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

This paper reviews the development of the current understanding of childhood depression. Psychoanalytic thought is briefly reviewed and recent studies regarding diagnosis, incidence, etiology, treatment, and prognosis are covered. The Diagnostic and Statistical Manual III is thought to adequately diagnose both adult and childhood depression. Depressive disorder in children is more frequently recognized and important studies are enhancing our knowledge of biologic, genetic, and psychological factors in depression. Treatment of depression is being refined and developed. The authors suggest that the understanding of childhood depression continues to be best conceptualized within a biopsychosocial model.
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PMID:Childhood depression. 683 4

Eighteen depressed chronic schizophrenic out-patients were matched with non-depressed schizophrenic out-patients. The depressed schizophrenics had had significantly more psychiatric admissions, past depression, past treatment for depression, significantly more had attempted suicide, lived alone, had low self-esteem, had early parental loss and had had more life events in the six months before the onset of depression. Depressive disorder in schizophrenic out-patients well controlled by neuroleptics may occur in those who are at risk for depression and experience an excess of life events.
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PMID:Depression in chronic schizophrenia. 687 60

The paper is a report on results obtained in the course of a multi-centre international study on depressive disorders in four countries, which was sponsored and co-ordinated by the World Health Organization. A screen form was developed and tested in order to select depressive patients among psychiatric in-patient and out-patient populations. The patients selected in this way were assessed clinically by experienced investigators using the WHO schedule for Standardized Assessment of Depressive Disorders (SADD). A total of 53 patients were evaluated in the five research centres, and the data were utilized in uni- and multivariate statistical analyses aiming to establish whether similar cases of depression could be found in different cultures, to describe their characteristics and to ascertain the extent to which diagnostic concepts and classification categories could be applied in different settings. The results point to a considerable degree of similarity in depressive symptomatology across the cultures if particular selection criteria are applied, and suggest that broad diagnostic groupings such as 'endogenous' and 'psychogenic' depressions could be used consistently by clinicians working in different cultures.
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PMID:Characteristics of depressive patients contacting psychiatric services in four cultures. A report from the who collaborative study on the assessment of depressive disorders. 731 84

Depressive disorders are a common problem in late life, requiring consistent and reliable screening by clinicians. Such screening should be based upon the most recent criteria available to facilitate diagnostic and nosologic agreement. This study presents a new screening instrument for geriatric depressive disorders based upon DSM-III-R criteria and the known differences in the display of depression that occur among older persons. The Older Adult Health and Mood Questionnaire (OAHMQ) is a 22-item questionnaire with sound psychometric properties and high validity. Its validation included comparisons with diagnostic assessments by geriatrically-trained psychiatrists and psychologists, and factor analysis. Using a three-part division of "normal," "clinically significant depressive symptoms," and "probable major depression," its sensitivity is .80 and its specificity is .87 for major depression, and .92 and .87, respectively, for any depressive disorder. Separate scoring of affective symptoms versus other symptoms of depression (i.e., physiologic, cognitive, or behavioral) can be useful for diagnostic and research purposes.
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PMID:The Older Adult Health and Mood Questionnaire: a measure of geriatric depressive disorder. 757 40

A clinical analysis of the psychiatric referrals (N = 889) during 1989-1991 is presented. The most prevalent psychiatric syndromes seen in both inpatients and outpatients are compared with reference to those areas of psychopathology that are less frequently identified by nonpsychiatrist physicians. The distribution of psychiatric referrals according to the various clinics in order of frequency was as follows: internal medicine, surgery, dermatology, and neurology. The most frequent reasons for consultation requests were (in order of frequency) the referring physician's difficulty in making a diagnosis; and patient anxiety, depression, adjustment problems, and past psychiatric illness in the history. Depressive illness was the most prevalent psychiatric disorder among both inpatient and outpatient referrals. However, the frequency of alcohol and substance abuse disorder in the inpatient population was only 3.17% and organic brain syndrome was the least frequently recognized psychiatric syndrome by the other clinicians. In this report, the clinical activities of the Liaison Psychiatry Unit of the Psychiatry Department in the Istanbul Medical Faculty are presented. The major problem areas and clinical training objectives of the Consultation-Liaison Psychiatry Unit are discussed.
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PMID:The development of psychiatric medicine at Istanbul Faculty of Medicine and evaluation of 889 psychiatric referrals. 764 66

