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

This study examined the relationship of function-specific mental health measures, anxiety and depression subscales of the Mental Health Index (MHI), to psychiatric diagnoses of generalized anxiety disorder and major depression, as assessed by the Diagnostic Interview Schedule (DIS). Focusing on the clinical relevance of the MHI scales, we evaluated their performance in screening for DIS-diagnosable disorders in a sample of primary care patients with multiple unexplained somatic symptoms. Receiver Operating Characteristic curves and examples of sensitivity, specificity, and predictive value for different cutoff scores on the MHI are presented. When sensitivity is set at approximately 90%, positive predictive value exceeds 50%. Because the base rates of disorder in this sample are high, however, the screening measure has little independent usefulness. Similarly, cutoff scores yielding negative predictive value of approximately 90% fail to detect most of the true-negative cases. Future research should examine the use of these scales in other high-risk populations.
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PMID:The relationship of function-specific mental health measures to psychiatric diagnoses. 166 54

Twenty-one patients completed an intensive in-patient and out-patient group-based programme, to achieve withdrawal from long-term benzodiazepine dependence. By 6-month follow-up (post-withdrawal), eight patients (38%) had achieved a 'good' outcome. Generally, patients demonstrated moderate levels of psychiatric morbidity and depression in the pre-withdrawal phase; a diagnosis of a depressive disorder being associated with either an 'intermediate' or 'poor' outcome in comparison to patients receiving a diagnosis of anxiety disorder, who showed a predominantly 'good' outcome. Two patients committed suicide some time after withdrawal. Additionally, older patients fared less well than their younger counterparts. We conclude that maintenance benzodiazepine prescription, rather than withdrawal, may be the preferred treatment for some dependent patients. Furthermore, more data are required regarding the association, and causality, between depression and benzodiazepine withdrawal in long-term users.
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PMID:In-patient withdrawal from long-term benzodiazepine use. 167 99

The survival probability and causes of death before the age of 70 years were analyzed among 3302 inpatients with "pure" anxiety neurosis in Stockholm County, Sweden, who were tracked in case registries by means of automated record linkage during a 14-year period. When all patients with other psychiatric diagnoses and substance abuse were excluded, and marital status controlled for, there was a significant excess of deaths due to verified and undetermined suicides, ie, nearly one third of all deaths. These unnatural deaths preempted any excess in natural causes before the age of 70 years, such as cardiovascular disease. Treatment policy with regard to the use of anxiolytic drugs was not found to influence mortality. We concluded that the risk of suicide in inpatients before the age of 70 years with anxiety disorders may be as high as that in persons with depression or other diagnoses who require inpatient care.
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PMID:Excess mortality among 3302 patients with 'pure' anxiety neurosis. 167 84

The authors review both the preclinical and the clinical evidence for a role of serotonin (5-HT) systems in the regulation of drug-taking behavior. Animal studies show that pharmacologic treatments that enhance 5-HT function, notably selective reuptake inhibitors, reduce the self-administration of a variety of substances of abuse, including ethanol and cocaine. These treatments also tend to suppress consummatory behavior in general. In contrast to the broad spectrum of suppression following 5-HT enhancement, selective antagonists at the 5-HT3 receptor subtype have been reported to reduce ethanol but not cocaine or food intake. Although essentially limited to alcohol abusers, clinical studies seem to support the preclinical findings that a number of 5-HT reuptake inhibitors decrease interest in and intake of alcohol in mild-moderate ethanol-dependent individuals. Furthermore, other serotonergic drugs may show utility in the treatment of alcohol abuse. Another way in which serotonergic medications can be used in treating substance abuse is by the treatment of comorbid psychoactive illness for which such drugs are already known to be effective, e.g., depression and anxiety disorders.
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PMID:Opportunities for treatment of psychoactive substance use disorders with serotonergic medications. 175 60

