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

Sleep disorders are common and well documented in patients with Parkinson's disease (PD). However, most data on sleep in patients with PD are derived from selected patient populations. This community-based survey evaluated the prevalence of and risk factors for sleep disturbances in an unselected group of 245 patients with PD and two control groups of similar age and sex distribution: 100 patients with another chronic disease (diabetes mellitus) and 100 healthy elderly persons. Nearly two thirds of the patients with PD reported sleep disorders, significantly more than among patients with diabetes (46%) and healthy control subjects (33%). About a third of the patients with PD rated their overall nighttime problem as moderate to severe. The most common sleep disorders reported by the patients with PD were frequent awakening (sleep fragmentation) and early awakening. Sleep initiation showed no significant difference compared with the control groups. Pain and cramps were not more prevalent among the patients with PD, but they were more likely to report sleep disturbed by myoclonic jerks. Use of sedatives was common in all three groups but significantly higher in the PD group than in the healthy elderly. Symptoms of depression and duration of levodopa treatment showed a significant correlation with sleep disorders in the PD group. This community-based study confirms that sleep disorders are common and distressing in patients with PD. The strong correlation between depression and sleep disorders in patients with PD underlines the importance of identifying and treating both conditions in these patients.
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PMID:A community-based study of sleep disorders in patients with Parkinson's disease. 982 12

Depression, a chronic disease and a leading cause of disability worldwide, will generate increasing needs in terms of public health in the coming years. Many antidepressants are now available. However, these molecules present real limitations and disadvantages. Thus there are great expectations on the part of the clinicians for more efficient drugs that are better tolerated. How can we satisfy such hopes and innovate in this domain today? One original and most promising strategy for developing new antidepressants that are more efficient and better tolerated involves antagonizing both alpha 2-noradrenergic and 5HT2 and 5HT3 serotonergic receptors, without blocking 5HT1A serotonergic receptors. The technology now available in pharmacological research allows the development of such molecules.
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PMID:[Pharmacological management of failure of treatment with antidepressants]. 992 1

Depression, a chronic disease and a leading cause of disability worldwide, will generate increasing needs in terms of public health in the coming years. Many antidepressants are now available. However, these molecules present real limitations and disadvantages. Thus there are great expectations on the part of the clinicians for more efficient drugs that are better tolerated. How can we satisfy such hopes and innovate in this domain today? One original and most promising strategy for developing new antidepressants that are more efficient and better tolerated involves antagonizing both alpha 2-noradrenergic and 5HT2 and 5HT3 serotonergic receptors, without blocking 5HT1A serotonergic receptors. The technology now available in pharmacological research allows the development of such molecules.
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PMID:[Pharmacological approach to failures of antidepressant treatment]. 994 41

Rheumatoid arthritis (RA) is a chronic disorder that can have a severe impact on patient's lives. This present study investigated four questions regarding the psychosocial effects on patients and their well partners. First we found that depression for both patients and partners were slightly elevated and 35.7% of patients and 23.3% of well partners had scores above the cut-off for possible clinical depression on the Center for Epidemiological Studies Depression Scale. Second, there was no significant difference between the patients' level of distress and that of the partners. Third, there were moderate positive correlations between patients' and partners' scores on measure of psychological functioning. Fourth, there were no differences in either the patients' or partners' well-being based on the gender of the patient. Finally, an exploratory analysis was conducted to examine the factors which influence the patients' and partners' depression and their view of the relationship.
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PMID:The psychosocial effects of rheumatoid arthritis on the patient and the well partner. 1008 44

Nurses in the Tucson area are not only serving persons in hospitals but also caring for them in their homes and neighborhoods and teaching them how to maintain their health. Three nursing programs--community nursing centers, home health services, and nurse case management--are part of the nursing continuum of care within Carondelet Health Care. Promoting clients' optimal wellness level, helping them maintain their highest level of functioning, preserving their dignity and independence, and enhancing their self-care are the goals of the Carondelet Community Nursing Centers. Nurse practitioners monitor clients' blood pressure and cholesterol and blood sugar levels and can test for episodic problems. Carondelet Home Health nurses teach clients about disease processes, symptom management, and medications; assess or monitor a patient's condition; care for wounds, and coordinate services such as physical therapy, occupational therapy, and home-delivered meals. Persons are usually referred to home health as they are discharged from the hospital. In addition to helping clients with psychosocial problems, nurse case managers perform traditional nursing functions like monitoring and teaching about medications. Nurse case management clients include the frail elderly or persons who have at least one of the following: a chronic disease that is causing steadily declining health; a terminal illness; an acute episode that requires monitoring and support; care-giver stress; or an inability to cope, as evidenced by anxiety, depression or substance abuse. Services for such clients will gain prominence in a reformed healthcare system.
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PMID:Nursing's renaissance. An innovative continuum of care takes nurses back to their roots. 1012 99

