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

Depression is one of the common threats to the mental health of the aged. The chief cause is the interiorization of the personality and the growth of inferiority feelings due to poor adjustment to retirement, widowhood, and/or chronic physical conditions. Psychotherapy for geriatric depression can be done by a primary care physician. Specific guidelines are given for the use of psychotherapy, psychotropics, and electroconvulsive therapy (ECT) with aged patients suffering from depression in conjunction with various complications (suicidal risk, chronic brain syndrome, hypochondriasis, and paranoia).
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PMID:Depression in the aged: dynamics and treatment. 75 36

One hundred elderly persons consecutively admitted to the Jewish Home and Hospital for Aged were studied during the first month after admission. Medical changes (chiefly cardiovascular) and behavioral changes were analyzed independently and then correlated. Four subgroups were found: 1) smooth adjustment and no significant medical changes (33 subjects); 2) smooth adjustment with significant medical changes (17 subjects); 3) severe adjustment problems but no significant medical changes (31 subjects); and 4) severe adjustment problems with significant medical changes (19 subjects). The aged persons most likely to have initial adjustment difficulties usually had poor capacity for interpersonal relationships, were socially isolated, were either single or divorced, had a dependent personality, had severe chronic brain syndrome, had a negative or ambivalent attitude toward admission, and often had been referred for psychiatric evaluation before admission. Major patterns of reaction were anxiety, aggressiveness and depression. Significant medical changes were more likely to develop in those with previous poor health who manifested an advanced state of confusion and depressive trends. Depression was related to concomitant medical changes rather than to the previous health status; it exacerbated the reaction to medical illness, which resulted in a decline in the level of functioning. In 58 per cent of the 50 patients with initial adjustment difficulties, a satisfactory level of adaptation was reached during the first six months after admission.
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PMID:Initial adjustment to a long-term care institution: medical and behavioral aspects. 81 53

A review and a reappraisal are presented of earlier data on cerebral circulatory and metabolic studies in normal active elderly men (Group I) of mean age 71 years, compared with normal young subjects of mean age 21 years, conducted at the National Institutes of Health, Bethesda, MD, U.S.A., during 1956-1958. There was no significant difference in the mean CBF and cerebral metabolic rate for oxygen (CMRO2) values between the two populations; i.e., these important parameters did not fall with chronological aging per se. There was significant depression in the mean cerebral metabolic rate for glucose (CMRG) value (by approximately 23%) in the aged compared with the young. Newer methods using positron emission tomography and appropriate isotopes have confirmed these findings in normal aging in human subjects and experimental animals. As expected, MABP and cerebral vascular resistance (CVR) were significantly elevated in the normal aged. MABP was even more elevated in elderly hypertensive subjects, and the CVR more elevated in the subjects with arteriosclerosis (Group II), who also showed a small but significant fall in CBF and in internal jugular venous PO2. The CBF showed a more pronounced fall in senile aged patients with chronic brain syndrome (Group III), in whom the CMRO2 also showed a marked drop (by approximately 22%); the CMRG fell still further (approximately 40% of that in the young). Of the few aged subjects followed up after a lapse of 11 years by a repeat estimation of the same physiological and psychological parameters and of the EEG, most showed clear worsening, together with a fall in overall physical and intellectual performance, probably related to a rise in CVR and an increase in atherosclerosis with aging.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cerebral blood flow and metabolism in normal human aging, pathological aging, and senile dementia. 397 14

Examination of 163 nursing home residents revealed chronic brain syndrome of different amount in 84%. Demented patients with clinical evidence of arteriosclerosis had significantly higher values of emotional incontinence, dysphoria, depression and vegetative complaints than those without evidence of arteriosclerosis. Correlation of single psychopathologic parameters with other psychopathologic, neurologic and somatic variables resulted in very different correlation profiles for the following symptoms: emotional incontinence, apathy, dysphoria and euphoria. These changes in personality should be considered to a higher degree in dementia research intending more homogeneous subgroups.
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PMID:[Psychopathology of senile dementias in nursing home residents]. 647 86

