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

The acquired immunodeficiency syndrome (AIDS) and its related conditions are a public health problem of unprecedented proportions due to the debilitating and fatal nature of the disease, the sociocultural implications related to contagion, and its initial appearance in certain socially stigmatized groups. The ability of patients to tolerate the consequences of the disease depends on their psychological ability to cope based on emotional strength and the availability of social support. The psychological and social impact of AIDS may result in psychiatric symptoms similar to those seen in other life-threatening diseases, including anxiety, depression, and delirium. Neurologic complications are frequent, the commonest being an encephalopathy and dementia that is poorly understood. It is difficult in the early stages of AIDS to separate reactive depression and psychomotor retardation from symptoms associated with central nervous system complications. Guidelines are needed to manage the psychological problems posed by AIDS and its related conditions.
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PMID:The psychosocial and neuropsychiatric sequelae of the acquired immunodeficiency syndrome and related disorders. 405 51

Retrospective analysis of the phenomenology and the diagnostic process of 112 consecutive psychogeriatric admissions revealed the majority (61%) were suffering from affective illness. In 53 percent, the reason for admission was depression and 8 percent were in the manic phase of a bipolar disorder. Dementia was diagnosed in 32 percent, with a third of these patients having an associated depression. The remaining 7 percent had a schizophrenic or paranoid disorder. Ninety-two patients (82%) were found to have at least one coexisting medical and/or neurological disorder(s) requiring early intervention. Associated acute organic brain syndromes were common (18%) and often difficult to diagnose. The AOBS was at times the only sign of an underlying active medical condition. The diagnosis of this condition often required serial observations for fluctuations in mental status accompanied by appropriate laboratory investigations. These findings underscore the complexity of the diagnostic process in psychogeriatric patients suffering from concomitant medical and psychiatric disorders. High index of awareness is recommended for the need to search for coexisting delirium, which may be masked at times by the major psychiatric disorder.
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PMID:Empirical study on an inpatient psychogeriatric unit: diagnostic complexities. 405 57

Dementia affects an estimated 5 percent of the population 65 years of age and older, with 20 percent being affected at 75 years or older. Although the most common forms, primary degenerative and multi-infarct dementia, currently lack specific treatments, it is estimated that a thorough diagnostic evaluation will uncover a treatable cause in 10 percent to 20 percent. The differential diagnosis includes benign senescent forgetfulness, depression, adjustment disorder, paranoid states, amnestic syndrome, delirium, drug effects, systemic illnesses and intracranial conditions. The approach to each patient involves a history, physical examination, mental status evaluation and laboratory tests that focus on identifying treatable conditions. When no specific treatments are available, however, symptomatic treatments, including pharmacotherapy, environmental management, family supports and psychotherapy, can offer relief for both patients and their families and improve the daily functioning of the elderly patient with dementia.
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PMID:Diagnosis and treatment of dementia in the aged. 612 26

A cerebrovascular accident is unwelcome at any age, but for the elderly it involves concerns. The abrupt onset of a cerebrovascular accident signals anew the already present fears of loss of control, death, insanity, disfigurement, loss of physical function, and sexual impairment. The accident can also result in worry about the possibility of explosive recurrence, disruption of thoughts and emotions, lengthy treatment away from home, and exhaustion of retirement funds. Therapeutic endeavors must be eclectic and individually tailored to address the special needs of the elderly patient, the highly technical and diverse health care team, the worried family, and the depression, delirium, and subtle clinical syndromes manifesting as poor patient motivation that often accompany a cerebrovascular accident.
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PMID:Overview: cerebrovascular accident and the hospitalized elderly--a multidimensional clinical problem. 612 8

Dementia, delirium, and depression are not part of normal aging but are organic brain syndromes that often are reversible. Thus, it is imperative that primary care physicians carefully look for a reversible cause in a patient with one of these disorders. Even an irreversible condition, such as Alzheimer's disease, can be effectively treated with drugs that are carefully chosen to minimize serious side effects. Patients with cognitive impairment deserve to be treated with dignity, and every effort should be made to maintain the highest level of function possible.
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PMID:Organic brain syndromes in the elderly. When are they reversible? 613 11