The purpose of this study was to test the outcomes of group psycho-educational intervention (PEI) led by nurses on sexual health risks (knowledge, behaviour, disease burden) and psycho-social adaptation (depression, mood states, self-efficacy) in young adults with the chronic disease, genital herpes. Two hundred and fifty-two young adults with symptomatic genital herpes participated in a randomized controlled trial (RCT). The intervention was participation in a three-session group PEI facilitated by a nurse in the community. Participants completed questionnaires measuring sexual health risks (herpes knowledge, sexual risk behaviour, disease burden of patterns of recurrences of outbreaks of the disease), and psycho-social adaptation (depression using the Beck Depression Inventory [BDI], mood states using the Profile of Mood States [POMS], and feelings of self-efficacy for protection from sexually transmitted diseases [PSTD]) at induction into the study, and at 3 and 6 months. Participants were mainly employed, Caucasian, single women in their twenties (X = 27.1 years, SD = 4.3), with some college education; 23% of the sample were men. After controlling for baseline knowledge about genital herpes, the experimental group had significantly more knowledge than the control group at 3 and 6 months' post-intervention. They also reported using condoms and spermicides to prevent the spread of genital herpes more often than did the control group. The implications for nurses in the community include the following: (a) PEI is an intervention that can be used by nurses in the community with a high-risk population; (b) group intervention is a viable treatment for people with a highly stigmatized, chronic sexually transmitted disease (STD); and (c) further testing of the use of PEI by nurses in the community with other high-risk populations is needed.
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PMID:Effects of psycho-educational interventions on sexual health risks and psycho-social adaptation in young adults with genital herpes. 1021 75

Depression often presents with physical symptoms, primarily fatigue, pain, or sleep disturbance. Depressed mood may or may not be present. Supportive counseling and pharmacotherapy are more effective than either modality alone. The newer drugs are better tolerated than earlier agents, and they achieve much greater patient adherence. Depression is considered a chronic disease. The likelihood of recurrence increases with the number of episodes, often calling for prolonged maintenance of medication. Most patients with mild to moderate depression can be effectively managed by their primary care physician, with referral required only for those who are unresponsive to therapy or who are suicidal.
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PMID:Depression. 1031 45

We enrolled 543 elderly participants of a managed care organization in a cross-sectional study to test whether the association between self-rated physical health and clinically defined illness differs for persons who are not depressed compared with persons with minor or serious depression. Depression was measured with the Diagnostic Interview Schedule (DIS). Clinically defined illness was measured with the Chronic Disease Score (CDS), a pharmacy-based measure. Additional variables included age, sex, and self-reported pain and physical function. Self-rated physical health was associated with both minor and serious depression, independent of clinically defined illness; minor depression was no longer significant when self-reported pain and physical function were added to the model. A significant negative correlation between self-rated physical health and clinically defined illness was observed for minor and no depression, but no correlation was seen for serious depression. These results confirm the association between depression and self-rated physical health and emphasize that, for persons with serious depression, self-rated health provides a less accurate picture of clinically defined illness at both ends of the spectrum. Also, a diagnosis of minor depression should not forestall investigation of inconsistencies between patient report and clinical evidence.
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PMID:The role of depression in the association between self-rated physical health and clinically defined illness. 1039 87

The present work explores the impact of helping others on the physical and psychosocial well-being of the provider. Lay people were trained to listen actively and to provide compassionate, unconditional positive regard to others with the same chronic disease. The recipients of the peer support intervention were participants of a psychosocial randomized trial, whereas the peer supporters were study personnel and were therefore not randomized. We describe a secondary analysis of a randomized trial to explore the impact of being a peer supporter on these lay people. Subjects were 132 people with multiple sclerosis, all of whom completed quality-of-life questionnaires 3 times over 2 years. A focus group was also implemented with the peer telephone supporters 3 years after completion of the randomized trial. Effect size was computed for each quality-of-life outcome, and the focus group discussion was content analyzed. We found that compared to supported patients, the peer telephone supporters: (1) reported more change in both positive and negative outcomes as compared to the supported patients and that the effect size of these changes tended to be larger (chi2 = 9.6, df = 4, p < 0.05) and (2) showed pronounced improvement on confidence, self-awareness, self-esteem, depression and role functioning. Content analysis revealed that the participants articulated a sense of dramatic change in their lives in terms of how they thought of themselves and in how they related to others. We conclude with a discussion of response shift, a mediator of adaptation to illness which involves shifting internal standards, values, and concept definitions of health and well-being. We suggest that a response shift may be induced by a therapeutic strategy involving the externalization and re-internalization of concern among physically ill patients.
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PMID:Helping others helps oneself: response shift effects in peer support. 1040 Feb 57

Many, if not most, people with depression are at high risk to develop a recurrent and potentially chronic disorder, characterized by deleterious effects on vocational, social, and family functioning. Recent evidence also suggests that recurrent episodes of severe depression are associated with changes in brain function that further heighten vulnerability and functional impairment. The best way to deal with these sobering problems is prevention via vigorous treatment of the index episode (to produce complete remission) and more routine use of longer term models of prophylactic therapy. After briefly reviewing the relevant data on epidemiology and natural history, this article focuses on the 4 "arms" of preventative treatment: psychoeducation, pharmacotherapy, adherence, and psychotherapy. Like the modern approach to treatment of hypertension, a conscientious and integrated approach to preventative therapy saves lives and has profoundly beneficial effects for our patients, their loved ones, and society.
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PMID:Long-term nature of depression. 1040 19


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