality-of-life measurement. Most of the data is gathered from case control studies. Further work, particularly prospective longitudinal cohort studies, needs to be performed to validate the impact of acne on quality of life. Acne severity grading should incorporate life quality scores to better establish the true impact of this condition on our patients in order to optimize therapy.
 ...
PMID:Psychosocial effects of acne. 1577 23

Isotretinoin (13-cis retinoic acid) is an effective treatment for severe cystic or recalcitrant acne vulgaris; however, concerns have been raised regarding its potential association with depression and suicidal behavior. We sought to explore the proposed relationship between isotretinoin use and the risk of depression and attempted and completed suicide in patients with acne vulgaris by performing a systematic literature search for studies reporting primary data on depression and suicidal behavior in patients treated with isotretinoin for acne vulgaris. Nine studies met the qualifying criteria for our analysis. Rates of depression among isotretinoin users ranged from 1% to 11% across studies, with similar rates in oral antibiotic control groups. Overall, studies comparing depression before and after treatment did not show a statistically significant increase in depression diagnoses or depressive symptoms. Some, in fact, demonstrated a trend toward fewer or less severe depressive symptoms after isotretinoin therapy. This decrease was particularly evident in patients with pretreatment scores in the moderate or clinical depression range. No correlation between isotretinoin use and suicidal behavior was reported, although only one retrospective study presented data on this topic. Although the current literature does not support a causative association between isotretinoin use and depression, there are important limitations to many of the studies. The available data on suicidal behavior during isotretinoin treatment are insufficient to establish a meaningful causative association.
 ...
PMID:Depression and suicidal behavior in acne patients treated with isotretinoin: a systematic review. 1609 97

Acne is a common disorder that may have a considerable psychologic impact including anxiety and depression. Depression and suicide occur frequently in adolescents and young adults. Although case reports suggest an association between isotretinoin and depression and suicide, more rigorous observational studies and epidemiologic studies, using different designs, have not shown any effect of isotretinoin use in increasing the occurrence of depression and suicide. It is prudent for the practitioner to continue to use isotretinoin to treat severe acne, while at the same time informing patients and their relatives that depressive symptoms should be actively assessed at each visit and, if necessary, referral to a psychiatrist and a discontinuation of isotretinoin should be considered.
 ...
PMID:Acne, depression, and suicide. 1611 43

Common acne, the most frequently occurring dermatosis of adolescence may lead to mentally unstable states, even depression, due to localization, its very prolonged duration, and in some patients leaving deforming cicatrices. The objective of the present paper is to answer the following questions: which treatment procedures were used for curing patients with different types of acne who were admitted to Department of Dermatology, Silesian Medical School, Katowice, Poland, in the years between 1991 and 2000. During 1991 to 2000, 206 patients were hospitalized with the diagnosis of acne. Mean age of patients was 25.51 years. The following types of acne were recognized: 108 patients--acne punctata, 82--acne conglobata, 4--acne fulminant, 4--papulous-pustular acne, 8--inverse acne, respectively. Analyses have been performed on the basis of case records related to patients admitted to Department of Dermatology, and registered at Outpatient Clinic in the years 1991-2000. It has been proven that there existed a substantial statistical difference between the age of patients affected by acne conglobata and inverse one and those suffering from acne conglobata and acne punctata. A significant difference in the age between the group of patients locally treated and the group of those cured by Roaccutane was observed. The results obtained point out that most frequently diagnosed cases: acne conglobata and acne punctata were treated by Roaccutane and locally, respectively. Results obtained revealed that the percentage of patients treated orally by retinoids showed a rising tendency, while a relatively constant percentage of local treatment methods (strongly marked in the late 1990s) and variable rate of administered antibiotics for curing acne was observed.
 ...
PMID:[Methods for treating various forms of acne in the years 1991-2000, Department of Dermatology, Silesian Medical School]. 1611 56


<< Previous 1 2 3 4 5 6 7 8 9 Next >>