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

In the past 5 years, we have witnessed the continuation of important trends in clinical research that began earlier in the decade. With regard to the treatment of specific disorders in children and adolescents, the most significant developments have been the examination of the tricyclics for the treatment of depression and the initiation of controlled studies for the treatment of Tourette syndrome. Unfortunately, the findings from the depression studies have been uniformly negative, and the results of research on both depression and tic disorders show a relatively high rate of placebo responsivity, which raises nagging questions about the role of case reports and open trials. Another important trend in pediatric psychopharmacotherapy is the search for substitutes for the neuroleptics. Potential candidates include agents such as lithium, naltrexone, fenfluramine, clonidine, and carbamazepine. The most underresearched disorders are a combination of the least common (e.g. schizophrenia, mania) and those that are apparently perceived as less serious (e.g. sleep disorders, certain anxiety disorders). Not surprisingly, the most studied disorder and treatment is hyperactivity and stimulant medication, respectively. Considerable progress has been made in understanding the social implications of the associated symptoms and their response to stimulant drugs, aided greatly by the use of direct observation procedures. Researchers are beginning to attend to the implications of comorbidity for assessing response to medication. There has been additional confirmation of efficacy of stimulant treatment for preschoolers and adolescents. Dose-response issues remain to some extent unresolved, the primary impediments being interpretive misconceptions associated with trend analysis, an overreliance on the syndromal perspective and too little attention to target behaviors and their clinical implications, and the failure to operationalize the minimal effective dose with regard to the normalization and supranormalization of target and collateral behaviors. Disagreement over whether hyperactivity is a learning or a behavior disorder (or both) and what academic underproductivity means clinically and socially is also impeding progress. With regard to developmental disorders, controlled studies indicate that fenfluramine and naltrexone are effective for managing associated symptoms in some individuals. However, given the limited amount of research on these agents, their status as clinically useful palliatives must be considered tentative.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pediatric psychopharmacotherapy: a review of recent research. 137 Nov 22

Neurofibromatosis is one of the most frequent autosomal-dominant hereditary disorders. Neoplastic, dysplastic and dysraphic lesions characterize the disease from the viewpoint of a neurologist. Depression, suicide, emotional instability, learning disability and behavior disorder are important aspects for the neuropsychiatric evaluation. Treatment of the patients will be facilitated by following the diagnostic criteria and by an interdisciplinary approach to diagnosis. The gene-molecular differentiation of NF I and NF II provides a basis for a more profound understanding of the disease which allows for more than just the clinical description. Cloning of the gene of NF I will give the possibility of predictive diagnosis of NF I. At present an indirect prenatal diagnosis of the genetic disorder is possible by flanking markers of NF I.
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PMID:[Neurofibromatosis: current clinical and molecular genetic aspects from the neurologic viewpoint]. 167 77

Trichotillomania is a behavioral disorder characterized by the recurrent failure to resist removing one's own hair from the scalp, eyelashes, eyebrows, beard, axillary areas or pubic area. Patients report an increasing sense of tension immediately before the impulse to pull out their hair and a sense of gratification or relief during the act. On initial presentation, patients may deny that their hair loss is due to such behavior. The diagnosis of trichotillomania is excluded when there is a preexisting skin disorder or when the behavior results from underlying psychosis. Behavior modification training, psychotherapy, hypnosis and family counseling are common treatment approaches. Antidepressant medications such as amitriptyline and clomipramine are effective when depression or an obsessive-compulsive disorder coexists.
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PMID:Trichotillomania. 204 45

In adolescents with chronic illnesses, the rate of behavioral disorders is 10% to 20% higher than that in their well peers. Rheumatoid arthritis, chronic renal disease, cystic fibrosis, cancer, and many other chronic illnesses constitute risk factors for behavioral disorders in adolescents. Because they are now living longer, more productive lives, adolescents with chronic illnesses are more often seen by their primary care physicians with behavioral disorders that can interfere with disease control. Risk-taking behaviors, difficulties with parents, noncompliance, depression, and isolation may all be manifestations of behavioral disorders. Parents and siblings may also be at risk for disorder. Particular constellations of family and individual characteristics may be associated with behavior disorder. So that these behaviors may be discovered as early as possible, it is important that the primary care physician conceptualize chronically ill adolescents and their families as "at risk."
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PMID:Psychiatric aspects of chronic disease in adolescence. 239 21

Recent years have seen significant advances in sleep disorders medicine, including effective treatments for chronic psychophysiological insomnia and obstructive sleep apnea syndrome; greater understanding of biological rhythms and of the nature of sleep in depression, including seasonal affective disorder; and the discovery of REM behavior disorder. The author reviews selected developments in the sleep disorders field over the last three years. Developments are presented in the framework of the diagnostic classification of the American Sleep Disorders Association, with emphasis on areas relevant to the practice of psychiatry.
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PMID:Sleep disorders: a selective update. 264 52

