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

Many of the hundreds of thousands of survivors of polio are now developing postpolio syndrome. Symptoms include progressive muscle weakness, fatigue, decreased endurance, joint and muscle pain, weight gain, respiratory difficulties, and sleep disturbance, often precipitated or exacerbated by a Type-A Personality pattern. A postpolio patient with Type-A Personality was taught self-hypnosis as a vital component of treatment. Pre-post testing included the Profile of Mood States, the State-Trait Anxiety Inventory, the State-Trait Anger Inventory, and the Personal Orientation Inventory; the patient's spouse was interviewed during the follow-up. At the 6-month follow-up, improvements were documented in pain level, depression, self-regard, self-acceptance, capacity for intimate contact, time competence (living in the present), confusion, anxiety, insomnia, and in trait and state anger. Only a mild improvement occurred in fatigue, and no improvement was found in weight control. Follow-up at 12 months confirmed the maintenance of improvements. Self-hypnosis training may prove extremely helpful for postpolio patients and may prove helpful in modifying central characteristics of Type-A Personality.
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PMID:Hypnosis for postpolio syndrome & Type-A behavior. 195 Nov 42

Electroconvulsive therapy treatment for severely depressed adults is increasing because it economically and rapidly reduces symptoms in most patients. Improved administration and unilateral electrode placement have decreased complications. However, concern exists about cognitive and other adverse effects of electroconvulsive therapy. Nurses are in a critical position to educate patients about electroconvulsive therapy, to be advocates for patients' rights, and to monitor responses to treatment. Because both depression and electroconvulsive therapy may impair cognitive functioning, nurses should renegotiate patients' consent during electroconvulsive therapy. Nurses who know, research, and evaluate memory and confusion can effectively observe and diminish the side effects of electroconvulsive therapy.
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PMID:Electroconvulsive therapy. 195 47

Although numerous studies have examined the relationship among affect, personality, and physical activity, results are equivocal. Critics have cited inadequate experimental designs and analyses as the bases for ambiguity. This study addressed two identified weaknesses, length of exercise regimen and improper selection of subjects. Subjects were 72 college-age students who participated in one of three 75-min. activity classes (running, karate, weight lifting) and a lecture class (control subjects). The Profile of Mood States Test was administered prior to and immediately after exercise bouts. Analyses of variance and multiple t tests indicated that participating in a single bout of exercise significantly reduced reported total mood disturbance, tension, depression, anger, and confusion.
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PMID:Mood alterations with a single bout of physical activity. 176 99

Seven highly trained female cyclists (age 22 +/- 5 yr, height 165 +/- 6 cm, weight 60 +/- 5 kg, VO2max 55 +/- 6 ml.min-1.kg-1, mean +/- SD) consumed, for 1 wk each, isocaloric diets containing varying levels of carbohydrate, protein, and fat designated as low carbohydrate (LCHO), moderate carbohydrate (MCHO), and high carbohydrate (HCHO). Diets were administered in random order, and each subject consumed all three diet treatments. At the end of each weekly diet treatment, subjects rode on a cycle ergometer at 80% VO2max until fatigued. Cyclists continued light training during the diet treatments. Following each diet treatment and immediately prior to the fatiguing cycle ergometer ride, cyclists completed a Profile of Mood States (POMS) questionnaire. The POMS yields measures of tension (T), depression (D), anger (A), vigor (V), fatigue (F), and confusion (C), as well as providing a total mood score (TMS). Results indicated that subjects on LCHO had significantly (P less than or equal to 0.05) greater T, D, A, and TMS and less V compared with MCHO and HCHO. There were no significant differences between MCHO and HCHO. In the present study, LCHO in conjunction with training and exercise adversely affected the mood state of trained female cyclists as compared with MCHO and HCHO diets.
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PMID:Alterations in dietary carbohydrate, protein, and fat intake and mood state in trained female cyclists. 201 17

We performed a prospective, naturalistic study using standardized clinical rating scales to characterize the effect of electroconvulsive therapy (ECT) on mood, cognition, and medical status in late-life depression. Over a 16-month period, 40 patients aged 60 years and over who fulfilled DSM-III criteria for a major depressive episode received a total of 42 ECT courses. Three patients (7%) developed significant medical complications: one had a syncopal episode due to arrhythmia, and two had symptomatic vertebral compression fractures. Confusion was noted during 13 courses (31%) and persisted at discharge in four (10%). More than half the patients were either psychotic or demented on admission, and all but three had been either unresponsive or intolerant to pharmacotherapy. All patients experienced a decrease in their depressive symptoms and more than two thirds were in complete or partial remission at discharge. Patients with psychotic depression experienced a greater improvement than patients with nonpsychotic depression, and patients with organic mental disorders experienced the same improvement as other patients. This study confirms that ECT is a safe and effective treatment of depression in late life.
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PMID:A prospective naturalistic study of electroconvulsive therapy in late-life depression. 205 49

