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

Depressive disorders are both common and often easily treated. However, a major stumbling block in the care of these patients remains the recognition and accurate diagnosis of these conditions. The author summarizes commonly encountered pitfalls in the diagnosis of these patients and potential remedies. Issues of subtyping depression based on cross-sectional evaluation of the symptom picture, as well as prior course of illness, anticipated treatment response, and anticipated prognosis, are discussed.
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PMID:Problems associated with the diagnosis of depression. 218 72

Depressive disorder is a common complication of stroke. Although somatic symptoms of stroke may be mistaken for depression, DSM-III criteria for major depression are appropriate for use in this clinical setting. The etiology of poststroke depression can be viewed from a number of perspectives. Evidence from examining lesion characteristics and depression suggests that a disease model is suitable for some cases of poststroke depression. Alternatively, adequacy of social support and gender differences influence the occurrence of poststroke depression. Poststroke depression can be effectively treated with tricyclic antidepressants, and the use of these agents may also enhance physical and cognitive recovery.
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PMID:Depression and cerebrovascular disease. 200 83

The concept of pseudodementia was coined in the late XIXth century to refer to a syndrome mimicking dementia, but without underlying neurological lesions. Depressive disorders represent the main etiological factor and may present under two different forms, either "depressive cognitive disorders", or the more severe feature of "Wernicke's pseudodementia". The main issue remains diagnosing pseudodementia form organic dementia, especially from cortical degenerations of the Alzheimer type. Thus, the recognition of this clinical syndrome represents an alternative to the diagnosis of dementia which may lead to earlier and more effective psychiatric treatment. Recently, diagnostic criteria have been proposed to facilitate this distinction. Such criteria include clinical history, neuropsychological features, biological findings (dexamethasone suppression test and plasma MHPG) and electroencephalographic sleep studies. Finally, from a theoretical point of neurological conception of depression as well as for current hypotheses on the relationship of this last one with dementia.
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PMID:[Current concept of pseudodementia]. 220 77

We estimated clinicians' awareness of depression for patients with current depressive disorder (N = 650) who received care in either a single-specialty solo or small group practice, a large multispecialty group practice, or a health maintenance organization in three US sites. Depressive disorder was determined by independent diagnostic assessment shortly after an office visit. Detection and treatment of depression were determined from visit-report forms completed by the treating clinician. Depending on the setting, from 78.2% to 86.9% of depressed patients who visited mental health specialists had their depression detected at the time of the visit, compared with 45.9% to 51.2% of depressed patients who visited medical clinicians, after adjusting for case-mix differences. Among patients of mental health specialists, there were no significant differences by type of payment in the likelihood of depressive disorder being detected or treated. Among patients of medical clinicians, however, those receiving care financed by prepayment were significantly less likely to have their depression detected or treated during the visit than were similar patients receiving fee-for-service care.
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PMID:Detection of depressive disorder for patients receiving prepaid or fee-for-service care. Results from the Medical Outcomes Study. 232 26

Depressive disorders in children and adolescents are valid clinical entities which can be identified using adult diagnostic criteria. Recent research has resulted in significant progress in the areas of diagnosis, epidemiology, family pathology, pharmacokinetics and psychopharmacology. Many rating instruments have been developed to screen, diagnose and measure changes of depression in children and adolescents. The prevalence of depressive disorders in prepubertal children is about 2% and in adolescents about 5%. Depressive episodes are usually of long duration, with high rates of relapse. These relapses are usually associated with school, family and social failure. Follow-up studies of depressed adolescents indicated that about half of the patients continue to suffer from mood disturbances and psycho-social adaptational problems. In North America suicidal behaviour in adolescents has increased 300% in the past 30 years. However, its relationship to depression is more complex than in adults. There is a significant excess of affective illness and alcoholism in the families of depressed adolescents. Similarly, there is a high rate of impairment among children of parents with affective disorders. During depressive episodes, prepubertal children show abnormalities of growth hormone and cortisol secretion. However, DST findings are contradictory. Polysomnographic findings in childhood depression appear unremarkable. In adolescent depression these findings are similar to those in depressed adults. Biological manifestations of depressive disorders may be significantly affected by developmental and hormonal changes. Antidepressants have been effective in the therapy of several disorders in childhood. These include enuresis, school phobias, attention deficit, conduct disorders and obsessive-compulsive disorders. Open drug studies suggest that antidepressants are useful in depressed children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Depressive disorders in children and adolescents. 266 89

