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

Electroconvulsive therapy (ECT) is a safe, effective, valuable treatment for serious affective disorders (eg, major depression). Sometimes indicated for other, occasionally nonpsychiatric, medical conditions, ECT is a moderately complex procedure for which training is provided routinely during psychiatric residency. Although temporary confusion and amnesia are expected immediately after treatment, no reliable data suggest that permanent memory loss or cognitive deficit is caused by modern ECT. Indeed, because severe depression itself often causes both memory and cognitive deficits, ECT's remarkable therapeutic effectiveness is associated with long-term improvement in cognition, learning ability, and memory for many patients. Controversy over safety and effect on memory is fueled largely by public misinformation.
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PMID:Electroconvulsive therapy. 834 62

Nonanesthetic gases or vapors do not abolish movement in response to noxious stimuli despite partial pressures and affinities for lipids that would, according to the Meyer-Overton hypothesis, predict such abolition. We investigated whether nonanesthetics depress learning and memory (i.e., provide amnesia). To define learning, we used a "fear-potentiated startle paradigm": rats trained to associate light with a noxious stimulus (footshock) will startle more, as measured by an accelerometer, when a startle-eliciting stimulus (e.g., a noise) is paired with light than when the startle-eliciting stimulus is presented alone. We imposed light-shock pairings on 98 rats under three conditions: no anesthesia (control); 0.20, 0.29, and 0.38 times the minimum alveolar anesthetic concentration (MAC) of desflurane; or two nonanesthetics (1,2-dichloroperfluorocyclobutane and perfluoropentane) at partial pressures predicted from their lipid solubilities to be between 0.2 and 1 MAC. Desflurane produced a dose-related depression of learning with abolition of learning at 0.28 MAC. Perfluoropentane at 0.2-predicted MAC had the same effect as 0.28 MAC desflurane. 1,2-Dichloroperfluorocyclobutane at 0.5- to 1-predicted MAC abolished learning. Because nonanesthetics suppress learning but not movement (the two critical components of anesthesia), they may prove useful in discriminating between mechanisms and sites of action of anesthetics.
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PMID:Nonanesthetics can suppress learning. 856 35

In Parkinson's disease, mental disturbances frequently accompany the typical motor disorder. Subcortical dementia develops in 10 to 20% of patients. Contrary to the dementia of Alzheimer's type, the apraxia-aphasia-amnesia syndrome is uncommon. Depression and specific impairment of speech, visuospatial functions, and memory are present in an important proportion of patients. As a principal feature of cognitive disorder, deficit of executive functions can be characterised by decreased mental flexibility and inability to cope with changing external conditions. Further, psychiatric complications of pharmacological treatment of Parkinson's disease are briefly described. Finally, presumed pathophysiological mechanisms of cognitive dysfunction are characterized involving dopaminergic and non-dopaminergic changes and complex interactions on the subcortico-cortical level.
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PMID:[Mental dysfunction in Parkinson's disease]. 868 66

Flumazenil is safe and highly effective at reversing both benzodiazepine-induced sedation and amnesia. Bolus intravenous injection is the most appropriate technique when the goal is to fully reverse conscious sedation. Currently, the proven effective dose of flumazenil is 0.5 mg. For practical purposes, in this clinical setting, true resedation does not occur, and if the appropriate type and dose of agonist have been used, residual sedation is not a clinical problem. Concerns over acute anxiety reactions and precipitation of acute withdrawal syndrome in chronic benzodiazepine users remain theoretical and unsubstantiated by human data. Further clinical studies are required to determine whether the clinical practice of using flumazenil could include this group of patients. Depression of ventilatory responsiveness induced by benzodiazepines can be reversed effectively and promptly by flumazenil. Flumazenil must be immediately available as an emergency drug in any area where benzodiazepines are used. The clinical and economic benefits of elective and routine use of flumazenil have been demonstrated, but yet to gain widespread acceptance.
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PMID:Reversal of conscious sedation by flumazenil: current status and future prospects. 869 23

General anesthesia is a state of reversible, descending depression of the central nervous system that is induced by inhalational or intravenous drugs. Components of general anesthesia include hypnosis, analgesia, amnesia, and muscle relaxation. Recognized anesthesia providers include CRNAs and anesthesiologists. Improvements in pharmacologic agents, technology, and education of providers have sharply reduced morbidity and mortality associated with anesthesia.
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PMID:Clinical aspects of CRNA practice. General anesthesia. 875 93

Flunitrazepam (Rohypnol) is a benzodiazepine sedative-hypnotic that has generated significant media attention in the United States because of its abuse and its association with "date rape." A field investigation was conducted in south Texas to ascertain the nature and consequences of the abuse of flunitrazepam. In semistructured interviews, 66 subjects identified as flunitrazepam users were asked about their use of alcohol and other drugs and their sexual behaviors. Many subjects identified the drugs they had used as "roches" and gave descriptions of tablets of other benzodiazepines that were not consistent with flunitrazepam. Almost all subjects used other drugs, primarily alcohol and marijuana. Adverse consequences included amnesia, discoordination, automobile accidents, sexual assault, and respiratory depression or arrest. A significant proportion of the subjects reported that continued use was unappealing to them. The abuse of sedative-hypnotics in southeast Texas involves several benzodiazepines and is not limited to flunitrazepam.
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PMID:Abuse of flunitrazepam (Rohypnol) and other benzodiazepines in Austin and south Texas. 881 86