A differentiation between the normal sensation of tiredness and the symptom "fatigue" is often difficult. Both are influenced by cultural, social, psychological and biological factors, which can lead--interactively--to symptom formation. Psychiatric disorders frequently associated with fatigue are all forms of depression, somatization and anxiety disorders, chronic pain states and drug abuse among many others. In at least 2/3 of patients with the fashionable chronic fatigue syndrome--formerly called neurasthenia--a psychiatric diagnosis can be made, most of them also suffer from many symptoms attributes to the autonomous nervous system. The clinical approach should be cautious avoiding diagnostic and therapeutic overaction and therapy should emerge from a diagnosis properly assessed.
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PMID:[Intense fatigue in humans. Psychosocial and cultural aspects]. 175 73

Fifty-five adolescent girls with conduct disorder from a psychiatric hospital were examined with a structured interview schedule and then reevaluated 2 to 4 years later. The majority also had depressive or anxiety disorders. The criteria used for conduct disorder were less weighted toward violent crime and differed from the criteria in DSM-III-R. Their outcome was poor; 6% had died a violent death, the majority had dropped out of school, one-third were pregnant before the age of 17, half were rearrested, and many suffered traumatic injuries. Diagnoses of depression or anxiety disorders at the index admission were not associated with a better outcome.
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PMID:Characteristics and outcome of hospitalized adolescent girls with conduct disorder. 175 47

1. Azapirones, selective partial agonists at the 5-HT1A receptor subtype, induce hypothermia and corticotropin (ACTH)/cortisol release as specific functional correlates of central 5-HT1A receptor activation. 2. Compared to controls, hypothermic and ACTH/cortisol responses to the azapirone ipsapirone are attenuated in patients with unipolar depression and panic disorder but not in patients with obsessive-compulsive disorder. The impaired thermic and neuroendocrine responses are associated with increased basal cortisol secretion in depressed patients but not in patients with panic disorder. 3. Chronic treatment with the selective 5-HT reuptake inhibitor fluoxetine decreases 5-HT1A receptor-mediated responses in patients with obsessive-compulsive disorder, while long-term treatment with the tricyclic antidepressant amitriptyline further decreases hypothermia following ipsapirone but has no effect on ACTH/cortisol release. 4. Alteration of the 5-HT1A receptor and/or its signal transduction pathways may play a role in the pathophysiology and treatment of anxiety disorders and depression.
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PMID:5-HT1A receptor responsivity in anxiety disorders and depression. 176 90

In an epidemiological population study 87 subjects were studied with home sleep recordings. Nineteen subjects had minor psychiatric disorders: six subjects had a minor depression, six subjects had a generalized anxiety disorder, and seven subjects had a mild vegetative discomfort syndrome. Syndrome profiles of the three groups, using the AMDP system, showed a significantly higher degree of insomnia in the anxiety group than in the depressive group. The mean rapid eye movement (REM) latency in the anxiety group was significantly longer than in the other groups, including normals. The study showed a slight tendency towards a reduced REM latency in the minor depressives, but no statistical significance was obtained.
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PMID:An epidemiological study of REM latency and psychiatric disorders. 177 25

The article reviews research and presents our results on the natural history of 2 forms of anxiety disorder, panic disorder and generalized anxiety disorder. Data from our epidemiological cohort study give evidence of premorbid anxiousness and overadaptation already in childhood. Distressing conditions in the family are more prevalent among subjects with anxiety disorders or major depression than among controls. Anxiety disorders frequently begin between age 20-30 and can be triggered by life events. The course is often characterized by a certain chronicity that manifests itself in residual symptoms and mild impairment in social roles even after many years and is frequently complicated with depression. The best predictors are severity and duration of symptoms, as well as comorbidity with depression. Future studies of the natural history should take into account these factors in multivariate approaches.
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PMID:The natural history of anxiety disorders. 177 98

Using standardized interviews 374 subjects randomly selected among people living in two villages in a mining district in Sardinia (Italy), were studied. Of these, 57 subjects (15.2%) were identified as 'cases'. Ten per cent of the sample was affected by a depressive syndrome and 4% by an anxiety disorder. Females were significantly more at risk for anxiety disorders, while a trend towards a major risk for depression emerged among middle-aged and elderly people. Of the sample 9.8% were taking benzodiazepines, with a significant over representation of females. Depressed subjects took benzodiazepines more frequently than anxious subjects, while the use of antidepressants was negligible.
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PMID:Prevalence of mental disorders in Sardinia: a community study in an inland mining district. 178 Mar 99


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