We performed electroencephalograms in 32 neonates of intrauterine growth retardation (IUGR) within seven days of birth. EEG findings were compared with those observed in neonatal brain damage. Seven EEGs had a dysmature pattern which is seen in the subacute and chronic stages of prolonged and mild neonatal brain depression, and five had a disorganized pattern which is seen in the subacute and chronic stages of severe neonatal brain depression. The other EEGs had a normal neonatal pattern. Seven neonates who had a dysmature pattern were severe IUGR (< or = 2.5 SD). Their head circumference was retarded at birth, and the S/D ratio of the umbilical artery increased, suggesting chronic brain damage in utero. On the other hand, five neonates displaying a disorganized pattern were preterm IUGR (< 37 weeks). They had NST abnormalities. The abnormal EEG pattern observed in IUGR was similar to that observed in postnatally injured neonates. The abnormalities in EEGs are correlated with the degree of later neurological sequelae. The present study suggested that the EEG of IUGR recorded immediately after birth was useful in evaluating their intrauterine environments and postnatal neurological outcome.
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PMID:[Neonatal EEG findings soon after birth in the intrauterine growth retarded infant]. 770 50

Mental disorders are characterized by disturbances of thought, perception, affect and behavior, which occur as a result of brain damage. Recognizing and treating these conditions is necessary not only for psychiatrists but for all physicians. Disorder of mental function is one of the most common associated conditions in intensive care unit (ICU) patients. However, disturbances of mental function often remain unrecognized. In ICU patients, different types of mental function disorders may develop. They range from sleep disorders, severe depression, anxiety, posttraumatic stress disorder (PTSD) to cognitive disorders including delirium. The causes of mental dysfunction in ICU patients can be divided into environmental and medical. Cognitive disorders are related to mental processes such as learning ability, memory, perception and problem solving. Cognitive disorders are usually not prominent in the early postoperative period and in many cases are discovered after hospital discharge because of difficulties in performing everyday activities at home or at work. The etiology of postoperative cognitive impairment is unclear. Older age, previous presence of cognitive dysfunction, severity of disease, and polypharmacy with more than four drugs are some of the risk factors identified. Delirium is a multifactorial disorder. It is an acute confusional state characterized by alteration of consciousness with reduced ability to focus, sustain, or shift attention. It is considered as the most common form of mental distress in ICU patients. Nearly 30% of all hospitalized patients pass through deliriant phase during their hospital stay. Delirium can last for several days to several weeks. Almost always it ends with complete withdrawal of psychopathological symptoms. Sometimes it can evolve into a chronic brain syndrome (dementia). The causes are often multifactorial and require a number of measures to ease the symptoms. Delirious patient is at risk of complications of immobility and confusion, leading to a high prevalence of irreversible functional decline. An interdisciplinary approach to delirium should also include family or other caregivers. In the diagnosis of delirium, several tests are used to complement clinical assessment. Among the most commonly used are the Confusion Assessment Method (CAM-ICU) and Clinical Dementia Rating (CDR) test. Depression is a common disorder among patients treated at ICU and occurs due to the impact of the disease on the body and the quality of life, independence, employment and other aspects of life. Depression can interfere with the speed of recovery, affects the postoperative quality of life, and in a certain number of patients may lead to suicidal thoughts and intentions. Phobias and generalized anxiety are the most common anxiety disorders. Generalized anxiety disorder is characterized by strong, excessive anxiety and worry about everyday life events. PTSD is delayed and/or protracted response to a stressful event or situation, extremely threatening or catastrophic nature, which is outside the common experience of people and would hit or traumatize almost all people. Treatment of delirium and other disorders is causal. The causes of psychosis are often multifactorial and require a number of measures to ease symptoms. The primary objective of prevention is appropriate therapy and correction of potential imbalances possibly underlying disturbances, stabilization of vital functions as well as early return to daily activities. Doctors and other medical staff must be aware of the importance and consequences of behavioral and emotional disorders in critically ill patients. Additional research is needed to discover the ways to prevent and/ or reduce the frequency and severity of the consequences and treatment of cognitive and emotional disorders.
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PMID:[Perioperative disorders of mental functions]. 2308 91