This study investigated the degree of association between four sets of predictor variables (demographic, injury-related, patient functioning, and caregiver functioning variables) and the criterion variable of long-term family functioning following severe traumatic brain injury (TBI). Thirty families participated in the study and a minimum of 3.5 years had elapsed since the time of injury. The mean length of post-traumatic amnesia (PTA) for the brain-injured individuals was 92.4 days. Data collection took place in the family home and both the brain-injured family members and primary caregivers were involved. Standard regression analyses revealed that two sets of variables accounted for a significant amount of variance in long-term family functioning. The largest amount of variance, 55% (44% adjusted), was accounted for by the caregivers' self-report variables which measured caregivers' depression, social support, and coping as well as caregivers' preceptions of patient competency. Overall, measures of severity of injury (PTA), residual neurobehavioural function, and adequacy of social support for caregivers proved to be reliable and significant indicators of family functioning. These findings are discussed with respect to their implications for service delivery and long-term provision of support for caregivers of severely brain-injured individuals living with their families.
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PMID:Indicators of long-term family functioning following severe traumatic brain injury in adults. 890 60

This article discusses the development and validation of a paper and pencil screening measure, the Structured inventory of Malingered Symptomatology (SIMS), designed to detect malingering. Test items were constructed from a combination of revised validity questions from existing instruments and characteristics of malingerers noted by existing research. Items were organized on one of five subscales by experienced clinical psychologists. College students (N = 476) were assigned to one of seven simulation conditions (i.e., psychosis, amnesia, neurologic impairment, mania, depression, low intelligence, and "fake bad") or an honestly responding group. All subjects were administered the SIMS, the F and K scales of the MMPI, 16PF Faking Bad scale, and portions of the malingering scale. The SIMS total score demonstrated the highest sensitivity rating (95.6%) for detection when compared with the other validity indices. Suggestions concerning further research using the SIMS as well as its potential utility in a complete evaluation process are discussed.
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PMID:Detection of malingering: validation of the Structured Inventory of Malingered Symptomatology (SIMS). 921 90

Our study objective was to assess health-related quality of life in survivors of acute lung injury (ALI) and to supplement generic and disease-specific questionnaires with findings from a focus group of ALI survivors. Six patients participated in the focus group, which revealed patient concerns with amnesia, depressed mood, avoidance behaviors, and a prolonged recovery period. Using a cross-sectional study design, 24 patients completed a questionnaire 6 to 41 mo after their lung injury. A total of 43% of the patients with ALI met criteria for depression; 43% had self-reported significant functional limitations, although 39% had minimal or no limitations. Significant respiratory and psychologic symptoms were reported in a quarter to a third of patients. There were large decrements in all domains of the SF-36 (a generic health-related quality-of-life instrument) in our sample compared with norms previously established for the general population. In addition, our patients had similar physical difficulties compared with previously studied patients with chronic medical illnesses but had more deficits in the social functioning and mental health domains. We conclude that long after lung injury, survivors have significantly lower health-related quality of life than the general population and are likely to have pulmonary and psychologic symptoms.
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PMID:Health-related quality of life after acute lung injury. 935 11

According to a brain model, encoding synapses record presynaptic axonal 'on-off' patterns as memory, and modulating synapses convert short-term memory into long-term memory by helping encoding synapses develop long-term potentiation and depression. Sensory organs conduct sounds and images as series of axonal 'on-off' patterns to encoding synapses of perceptive cortices where the patterns are recorded, computed, and rerouted to mesotemporal lobes, hippocampal formations and higher cortical centers. Mesotemporal lobes and hippocampal formations compute and convey the 'on-off' patterns to dorsomedial thalamic nuclei (circuit A), septal nuclei and mammillary bodies (circuit B), where the patterns are computed and conveyed to prefrontal lobes (circuit A) and anterior thalamic nuclei (circuit B) respectively. Anterior thalamic nuclei project axonal 'on-off' patterns to cingulate gyri that compute and convey the patterns to prefrontal lobes. Finally, prefrontal lobes send modulating axons to encoding synapses of perceptive cortices. Amnesia of Korsakoff's syndrome results from unilateral dysfunction of circuit A and contralateral dysfunction of circuit B, or bilateral dysfunction of either. The fact that there is more severe memory deficit in Alzheimer's disease than in Korsakoff's syndrome suggests that the former has a wider spread of failing synapses besides circuit A and circuit B.
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PMID:Two circuits to convert short-term memory into long-term memory. 942 1


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