Epidemiologic studies in psychiatry in general, and child psychiatry in particular, represent a new focus. Certain disease entities in children and adolescents are better studied than others. Depression and anxiety of childhood seem to exemplify this statement. Depressive illness in childhood, although recently accepted in its full clinical implications, is a relatively well researched area with regard to epidemiology and prevalence. A number of factors have been identified as being influential such as age, race, socioeconomic status, sex, IQ, and source of information. Anxiety, however, still remains an area that is unexplored and not well researched. Very few studies have epidemiologically looked at the various types of anxiety and their prevalence in childhood and adolescence. Factors that further complicate this have been the relationships between anxiety and the normal developmental stages as well as the association between anxiety and depression. The various symptoms or subtypes of anxiety seem to be normal phenomena at different developmental stages. As a result, the identification of anxiety disorders, as they specifically influence children and adolescents, has been very much undervalued. Further research is needed to differentiate anxiety from depressive disorders and more specifically to distinguish among the different subtypes of anxiety disorders and to study their prevalence. It is only then that greater attention can be given to the course, prognosis, and treatment outcome of the anxiety disorders.
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PMID:Epidemiology of affective and anxiety disorders in children and adolescents. 269 25

Depressive disorders are more common in the relatives of depressed probands than in the population at large, and there is compelling evidence that the familial aggregation of bipolar disorder and severe unipolar depression is at least partly due to genetic factors. However, the evidence concerning 'non-endogenous' depression is less clear, and family environment probably plays a stronger role. Much current research is focused on two areas: firstly, the mode of inheritance of manic-depressive illness, with the use of molecular biological techniques to detect and localise major genes; and secondly, the ways in which familial predisposition and environmental insults combine to produce depressive disorder.
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PMID:The genetics of depression and manic-depressive disorder. 269 60

One hundred and seven accidentally injured adults were studied while in hospital and assessed prospectively twice more in a mean period of 28 months. The patients were studied by means of taped clinical interviews, including the Comprehensive Psychopathological Rating Scale (which includes the Montgomery-Asberg Depression Rating Scale), and several self-report measures of distress (Schedule of Recent Life Events, General Health Questionnaire, Impact of Event Scale and State Anxiety Inventory) at the three assessments. The total incidence of psychiatric disorders considered to be caused by the accident during the follow-up period was 22.4%. The incidence of non-organic psychiatric disorders caused by the accident was 16.8% at the first follow-up and 9.3% at the final follow-up. Depressive disorders of different severity were most often seen. Only one patient suffered from a post-traumatic stress disorder during the follow-up, and none at the final follow-up (DSM-III). Organic mental disorders were diagnosed in 9.3% of the patients. In 5.6% of the patients this was the only disorder.
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PMID:The long-term psychiatric consequences of accidental injury. A longitudinal study of 107 adults. 325 81

Referrals for psychiatric consultation from all inpatient and outpatient departments in a large general hospital were analysed. There were 597 referrals--the combined inpatient and outpatient referral rate was approximately 0.78% and the inpatient rate 1.8%. The most common reasons for referral were parasuicide, depression/symptoms of depression, abnormal behaviour and alcohol abuse. Depressive disorders, drug dependence and neuroses were the most common diagnoses made. Medication was prescribed in 38% of cases and psychotherapy was offered in 18%. In 21% of cases the patient was either managed in his original ward or transferred back to the ward with advice regarding management. In 79% of cases management was within the Department of Psychiatry; many of these patients required concurrent treatment from the referring doctor for a physical disorder. The value of improving the quality and availability of consultation-liaison psychiatry services is discussed.
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PMID:Referral patterns for psychiatric consultation in a large general hospital. 342 32

Depressive illness is known to be associated with low self-evaluation, but it has been suggested that there may be a reciprocal connection as well, such that low self-appraisal (in the absence of illness) makes the subsequent onset of depression more likely. A prospective study, using a community sample of 376 women, provided data about clinical state over a period of 18 months, and self-appraisal questionnaire scores were determined on two occasions separated by 6 months. There was no evidence that low self-evaluation predicted future episodes of depressive illness, except in women who reported previous psychological episodes for which they had sought medical help, and, even for those with previous episodes, much of the predictive power of low self-esteem was accounted for by individuals who were subsequently recognised to have been in the early stages of illness. Conversely, there was little evidence that prior episodes predicted future illness in people with high self-esteem. One explanation of the findings is that recurrent episodes of illness cause progressive impairment of self-appraisal, but other possibilities are also considered. Women who had recovered from illnesses detected at the first interview still had significantly less self-confidence 6 months later than those who were well throughout.
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PMID:Self-appraisal, anxiety and depression in women. A prospective enquiry. 344 9


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