This study was designed to investigate behavioral and/or affective manifestations of stress in children with cystic fibrosis (CF). Most children with cystic fibrosis are compliant with treatment and are perceived as adapting to the stresses of their illness. Recent literature has proved this to be a misperception. The Child Depression Inventory and the Conner's Parent and Teacher Rating Scales are uncomplicated, valid tools to screen for the manifestations of stress in children and adolescents. Data generated from these tools will aid in: a) determining extent of depression and/or behavioral disorder in children with CF, b) establishing a base line for a projected study of developmental changes in reactions to stress in these children, and c) evaluating the psychotherapeutic interventions.
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PMID:Stress reactions in children with cystic fibrosis. 316 9

Thirty patients who committed wrist cuttings were divided into four groups according to the patients' psychiatric diagnosis: hysteria group, depression group, adolescent behavioral disorder group and other diagnostic group. In the hysteria group, wrist cutting was considered as an expression of the patients' unconscious intention to seek sympathy for themselves from other people. In the depression group, wrist cutting seemed to be a preliminary rehearsal of suicide. In the adolescent behavioral disorder group, internal conflicts in adolescence or discordance with the patients' parents seemed to be the chief motivations of wrist slashing. The core groups were the hysteria and adolescent behavioral disorder groups, and the peripheral groups were the depression group and others.
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PMID:A clinical study of 30 wrist cutters. 359 59

Because of the methodologic differences and limited data, the sensitivity and specificity of the dexamethasone suppression test in children are in question. In our study we used 0.5 mg of dexamethasone and a 4 p.m. cortisol sample to perform the DST on 32 hospitalized prepubertal children diagnosed by a structured interview (DICA) and DSM-III criteria. Cortisols differed significantly by ANOVA among principal diagnoses, with highest values in children with major depression (MDE) or separation anxiety (SAD) and lowest in those with behavior disorders (BD). Using 5.0 micrograms/dl as a cutoff value for positive DST, MDE and SAD are positively and BD negatively associated with positive DST results. Rating scales for anxiety and depression showed no significant association with cortisol level. We conclude that the DST in this sample shows excellent sensitivity but its specificity is limited to distinguishing depressed or anxious children from those with pure behavior disorder.
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PMID:Depression, anxiety and the dexamethasone suppression test in hospitalized prepubertal children. 365 43

Standardized teacher observations of 2,527 schoolchildren, selected at random for the revised Bristol Social Adjustment Guides were partitioned into four subsamples consisting of 797 5- to 10-year-old boys, 758 5- to 10-year-old-girls; 508 11- to 15-year-old boys, and 464 11- to 15-year-old girls, respectively. The children were observed by over 900 teachers and rated on 104 indicators of maladaptive behavior. Item scores for each age/sex sample were subjected to first- and second-order factor analysis, with varimax rotation yielding identical second-order models of behavior disorder across age and sex samples and somewhat different first-order models for each sample. Comparison of derived dimensions with dimensions emergent in other behavior problem research indicated considerable consistency. Moreover, the similarity of the factorially derived dimensions confirmed the cross-age and -sex generality of the syndromes known as unforthcomingness, hostility, and depression, and provided reasonable support for the utility of the syndrome of inconsequence, although it was apparent that inconsequence stands as more a composite of underlying factor dimensions reflecting hyperactive and attention-seeking behaviors. While the withdrawal syndrome found factorial support, its integrity was clearly specific to child age and sex.
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PMID:Child behavior disorders by age and sex based on item factoring of the revised Bristol Guides. 671 90

Cluster analysis was carried out on a sample of 92 patients with behavior disorders caused by degenerative, vascular, (alcohol) toxic, and other diseases of the brain. Rating variables of the AMDP system concerning mental state, social behavior, need for special care, sleep disorders, autonomic, physical, and neurologic symptoms were used in the absence of severe degrees of disordered consciousness such as stupor, coma, delirium tremens, and gross cerebral lesions. Results suggested the existence of four major groups of global cognitive impairment combined with neurasthenia and irritability in the first, hypochondriasis and depression in the second, withdrawal symptoms in the third, and severe disorientation in the fourth. At the seven-group level the groups were further distinguished according to severe withdrawal, amnestic syndrome, and dementia by various social and illness behaviors, sleep-wakefulness pattern, hypo- or hyperactivity, additional physical, and neurologic symptoms. Other minor types of organic brain syndromes were identified as individual cases by hallucinations or other circumscribed cognitive, psychomotor, affect, motivation, personality, and/or behavior disorder, symptomatic manic, or schizophreniform psychosis. The findings lent support to old classifications and new ones of organic mental syndromes (DSM-III).
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PMID:Classification of organic brain syndromes by cluster analysis. 742 21


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