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

The prevalence of psychiatric disorders and behavioral disturbances in nursing homes is high, but the relationship between the two is unknown. We studied 454 new admissions who were diagnosed by research psychiatrists using DSM-III-R criteria and compared patients who nursing staff designated as cooperative or uncooperative by psychiatric diagnosis and use of restraints and neuroleptics. Uncooperative patients (n = 79; 17.4%) had a variety of psychiatric disorders (total, 87.3%) but particularly had dementia syndromes complicated by delusions, depression, or delirium (44.3%). Uncooperative patients were more frequently restrained and prescribed neuroleptics. Determining the origins of behavior disorders in patients with psychiatric disorders in nursing homes may reduce behavior disturbances.
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PMID:Psychiatric diagnosis and uncooperative behavior in nursing homes. 159 Sep 10

Urinary incontinence affects a large percentage of persons over age 65 and predisposes them to social isolation, depression, and premature nursing home placement. Transient incontinence may be precipitated by such factors as delirium, infection, atrophic vaginitis/urethritis, medication use, and restricted mobility. Persistent incontinence may be of the urge, stress, overflow, or functional type. The patient history and simple tests such as bedside urodynamics generally isolate the cause. In this first part of a two-part article, we discuss the primary care evaluation of the older patient with urinary incontinence. In part 2 (page 37), we discuss a primary care management strategy.
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PMID:Urinary incontinence in the aged, Part 1: Patient evaluation. 159 66

Surveys of psychiatric population had previously shown a high incidence of patients with low serum vitamin B12. A variety of psychiatric syndromes have been described, ranging from mild disturbance in mood state like depression to maniacal excitement; psychotic conditions like paranoid states and schizophrenia; and cognitive dysfunctions such as memory defect, delirium and dementia. A case of a 67-year-old Chinese lady suffering from pernicious anaemia, but presenting with prominent paranoid delusions is reported. Treatment with cyanocobalamine and anti-psychotic medication led to prompt resolution of her psychotic experience. Subsequently she developed a transient depressive syndrome which also responded well to a short course of antidepressant.
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PMID:Psychiatric syndromes in pernicious anaemia--a case report. 159 18

For a period of six months (april to october 1990) 361 manic-depressive in-patients or out-patients were examined and treated. 178 patients (119 females and 69 males) were suffering from depression at examination time. Among them, 34 women and 11 men had mixed mood disorders with a symptomatology near that of typical depression (major depression, according to the DSM III-R criteria) but not of mixed bipolar disorder. The main symptoms were: dysphoric mood with irritability; internal tension, psychic and sometimes physical agitation; emotional lability; head crowded with thoughouts or thoughts that vanish too quickly; sleep disorders with initial insomnia or with frequent night awakenings; suicidal thoughts or attempted suicide with impulsiveness. These patients sustained severe suffering. They were in no way slow-minded but rather talkative and expressive. Antidepressant drugs increased agitation and insomnia, and in some cases, suicidal impulses. BZDs had limited efficacy but neuroleptics given in small doses, anticonvulsants and lithium gave very effective results. A limited number of electroshocks provided rapid improvement. In many respects, depression with delirium seems a more severe form of the above-described combined depressive syndrome and responds to the same treatments. We think that this mood disorder includes excitement as an important component, although this was not clearly evident. However, it is not easy to conceive this syndrome as a mixture of depressive and manic symptoms; it should rather be regarded as another specific mood condition, either permanent or transient, situated between the two other conditions.
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PMID:[Mixed depressive syndrome]. 160 Aug 99

As many as 60 patients suffering from dysmorphomania were examined. The patients' age ranged from 17 to 61 years at the moment of examination. Analysis of the disease course has demonstrated that all the patients suffered from attack-like progredient schizophrenia. Depending on the structure of the attacks and dynamics of dysmorphomania two clinical groups were distinguished. In group I, the disease picture was specified by mainly affective attacks; dysmorphomania occurred at the adolescent (more rarely at the juvenile) age. It was characterized by a tendency towards complication, with a progressive deactualization in repeated attacks of the disease. In group II, the disease manifested itself by complication of the attacks which progressed from affective ones to the states of depression with interpretive paranoid or (and) affective-paranoid attacks. The syndrome of dysmorphomania occurred at varying age and was marked by diversity of manifestations, complication in the attacks that followed (fabula expansion, formation of hypochondriac delirium coinciding with dysmorphomania in the subject matter). The given group was characterized by progredient course of schizophrenia.
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PMID:[Characteristics of the course of recurrent-progressive schizophrenia with the dysmorphomania syndrome]. 164 20