Depressive disorders are a chronic, recurrent, and severe burden to both patients and their families. Depressive disorders represent a major national public health problem, ranking within the top 10 most costly diseases in the United States. In 1990, depressive disorders afflicted at least 11 million Americans and cost the U.S. economy an estimated $44 billion. In addition, affective disorders are associated with increased accident rates, increased rates of substance abuse (especially alcoholism), increased medical hospitalization, and an increase in somatic illnesses and outpatient medical utilization. Despite their ranking as a major health problem, depressive disorders are often underdiagnosed and undertreated. Brief treatment strategies that focus only on acute episodes are often ineffective and result in chronic impairment, impairing performance at work and socially. Inadequate treatment increases costs, suffering, and lost productivity. Recent data suggest that effective treatment of depression requires long-term, skillful follow-up and active pharmacotherapy.
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PMID:The clinical and financial burden of mood disorders. Cost and outcome. 772 8

Depression is a frequent and treatable disorder, but it is insufficiently recognized. A generally used classification system is lacking. In a consensus meeting the following terms were defined: a normal feeling of depression, depression as a symptom and depression as an illness. The use of the term 'masked depression' was advised against. The undertreatment mentioned is caused by the following factors: presentation of physical symptoms by depressive patients, unfamiliarity of patients with depressive disorders and difficulties of patients and GPs in labelling depression as mental. Depressive disorders have various causes. For scoring the severity of depression the Bech version of the Hamilton Depression Rating Scale is preferred. There is no valid laboratory test for diagnosing depression. Laboratory tests are recommended to exclude physical disorders, for choosing an antidepressant and for the follow-up of drug treatment. Cognitive Behavioural Therapy and Interpersonal Therapy are preferred psychotherapeutic methods because of their scientifically proved efficacy. Women suffer from depression twice as frequently as men, which is due to social factors rather than to genetic or hormonal factors. Therefore hormonal therapy is not indicated, a more equal doctor-patient relationship is. Patients with a depressive disorder may consider suicide; this should regularly be discussed with them.
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PMID:[Consensus depression in adults. Dutch Association for Psychiatry]. 747 1

Epidemiological studies hold that depressive disorders are among the most common forms of mental illness in the population and should produce a substantial economic impact upon corporate America. However, only a few studies have examined the economic impact of depression in the workplace. A study of the medical and disability costs of depressive disorders was conducted at the First Chicago Corporation. In this analysis, short-term disability data, medical plan costs and Employee Assistance Program referral data for depressive disorders were compared with selected common chronic medical conditions. The average length of disability and the disability relapse rate was greater for depressive disorders than for the comparison medical groups. Depressive disorders were also found to have the largest medical plan costs of all behavioral health diagnoses. Finally, depressive disorders proved to be the most common Axis-I-level diagnosis encountered in the Employee Assistance Program. These findings have important implications for medical benefit plan design, disability plan management, and occupational health professionals' training. The observed higher prevalence of these disorders in women force their recognition as a women's health issue.
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PMID:The economic impact of depression in a workplace. 782 20

Depressive illness places an enormous economic burden on health services, the community and the individual patient. It is a serious medical disorder associated with high levels of social and physical disability. Antidepressant drug therapy can produce significant improvement in the majority of patients. However, despite its high prevalence depressive illness is frequently undetected, misdiagnosed or inappropriately treated. The selection of a cost-effective antidepressant requires a broad evaluation of the risks, costs and benefits. A choice should not be made on prescription drug costs alone but on the basis of the overall value a treatment option offers in the management of illness. Benefits, such as improved treatment compliance, reduced toxicity in overdose, long-term safety and efficacy in the prevention of relapse and recurrence of depression, improved patient quality of life and decreased accident liability all have cost implications which must be considered when determining the relative cost of medication.
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PMID:Reducing the economic burden of depression. 786 45

Depressive disorders can affect all aspects of a person's functioning and are often associated with significant psychosocial impairment. Such psychosocial problems promote studies of the efficacy of short-term psychotherapy for depressive disorders. This report summarizes the literature on acute-phase, short-term psychotherapy for adult outpatients with major depressive disorder and is an updated component of a larger review commissioned by the United States Public Health Services Agency for Health Care Policy and Research (AHCPR review on "Short-term Psychotherapy for Depression," Jarrett and Maguire [1991]; Jarrett and Down [in press] during the preparation of the Clinical Practice Guidelines in primary care (Depression Guideline Panel 1993). The short-term psychotherapies reviewed here and studied most often include behavior therapy, cognitive therapy, interpersonal psychotherapy, and brief dynamic psychotherapy, which all aim to reduce depressive symptoms. We comment on the state of the literature and raise some of the questions which await data.
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PMID:Short-term psychotherapy of depressive disorders: current status and future directions. 793 31


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