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

The steady rise in the promiscuous use of phencyclidine (PCP) as a "recreational" drug has recently gained nationwide attention because of the numerous violent and/or bizarre incidents caused by the use of this drug. Because the media often exaggerate reports of bizarre and violent behavior to make a "good" story, the potential PCP user may be tempted to ignore the media warnings. In the case of PCP, however exaggerated the story, a real danger does exist. So, despite numerous newspaper, radio and television warnings about the possible consequences of PCP use and abuse, the incidence of toxic reactions continues to climb. In many cases PCP is sold as other drugs, particularly THC, and in various colored capsules, tablets, liquids and crystals which may explain the increased usage despite the numerous warnings against its use. The advances in laboratory techniques and chemical processess have enabled the clandestine chemist to prepare relatively pure PCP and thus eliminate many of the toxic side effects due to impurities in the drug. In addition, 30 or more psychoactive PCP analogues have been developed and are starting to make an appearance on the street. PCP is perhaps the most potent psychotomimetic compound known at the present time and is capable of inducing a psychosis which is clinically indistinguishable from schizophrenia. The psychosis-producing effects of PCP are the most common toxic effects seen in hospital emergency rooms; but as the amount of PCP taken and/or the simultaneous involvement of other drugs, particularly barbiturates, occurs, severe medical problems (e.g., coma, seizures, respiratory arrest) begin to appear. Death from high doses of PCP or PCP plus other drugs does occur, but the principal cause of death from PCP abuse is due to trauma, homicide or suicide (usually of the bizarre or violent form). Young adult males, persons predisposed to mental illness and naive drug users appear to be the most susceptible to the adverse effects of PCP. The fact that chronic PCP users are starting to increase in number is mute testimony that not all users experience "bad trips" with PCP. Unfortunately for the user, however, this does not guarantee that the next trip will not be a bad one. The effects of chronic use seem to be twofold: severe depression with suicidal thoughts and numerous violent, agitated behavioral patterns. Neither seems to be a suitable alternative. At the present time there is not specific antidote for toxic PCP reactions and the prolonged psychosis induced in some cases does not appear to respond to the standard antipsychotic medications as quickly as do the functional psychoses. The major improvement from a medical standpoint is the development of more sensitive laboratory techniques to confirm the presence of PCP in body fluids. This advance has undoubtedly led to the apparent increase in the number of PCP cases reported by hospitals and to the accuracy of clinical diagnosis by medical, drug or law enforcement communities...
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PMID:PCP (phencyclidine): an update. 4 8

A number of drugs are traditionally blamed for causing depression: in general medicine, the antihypertensives, the oral contraceptives and the appetite suppressants; in psychiatry, the neuroleptics. The identification of iatrogenic depression is difficult methodologically, for two reasons: 1. Detection of the depression. 2. Linking convincingly that state of depression with the administration of a particular drug, given the presence of many non-pharmacological factors. The literature and the experience of clinicians provide fairly contradictory evidence, but an analysis of published work calls for the following observations: --the type and severity of depression are rarely specified;--a history of psychiatric disorder is commonly stressed;--the specific role of the disability caused by physical or mental illness and the need to use palliative rather than curative measures are usually underestimated;--biochemically, it is surprising that the effects which some of these drugs are known to have upon the cerebral amines do not cause more depression of mood. In fact, if we consider how widely the drugs incriminated are used, it is clear that real drug-caused depression is rather uncommon.
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PMID:[Iatrogenic depression (author's transl)]. 4 64

Actions of morphine include analgesia, sleep, euphoria, and depression of respiration. Transmitter or modulator substances in the brain that have actions similar to morphine may control these functions in man. This hypothesis proposes that enkephalin is a controlling neurotransmitter and its binding to opiate receptors determines mood state as well as influencing respiratory and sleep patterns. Lithium may act through modification of the opiate receptor affinity for an endogenous morphine-like substance. The theory predicts blocking action of naloxone in mania and in most drug-induced euphorias. It implies a new chemical pathophysiological basis for the phenomenology of mental illness.
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PMID:Peptide transmitters: a unifying hypothesis for euphoria, respiration, sleep, and the action of lithium. 5 53