Diazepam (0.21 mg/kg; group 1) and midazolam (0.03 mg/kg; group 2) was applied for sedation in two groups of urological patients (n = 10 in each) requiring transurethral resection (urine bladder, prostata) using spinal or peridural anaesthesia. Before anaesthetic procedure, 500 ml hydroxyethyl starch were administered for precluding severe vascular depression. Patients receiving midazolam began to sleep within one minute. Heart rate dropped in both groups after injection of both benzodiazepines which was considered a physiological sleeping effect. No hypotensive reactions were registered. Using this therapy maximum PaO2 values of 14.9 kPa in group 1 (diazepam) were registered and of 14.0 kPa in group 2 (midazolam). During the operation all patients were arousable. Side-effects such as nausea, vomiting and confusion were not observed.
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PMID:[The effect of diazepam and midazolam on the circulation and respiration during spinal and peridural anesthesia]. 208 5

A series of studies have focused on the problem of identifying and defining the specific characteristics of senile psychiatric pathology with greater precision. The aim of the present study was to examine symptomatological aspects of a group of psychiatric patients divided into different age ranges. The possible presence of psychopathologically defined (e.g. phobia, obsession, convulsive symptoms, hallucinations, deliria) and more aspecific symptoms (e.g. those which are generically involutive, confusion, anxiety, depression, insomnia, suicide attempts) was assessed in a group of 2018 psychiatric out-patients. It was found that senile psychiatric pathology presents a symptomatology which is generally aspecific and not clearly defined, and that there are peculiarities which differentiate it from that in the adult.
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PMID:[Psychopathological characteristics of psychiatric disturbances in the elderly]. 209 66

Little systematic attention has been directed toward the subject of treatment-resistant depression. Although these patients constitute a distinct minority, their treatment consumes a major portion of the clinician's time. Thus, the authors address the problems of defining and treating the estimated 750,000 patients with treatment-resistant depression. Several major factors concerning treatment-resistant depression appear evident: (1) although there is an emerging consensus of what constitutes "adequate" treatment, the majority of patients receive suboptimal drug regimens; (2) misdiagnosis of depression subtypes can lead to suboptimal treatment and "pseudo-resistance" to drug therapy; (3) treatment strategies for resistant depression should use systematic algorithms to avoid confusion and limit "therapeutic nihilism" in the patient and physician; and (4) the patient's risk/benefit ratio for each successive treatment application must be considered with the potential benefit weighed against the increasing risk of illness morbidity and likelihood of adverse events and/or suicide.
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PMID:Treatment-resistant depression: definition and treatment approaches. 211 32

Delirium, an acute confusional state, is an organic brain syndrome that manifests deficits in attention, irrelevant or rambling speech, and other cognitive deficits. Its symptoms often fluctuate over the course of the day, and patients may be hyperactive--for example, restless and screaming--or hypoactive--for example, quiet, inactive, and stuporous. Occurring in approximately 20% of hospitalized elderly patients, delirium is the most common psychiatric syndrome in acutely ill general medical and surgical patients. Fifteen to 30% of delirious patients expire, and others are prone to a variety of complications: falls, pressure ulcers, oversedation, dehydration, and others. Almost any acute illness can cause delirium in the elderly, but the most common offenders are acute infections and drugs. Many patients have a pre-existing dementia. The first step in arriving at a correct diagnosis is to distinguish delirium from other psychiatric syndromes that can cause confusion, such as dementia, depression, schizophrenia, and mania. Once delirium is established, a comprehensive general examination and a mental status examination is required. Routine laboratory and radiologic tests are directed at the common metabolic and infectious disorders that precipitate delirium. Treatment is directed at the underlying acute illness. In all patients, it is important (1) to treat the underlying acute illness, (2) to provide appropriate fluid and electrolytes, (3) to discontinue any unnecessary drugs, and (4) to allay the patient's fear and agitation through the use of simple, repetitive instructions, orientation cues, and by limiting the use of physical restraints. If psychotropic medications are needed to treat psychotic symptoms, to prevent patients from harming themselves or others, or to facilitate necessary diagnostic and therapeutic interventions, then haloperidol is the drug of choice in most instances. Drugs with anticholinergic properties should be avoided.
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PMID:Delirium in the elderly. 218 81

Psychiatrists increasingly combine medication with psychotherapy when treating depression and other disorders. Among the public and practitioners, however, there remains controversy about the compatibility of these treatments. The roots of the controversy can be traced to the ubiquity of dualistic beliefs about mind and body and the historical development of mental health professions. Confusion has also been generated by deriving notions of etiology from observations of phenomenology and treatment response. Understanding these issues will help the practitioner to more successfully combine treatment modalities when both are indicated.
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PMID:The dichotomy of drugs and psychotherapy. 219 Dec 78


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