In hospitalized patients, the commonest causes of acute insomnia are the effects of illness, environmental sleep disruption, medication, anxiety, and depression. Treatment should correct underlying medical disorders; reduce environmental sleep disruptions; and lower anxiety with psychological interventions, sedative or hypnotic medication, and relaxation training. Special clinical problems include chronic pain, delirium, and insomnia in the elderly.
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PMID:Management of insomnia in hospitalized patients. 614 53

The effectiveness of sultopride in acute psychiatric syndromes with prominent agitation was tested in patients seen in the emergency department of a general hospital. Among 32 patients, 26 were given a single injection of 200 mg and 6 had two injections. Seven items were evaluated at ten minute intervals for one hour. Results showed excellent control of agitation and anxiety but little effect on delirium, hallucinations and depression. Furthermore, the patients' unwillingness to be cared for can be overcome by this agent and diagnosis, therapy and orientation can be established. These good results are partly achieved as early as 20 minutes after the injection. Psychomotor agitation thus appears to be the choice indication of sultopride.
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PMID:[Open trial of sultopride in psychiatric emergencies]. 630 77

Thallium poisoning is one of the most complex and serious toxicities known to man. The symptomatology of its toxicity is usually nonspecific due to the multi-organ involvement. The initial symptoms of thallium poisoning may include fever, gastrointestinal problems, delirium, convulsions and coma. Symptoms may appear rapidly, but more commonly the acute toxicity subsides to be replaced by a gradual development of mild gastrointestinal disturbances, polyneuritis, encephalopathy, tachycardia, skin eruptions, stomatitis, atrophic changes of the skin, nail changes (Mee's lines), and skin hyperesthesia (mainly in the soles of the feet and the tibia). Degenerative changes of the heart, liver and kidney, subarchanoid hemorrhage, bone marrow depression, and increased radiopacity of the liver may also occur. Development of psychotic behavior with hallucinations and dementia has also been reported. In humans the most characteristic sign of thallium toxicity is alopecia which usually appears in cases when death is delayed for 15-20 days. Other signs and symptoms may develop at any stage of toxicity. The current therapy for thallium poisoning is the use of prussian blue and potassium chloride. Potassium therapy is probably the single most effective agent in the treatment of thallium poisoning. Further research, however, is needed to find an optimal antidote for thallium.
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PMID:Thallium poisoning: a review. 633 55

Epidemics of epilepsy, a form of mass hysteria, were known in Eastern and Western cultures in the 17th and 18th centuries. A unique situation in the United States during the 19th centurey was the frontier religious movement, the setting in which the "jerks" occurred. The "falling exercise," "dancing exercise," "barking exercise," "laughing exercise," and the "running exercise" centered around the excitement involved in the religious revival. During some exercises, people saw "visions," and exhibited bizarre behavior and sudden jerking motions. During the summers of 1801-1803 on the Kentucky frontier, some pioneers who attended the religious revival camp meetings had convulsions, hallucinations, tremors, jerks, compulsive dancing and "epileptic trances." Although these have been assumed to be psychological in origin, the epidemiology of the symptoms may correlate with the diagnosis of ergotism. Those affected were usually children and young adults. Symptoms of ergotism include giddiness, fatigue, depression, formications, muscle twitching, tonic spasms, convulsions, delirium, and loss of speech.
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PMID:Ergot, the "jerks," and revivals. 636 76

Combined MAOI-tricyclic treatment remains a plausible approach to depressions refractory to single drugs. Adherence to published guidelines should minimize special risks of the combined treatment. However, such risks do exist, and should be borne in mind. Most severe reactions - characterized by hyperthermia, delirium, convulsions, and sometimes fatal outcome - have occurred after a tricyclic was added to established MAOI treatment. Combined treatment may be associated with a lower risk of hypertensive crisis than treatment with MAOI alone. There are no data from double-blind, control-group studies to demonstrate an advantage for the MAOI-tricyclic combination in refractory depression. However, almost no such data exist to establish the advantage of any other treatment in this clinical situation. Clinical experience provides the primary basis for continued consideration of this approach when usual treatments have failed.
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PMID:The combined use of MAOIs and tricyclics. 637 86


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