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

Two cases of electroconvulsive therapy (ECT) in adolescence are presented and the literature on the use of ECT in childhood and adolescence is reviewed. ECT was effective in children and adolescents with bipolar disorder and depression. Inadequate information exists to make a judgment regarding schizophrenia, delirium, and anorexia nervosa. ECT is not effective in autism and chronic organic brain syndromes. Complications cited include organicity and seizures in the period immediately after ECT, anxiety reactions, and disinhibition. Long-term memory deficit or cognitive impairment has not been found, although further research to rule out residual impairment is needed.
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PMID:A review of ECT for children and adolescents. 222 48

Increasing acuity of hospitalized patients with cancer has placed greater and more diverse demands on nurses. This is especially true in relation to the management of psychiatric problems that require added time and skills. This study surveyed all nurses (n = 100) working on 15 inpatient units in a 565-bed cancer research hospital on one day regarding psychiatric problems present in 475 patients under their care. Nurses reported that significantly more patients exhibited symptoms requiring psychiatric consultation than did not. Results also indicate that patients who were acutely ill and in need of intensive nursing care had significantly more psychiatric symptoms than patients with low acuity illness. The most prevalent symptoms were depression and/or anxiety and delirium. Nurses who must care for an increasingly ill population with more severe psychiatric symptoms need additional education to manage these problems. Study findings led to increased availability of nurse-to-nurse consultations as well as establishment of a task force to develop a psychosocial teaching manual.
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PMID:Nurses' reports of psychiatric complications in patients with cancer. 234 69

This paper discusses the definition of apathy, reviews its differential diagnosis, and proposes a classification for the conditions that may produce it. Apathy is defined as diminished motivation not attributable to diminished level of consciousness, cognitive impairment, or emotional distress. In its differential diagnosis, abulia, akinesia and akinetic mutism, depression, dementia, delirium, despair, and demoralization must be ruled out. Classification of apathy is organized in terms of its adaptive and functional consequences, its relationship to personality or to sociocultural or environmental events, and its association with psychiatric, neurological, and medical disorders. An approach to assessment and treatment is proposed.
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PMID:Differential diagnosis and classification of apathy. 240 72

Patients often present for evaluation of a suspicious cancer symptom after a delay. They appear to tolerate cancer treatment as well as younger patients, and, in studies comparing them on psychosocial parameters of adaptation, they appear to adjust better than younger patients. Attention to pre-existing social problems or psychiatric disorder (eg, alcoholism or depression) is necessary when physicians start treatment for cancer. Elderly patients have a greater tendency to develop delirium; cautious use of psychotropic medications is indicated. Management of the older patient during active treatment, palliative and terminal care, and when a remission is accomplished is both challenging and rewarding.
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PMID:Psychosocial aspects of cancer in the elderly. 244 30

An investigation has been made with regard to the clinical picture of 87 terminally ill patients with lung cancer. It has yielded the following points. 1) Seven patients had been informed of their diagnosis. 2) Intravenous hyperalimentation was administered in 78 cases (90%), oxygen therapy in 68 cases (78%), and morphine in 35 cases (40%). 3) The most frequent cause of death in these patients was respiratory failure, due to progress of cancer, then infection, pleural, or pericardial effusion, or interstitial pneumonitis. 4) Psychic disturbances involved anxiety over breathing, depression, and delirium. In only 12% of the patients did the mental condition seem normal until death. 5) To deal with the dying patient's needs, it is necessary to establish proper treatment for the control of sensory dyspnea and for psychosocial support by a psychiatrist and other professionals for members of the family.
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PMID:[The clinical picture of terminally ill patients with lung cancer]. 250 34

The use of neuroleptic medication as antiemetics, or in the treatment of neuropsychiatric disorders in patients with AIDS, may be associated with extrapyramidal side effects and lead to difficulty with diagnosis and management. Two cases are presented that describe severe extrapyramidal syndromes occurring in two patients with AIDS, one treated with prochlorperazine and the other with prochlorperazine and metoclopropramide. It is possible that the neuropathologic lesions found in patients with the AIDS dementia complex may pre-dispose to extrapyramidal side effects of neuroleptic medication. The differential diagnosis and treatment of delirium, dementia, depression, and extrapyramidal reactions in patients with AIDS is discussed.
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PMID:Extrapyramidal reactions. Neuropsychiatric mimics in patients with AIDS. 256 9

This is a report of the findings of a 6-year study of hospitalizations caused by adverse psychiatric reactions to prescribed medications. Of 15,800 consecutive psychiatric admissions to two university hospitals, 112 (0.7%) were caused by adverse reactions to medications. In 67% of cases these admissions were due to extrapyramidal symptoms such as parkinsonism and/or akathisia, and coexisting neuroleptic-related depression. In 25% the admitting diagnosis was drug-induced delirium or psychosis; one third of these patients suffered from Parkinson's disease and had been treated with a combination of two or more antiparkinsonian agents. Older age, polydrug therapy, and the parenteral administration of neuroleptics at high dosages were important risk factors for severe adverse drug reactions leading to hospitalization.
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PMID:Psychiatric admissions due to adverse drug reactions. 258 57

Psychiatric symptoms among medical in-patients in an Indian hospital were assessed: the SRQ was used as a screening instrument, and those with probable psychiatric disorders were given the PSE and MSE, for further, detailed assessment. The prevalence of psychiatric disorders was 34%, with a further 15% reporting distressing psychiatric symptoms only. The most frequent complaints were delirium and adjustment disorders. They were largely associated with connective tissue, as well as cardiovascular and endocrine, disorders, and were characterised by depression, worrying and irritability. The reliability of the SRQ varied with the cut-off score, which gave optimal specificity and sensitivity when set at 9.
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PMID:Psychiatric disorders among medical in-patients in an Indian hospital. 259 Jul 81

The neurotransmitter acetylcholine is important in memory function, and low brain concentrations may be associated with cognitive impairment. Our hypothesis was that atropine, a centrally acting anticholinergic drug known to cause amnesia, confusion, and delirium, may further exacerbate the amnesia and/or confusion resulting from electroconvulsive therapy (ECT) when used as a preanesthetic, and that the peripherally acting glycopyrrolate would by comparison decrease these side effects. We randomly administered glycopyrrolate versus atropine in equivalent doses as the preanesthetic agent to 20 consecutively admitted geriatric patients with major depression, for whom ECT was the clinical treatment of choice. Patients were matched for age, Hamilton Scale for Depression, and baseline performance on the Buschke Selective Reminding Task (BSRT). We found no significant difference in outcome between patients treated prior to ECT with atropine versus glycopyrrolate, as assessed by the above measures. We conclude from this study that atropine is no more deleterious to memory than is glycopyrrolate when given before ECT.
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PMID:Glycopyrrolate versus atropine in post-ECT amnesia in the elderly. 266 13

Mental status testing is an essential element of evaluating elderly patients. A structured examination often helps identify the etiology of symptoms that are responsible for changes in patient behavior, that lead to family stress, but that are otherwise not indicative of cognitive dysfunction. A structured mental status examination is also helpful in distinguishing cognitive changes caused by dementia, delirium, and depression. This article examines the steps in mental status assessment and the commonly used assessment instruments. The experience of a family medicine ambulatory multidisciplinary evaluation service in mental status testing is discussed.
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PMID:Mental status assessment in the elderly. 266 35


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