In 79 patients with endogenous depressions (66 MDP and 13 circular schizophrenic patients) which received high doses of tricyclic antidepressants (amitriptyline in agitated forms and melipramine++ in inhibited ones) that remained ineffective for at least one month, hemosorption (HS; 39 patients) or ECT (40 patients) were randomly applied. The overall efficiency of HS and ECT was 53.8% and 60%, respectively. The efficiency of HS was substantially higher than that of ECT in the cases with dominant obsessive-phobic symptoms in depression. The reverse relation was observed in the cases with dominant anxious-delirious symptoms. In order to determine the predictors of the efficiency of the therapies, the stepwise discriminant analysis was used and the linear discriminant function equations were derived for HS and ECT involving 11 and 8 parameters, respectively. Correlation coefficients between predicted and de-facto therapeutic effects determined in an additional test group of 20 patients were 0.63 for HS and 0.88 for ECT. This is important in terms of directing a practitioner toward one or another technique with due respect for the individual differential therapeutic prediction of its result.
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PMID:[Comparative effectiveness of detoxification hemosorption and electroconvulsive therapy in patients with endogenous depression resistant to tricyclic antidepressants]. 165 Jan 4

The recognition of cognitive disturbances in geriatric patients has important clinical implications for the primary care physician. Commonly seen cognitive dysfunctions include dementia, pseudodementia, delirium, and frontal lobe syndrome; these may be confounded by overlapping depression. The cognitive examination covers such intellectual and behavioral functions as attention, memory, and language. As many psychiatric disorders result from neurologic brain disease, a psychiatric examination is essential. Mental status questionnaires are useful for screening of high-risk populations for dementia and to quantify the degree of cognitive dysfunction for purposes of management planning and surveillance.
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PMID:Diagnosing cognitive dysfunction in the elderly: primary screening tests. 155 83

Psychosocial changes and physical disabilities that occur in the elderly contribute to an increase in the prevalence of psychiatric disorders in the elderly. A comprehensive approach to diagnosis is required. Depression, dementia, delirium and paranoid disorders are common psychiatric disorders seen in the elderly. Underlying treatable causes must be excluded. Treatment requires special considerations such as adverse drug reactions, drug interactions, side effects and concomitant physical illnesses. Management of the elderly should involve the family as well as the patient.
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PMID:Psychiatric problems in the elderly. 178 86

Potentially reversible dementia is reviewed with reference to diagnosis, causes and outcome. Many disorders which cause cognitive impairment, such as drug toxicity and depression, fail to meet diagnostic criteria for dementia. These tend to have the best prognosis. Studies of the neuropsychiatric syndromes associated with disorders causing potentially reversible dementias suggest that dementia is an infrequent outcome and when it does occur, few cases recover. Factors predictive of improvement are short duration of symptoms and mild degree of cognitive impairment, usually subcortical in type. It is suggested that potentially reversible cognitive impairment would be a more accurate term as many cases are due to delirium and depression. While cases of well established dementia do not require extensive investigation, all cases should have a thorough clinical assessment as in many instances dual pathology exists and all require psychosocial management.
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PMID:Potentially reversible dementia: a review. 164 31

Recognition and treatment of psychological factors relevant to the acute prehospital and in-hospital phases of myocardial infarction (MI) are reviewed. Various emotions and personality characteristics can be both risk factors for and consequences of acute MI. Components of the Type A behavior pattern and levels of somatic and emotional awareness have been linked with excessive treatment-seeking delay for MI patients. Psychiatric conditions such as panic disorder may mimic symptomatic presentation of MI and therefore have implications for differential diagnosis in the emergency room. Additionally, anxiety, depression, and neurobehavioral disorders such as delirium are relatively common during the hospitalization period and may contribute to potentially lethal complications of MI. Because psychological factors are associated with prognosis during each phase of MI, the identification and treatment of such factors are crucial in providing comprehensive care for MI patients.
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PMID:Psychological factors relevant to the prehospital and in-hospital phases of acute myocardial infarction. 180 23


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