The prevalence of depressive symptomatology was estimated in 154 patients attending a general out-patient clinic for the first time. The instrument used was Zung's Self-rating Depression Scale (SDS). The mean score on the SDS fell within the range of scores obtained by mildly depressed patients in previous studies. Even though many patients obtained scores corresponding to moderate or severe depression, non of the patients was referred to the psychiatric out-patient clinic located in the same hospital. The findings are discussed with respect to their diagnostic significance and the role of the general parctitioner in the management of patients with psychiatric disorder.
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PMID:Depressive symptomatology in patients attending a hospital-based general out-patient clinic. 10 44

In a sample of middle class individuals seeking martial and sexual counseling, 30% had diagnosable psychiatric illness, including 14% who had depressions at the time of interview. Those with psychiatric syndromes were significantly more likely to have prescribed psychoactive than those without these syndromes. Those with depression were more likely to have received diazepam and similar drugs than antidepressants. The same was true for those with other syndromes but in many of these cases, diazepam or other antianxiety agents seemed more appropriate. Thus, affective disorder might well be the psychiatric syndrome for which these drugs are most often inappropriately prescribed. Inappropriate treatment is a matter of concern in an illness which is potentially fatal.
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PMID:Appropriateness of drugs prescribed by primary care physicians for depressed outpatients. 16 81

A 41-year-old man with hypothalamic hypopituitarism (CRF-ACTH type) that persisted for 2 years after discontinuation of exogenous dexamethasone was treated with bilateral ECT for severe chronic depression. The depression improved only evanescently after 17 ECT sessions but the hypothalamic-pituitary suppression cleared completely and permanently, based on responses to four metyrapone stress tests in a 2-year follow-up period. ECT may be an effective treatment for persistent hypothalamic-pituitary suppression, even in the absence of a psychiatric disorder.
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PMID:Electroconvulsive therapy for iatrogenic hypothalamic-hypopituitarism (CRF-ACTH type). 22 58

The contribution of psychiatry to the evaluation and treatment of chronic pain is described. Psychological profiles may predict the outcome of surgery, while the psychiatric interview enhances understanding and may disclose formal psychiatric disorder. The measurement of pain is dependent on factors affecting pain complaint, and the psychiatrist can only accept the patient's experience. The reaction inhibition test and Chapman's Somatic, Anxiety, Depression (SAD) index provide ways of elucidating the functional versus organic dilemma. This is further understood by attention to the concepts of operant pain, the sick role, and illness behaviour. Psychotropic medications, psychotherapy, behaviour therapy, biofeedback, and distractional methods are the tools available to the psychiatrist. The patient's attitude and a combined physical and psychiatric approach are important for successful therapy.
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PMID:Chronic pain and the psychiatrist. 27 40

Ninety-three children with a diagnosis of depression were admitted to a residential children's unit over a six-year period. Background and clinical data were analysed in order to identify correlates associated with the disorder and to examine the concept of 'depressive equivalents'. The results indicated that parental loss, particularly loss of father, through death or desertion, psychiatric illness in the parents and stressful events in early childhood were important concomitants of the disorder. The study also supported the current literature on 'depressive equivalents' and their expression in childhood.
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PMID:Depression in childhood. 1: Clinical correlates of depressed children admitted for treatment to a residential program. 29 80

The problem of phobic anxiety is viewed in the context of the entire area of mental illness and of its epidemiology in the general population. The importance of the diagnosis of depression in phobic patients and its simultaneous treatment is emphasized. Psychotherapeutic and psychopharmacological methods are discussed and some results of recent trials of clomipramine (Anafranil) are reported. The author concludes that for the successful outcome of treatment an eclectic approach must be considered. The combination of behavioural techniques of desensitization along a hierarchy of anxiety-provoking situations, together with psychotherapeutic support and the simultaneous exhibition of the more specific antidepressant and antiphobic preparation clomipramine would offer the best hope of symptom relief.
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PMID:The management of phobic disorders using clomipramine (Anafranil). 32 31

This study focuses on physiological as well as psychological causes for psychiatric illness in renal transplant recipients. During an 18 month period 20 transplant recipients were evaluated in psychiatric consultation. A variety of psychiatric illnesses were noted with eight having a secondary depression diagnosed according to psychiatric research criteria. Case histories of these patients indicated that corticosteroid and meythyldopa therapy were significant etiologic agents in the development of the depressive syndrome. A step-wise approach to the management of patients with depressed mood or slowed thinking was proposed.
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PMID:Psychiatric illness and human renal transplantation. 34 83


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