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

The Dexamethasone Suppression Test (DST) was performed in 64 depressed inpatients, in 48 schizophrenics, and in 20 normal controls. Thirty-four percent of depressive inpatients were found to escape from dexamethasone suppression significantly higher than either schizophrenics (13%) or normal subjects (5%). Among subgroups, bipolar and unipolar endogenous depression patients had much higher abnormal rates for the DST (59% and 48%, respectively) than nonendogenous cases (8%). DST results were also found to be positively correlated with patients' Hamilton scores. These findings suggested that DST could be helpful in diagnosis, discrimination of subtypes, and in assessment of severity of symptoms. In 32 of the 64 depressed inpatients, urinary MHPG X SO4 excretion was determined and compared with 21 normal controls. Bipolar patients (n = 7) had less MHPG X SO4 excretion than unipolar endogenous patients (n = 16). Excretion was positively correlated with cortisol level at 17 hr after dexamethasone administration in 32 depressive inpatients, especially in the unipolar subgroup. A trend toward negative correlation, though not statistically significant, was found in bipolar depression between cortisol levels at 17 hr after dexamethasone administration and urinary MHPG X SO4 excretion. This may indicate that some differences in norepinephrine (NE) metabolism may exist between unipolar and bipolar depression, leading to differing correlations between deviation of central NE function and hypothalamus-pituitary-adrenal (HPA) axis in different subgroups of depression.
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PMID:Dexamethasone suppression test and urinary MHPG X SO4 determination in depressive disorders. 360 15

A follow-up of 1593 Iowans with major affective disorder showed excessive mortality from unnatural causes in primary and secondary depression, and bipolar depression, but not mania, compared with age- and sex-matched controls from the general population. Excessive death from natural causes was found in women with secondary unipolar depression and bipolar depression and in manics (men and women combined) who had concurrent organic mental disorders or serious medical illnesses. Natural death was not excessive in the absence of these conditions. We conclude that excessive natural death reported in psychiatric patients is due to complicating physical disorders and not to the primary psychiatric disorder per se, whereas excessive unnatural death is due to the psychiatric disorder. Also, psychiatrically ill persons are probably referred for hospitalization more frequently when complicating physical disorders are present. Finally, we conclude that mortality patterns were similar in patients with primary and secondary unipolar depression, but bipolar patients were at lower risk for unnatural death than were unipolar patients.
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PMID:Is death from natural causes still excessive in psychiatric patients? A follow-up of 1593 patients with major affective disorder. 368 Dec 78

The response of depressive symptoms to ECT was studied in 58 subjects who met DSM-III criteria for major depression. For data analysis, the sample was divided by diagnosis into categories of primary unipolar depression, bipolar depression, and secondary depression. Only 56% of the secondary depression group had a partial or complete remission of depressive symptoms, but 91% of the primary unipolar group and 100% of the primary bipolar group improved. Subdividing the secondary depression group by primary diagnosis revealed a differential response, with alcoholism and schizophrenia having the most favorable outcomes.
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PMID:ECT in primary and secondary depression. 371 Oct 27

There are five categories of psychiatric disorders in DSM-III that embrace depressive moods: adjustment disorder with depressed mood (group 1), bipolar depression (group 2), major depression (group 3), dysthymic disorder (group 4), and atypical depression (group 5). A large sample of patients seen in a metropolitan university psychiatric referral center, with these categories as primary diagnoses in axis I, constitute the subjects studied (N = 2988). The study includes a comparison of the cross-sectional clinical properties of these patients, including an inventory of psychopathological symptoms, entries in axes II to V (i.e., as described in DSM-III, plus a sixth axis measuring current adjustment) and immediate dispositions rendered by clinicians. This study addresses the descriptive validity of DSM-III diagnostic categories of depression. A clustering of depressions based on a continuum of severity is uncovered as well as unique features of certain subtypes that point to categorical aspects of DSM-III mood disorders. The nature and implication of these findings are discussed.
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PMID:Descriptive validity of DSM-III depressions. 376 Aug 47

Cerebral metabolic rates for glucose were examined in patients with unipolar depression (N = 11), bipolar depression (N = 5), mania (N = 5), bipolar mixed states (N = 3), and in normal controls (N = 9) using positron emission tomography and fluorodeoxyglucose F 18. All subjects were studied supine under ambient room conditions with eyes open. Bipolar depressed and mixed patients had supratentorial whole brain glucose metabolic rates that were significantly lower than those of the other comparison groups. The whole brain metabolic rates for patients with bipolar depression increased going from depression or a mixed state to a euthymic or manic state. Patients with unipolar depression showed a significantly lower ratio of the metabolic rate of the caudate nucleus, divided by that of the hemisphere as a whole, when compared with normal controls and patients with bipolar depression.
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PMID:Cerebral metabolic rates for glucose in mood disorders. Studies with positron emission tomography and fluorodeoxyglucose F 18. 387 49

In this review of depression research the author has focused the attention on twin and adoption studies, although problems of classification, epidemiology, and biological and environmental factors related to depression are also touched upon. It is being noted that the available studies in the area are few, the number of twins in the various samples is small and the diagnostic classifications vary. Of particular interest are the results presented by Bertelsen et al. because of the large systematic sample. A summary of the studies that are based upon sampling through twin registers, i.e. the Scandinavian investigations, employing a relatively strict concept of manic depressive psychosis (bipolar disorder), gives a mean concordance of 50% in MZ twins and 15% in DZ twins. Whereas genetical factors seem to play a significant role in the etiology of severely depressed subjects, there is no evidence that hereditary factors are of importance in the neurotic or reactive depressions, since concordance is low in both MZ and DZ. The available adoption studies are also few and replications are definitely necessary before one can arrive at firm conclusions. Mendlewicz & Rainer reported more psychopathology of an affective nature in the biological parents of the adoptees with bipolar illness than in the social parents. In contrast, von Knorring et al. did not observe an increase in affective psychopathology in the biological parents of adoptees with affective disorder. Noteworthy is the excess of affective psychoses in the social parents. The author holds the view that any speculation with regard to genetic transmission is premature. Although the findings from the various investigations are not unambiguous, twin and adoption studies support the notion that genetic factors play a considerable role in bipolar disorder, whereas non-bipolar depression is basically environmentally determined.
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PMID:Depression research: a review with special emphasis etiology. 387 92

Patterns of attachment were examined in normal and depressed mothers. Mother's diagnosis (bipolar, major unipolar, or minor depression, or no psychiatric disorder), self-reported current mood states, and affective behavior in interaction with the child were considered. A modified version of Ainsworth and Wittig's Strange Situation was used to assess attachment. Insecure (A, C, and A/C patterns) attachments were more common among children of mothers with a major depression (bipolar or unipolar) than among children of mothers with minor depression or among children of normal mothers. Insecure attachment was more frequent in children of mothers with bipolar depression than in children of mothers with unipolar depression. A/C attachments were associated with histories of most severe depression in the mother. In families in which mothers were depressed, depression in the father did not increase the likelihood of anxious attachment between mother and child. However, if mothers with a major affective disorder were without a husband in the household, risk of an insecure mother-child attachment was significantly increased. The mothers' expressed emotions (positive vs. negative) in interaction with their children in situations other than the Strange Situation, and independent of diagnosis, predicted patterns of attachment: mothers of insecurely attached children expressed more negative and less positive emotion. Mothers' self-reports of moods on the days they were observed were unrelated to attachment. Results are discussed in terms of the transmission of social and emotional disorders in relation to mothers' affective functioning.
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PMID:Patterns of attachment in two- and three-year-olds in normal families and families with parental depression. 404 51

Neuroendocrine abnormalities present in depressive illness and use of the dexamethasone suppression test (DST) in diagnosing depression are reviewed. The coexistence of neuroendocrine disturbances and depressive illness may be explained by a central nervous system neurochemical abnormality. Norepinephrine appears to inhibit hypothalamic corticotropin-releasing factor, thus decreasing ACTH secretion by the pituitary and, in turn, cortisol secretion by the adrenal glands. Thus, a deficiency in brain norepinephrine may lead to both depressive symptoms and increased adrenal cortisol production. Episodes of cortisol secretion are longer and more frequent in depressed patients, and the circadian rhythm of cortisol release is altered. Dexamethasone does not suppress plasma cortisol levels in depressed patients as compared with normal subjects. Abnormal DST results were obtained in 40-70% of inpatients and 20-50% of outpatients diagnosed as having unipolar primary depression or major depressive illness. The incidence of abnormal DST results in most nondepressed psychiatric patients is comparable with that in normal subjects. DST results do not distinguish between unipolar and bipolar depression but may differentiate primary from secondary depression. Depressed patients with abnormal DSTs responded positively to drug treatment. DST nonsuppressors responded more favorably to norepinephrine-reuptake blockers, while DST suppressors preferentially improved with serotonin-reuptake blockers. Normalization of DST response has been associated with clinical improvement. Certain drugs, a number of psychiatric conditions, and several major physical illnesses may alter DST response. The DST is a commonly used and practical tool in evaluating depressive illness; however, its diagnostic value in depressed outpatients and elderly depressed patients is not clear.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dexamethasone suppression test in diagnosis of depressive illness. 614 96

5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured in the lumbar cerebrospinal fluid of 57 drug-free female patients with DSM-III diagnoses of major unipolar or bipolar depression (n = 14), schizophrenic disorder (n = 18), alcohol dependence (n = 13) and a group of other disorders (n = 12). Following lumbar punctures all patients received a dexamethasone suppression test. Fourteen patients had attempted suicide immediately before admission, 4 of them by violent methods. Severity of depression, independent of the diagnosis, was assessed in every patient on the 24-item Hamilton scale. No significant differences in means and variances of amine metabolite or postdexamethasone plasma cortisol concentrations were found among the diagnostic subgroups. Suicidal patients, and in particular those who used violent methods, tended to have lower 5-HIAA, but not HVA, in their CSF; they also more often had non-suppression of cortisol after dexamethasone. Since correlation matrices in the diagnostic subgroups were homogeneous, we calculated partial correlations for the total group: here suicide attempts but not depression, seemed to be significantly correlated with CSF 5-HIAA. Thyrotropin stimulation tests were administered to 6 patients: maximal TSH responses showed a borderline significant correlation with CSF 5-HIAA, and a significant correlation with severity of depression. Neither suicide nor postdexamethasone cortisol levels showed any relation to maximal TSH changes.
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PMID:Amine metabolites and neuroendocrine responses related to depression and suicide. 619 56

Plasma levels of gamma-aminobutyric acid (GABA) were determined in 34 clinically symptomatic patients with diagnosis of affective disorder and in 20 normal controls. Lowest levels were found in patients with familial pure depressive disease and in depression spectrum disease, while levels of patients with sporadic depressive disease, though significantly lower than control, were not as low. Plasma GABA levels in secondary depression and in bipolar depression were similar to control. Bipolar manic patients had plasma GABA levels that were significantly higher than control values.
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PMID:Plasma GABA in affective illness. A preliminary investigation. 645 50


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