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

This summary provides an overview of the assessment and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Depressive Disorders. Depressive disorders in children and adolescents are marked by core symptoms similar to those seen in adults, although symptom expression varies greatly with developmental stage. These disorders are common, chronic, and recurrent, and they are associated with comorbid psychiatric conditions and poor outcome that can be alleviated by early identification and treatment. Opinions differ regarding treatment planning and duration of treatment required. Development of a treatment relationship with the patient and family is crucial for a successful outcome. Psychotherapy is an appropriate treatment for all children and adolescents with depressive disorders. Antidepressants may prove useful in some cases and are especially recommended for patients with psychosis, bipolar depression, and severe depression. Continuation treatment is necessary in all patients after the acute phase; long-term maintenance is required in some. Early detection and intervention is effective in ameliorating the poor psychosocial outcome.
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PMID:Summary of the practice parameters for the assessment and treatment of children and adolescents with depressive disorders. American Academy of Child and Adolescent Psychiatry. 1131 59

Depressive illness has been associated with variations of several aspects of immune functioning, as well as alterations of cytokine production in stimulated lymphocytes. In the present investigation we sought to determine whether pharmacologically-induced reductions of mood in healthy, male subjects would be associated with alterations in the levels of circulating IL-1 beta or IL-6 or to in vitro lymphocyte proliferation in response to T cell mitogens, PHA and Con A. Lowering tryptophan levels by means of a tryptophan-deficient amino acid mixture, which reduced plasma tryptophan and serotonin (5-HT) levels, produced a lowering of mood in a subset of male subjects (that had no personal or family history of depression) relative to subjects that received a balanced amino acid mixture. Correlational analyses revealed that the change of mood (particularly depression and anger) in subjects that received the tryptophan-free mixture was related to the extent of the tryptophan or 5-HT reductions. However, while fenfluramine administration resulted in recovery of tryptophan and 5-HT levels, this was not accompanied by recovery of mood. Furthermore, it was observed that the lowering of tryptophan levels and the reduced mood were not accompanied by variations of the cytokine levels or cell proliferation. Evidently, transient and modest alterations of 5-HT or mood induced by a tryptophan-free amino acid mixture were insufficient to promote variations of immune activity or circulating IL-1 beta or IL-6 levels. Even if depression were related to immune disturbances, the mood and 5-HT alterations associated with this type of manipulation may be too brief to promote immune changes comparable with those ordinarily associated with severe or chronic depressive illness.
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PMID:Influence of acute tryptophan depletion on mood and immune measures in healthy males. 1009 22

Depressive disorders in employees and their dependents pose a major occupational health challenge, with implications for productivity, competitiveness, disability program utilization and medical care costs. The following article shows just how big an impact depression has had on the benefit programs of a major Midwestern employer--generating over half of all mental healthcare diagnoses and claims and even more days of disability and 12-month recidivism than chronic physical complaints such as heart disease, diabetes, high blood pressure and low back pain.
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PMID:The cost of depression in the workplace. 1017 3

Immigrants have higher rates of suicidal behavior than those in their countries of origin and their new countries. Immigration is a stressful life event which may lead to depression and suicidal behavior. Depressive disorders and suicidal behavior have a firm neurobiological and genetic basis. The author suggests that most immigrants who exhibit suicidal behavior in the new country had suicidal tendencies, and/or some degree of depression, and/or certain maladaptive personality traits in their countries of origin. The paper emphasizes the role of genetic and neurobiological factors in the human response to stressful events.
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PMID:On the role of neurobiological and genetic factors in the etiology and pathogenesis of suicidal behavior among immigrants. 1053 1

Stroke represents a major public health problem in the United States, but relatively little work has been directed toward identifying and treating the common neuropsychiatric disorders occurring after stroke. This review discusses clinical and pathological correlates of depression, anxiety disorder, catastrophic reactions, pathological affect, or psychosis after stroke, as well as their epidemiology. Depressive disorder and anxiety disorder have been shown to inhibit physical recovery from stroke. It seems likely that other psychiatric disorders also inhibit recovery and limit quality of life. There are very few controlled trials examining the effectiveness of treatments for these disorders after stroke. Both depression and pathological affect, however, can be effectively treated with antidepressant medications.
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PMID:The neuropsychiatry of stroke. 1066 63

The epidemiology, clinical features, and drug treatment of depression in HIV-infected patients are discussed. The lifetime prevalence of depression in patients infected with HIV has been estimated at 22-45%. The signs and symptoms of depression are similar in HIV-infected and noninfected patients, but patients with HIV infection may more frequently have sleep and appetite disturbances. Diagnosis should focus on affective or cognitive depression symptoms that reflect mood state alone. Patients with a history of depression, homosexual men, women, and i.v. drug abusers are among HIV-infected individuals who may be at increased risk for depression. Depression may alter the course of HIV infection by impairing immune function or influencing behavior. Depression my contribute to nonadherence to therapy. Antidepressant therapy is effective in most HIV-positive patients with major depression. Tricyclic antidepressants (TCAs) have produced response rates as high as 89%, but their usefulness has been limited by adverse effects. Selective serotonin-reuptake inhibitors and other non-TCAs have also demonstrated efficacy and are generally better tolerated. Psychostimulants have improved mood, cognition, and energy level, and androgens have been used for their anabolic effects. The systemic concentrations of antidepressants may be altered by coadministered drugs that affect their cytochrome P-450 isoenzyme-mediated metabolism; in turn, the metabolism and toxicity of certain antiretrovirals may be affected by antidepressants. Guidelines on the treatment of depression in the general population may be applied to patients with HIV infection. Depressive disorders are prevalent among patients with HIV infection but often respond to a variety of treatments.
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PMID:Depression in patients with HIV infection. 1071 76

Numerous recent epidemiological studies indicate that depressive disorders in children and adolescents are quite common. Roughly 15% of adolescents admit to having suffered from such a disorder at some time or other. Depressive disorders increase with age with a preponderance of girls over boys. Risk factors that have been found to be associated with depressive disorders include parental psychopathology, familial dysfunction, and negative life events. Depression frequently occurs together with other disorders, and shows a tendency to become chronic. Finally the article discusses the implications of the latest findings for preventive and interventional strategies.
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PMID:[Increasing depression in children and adolescents. Only early intervention can prevent dire outcome]. 1085 69

Substance abuse has been associated with attempted suicide and suicide. Few studies have examined the prevalence and associations of combined depression and substance abuse in suicide attempters. A chart review study of 1136 adult general hospital patients referred for psychiatric consultation between 1995 and 1998 was conducted to assess this further. Among 371 cases with self-harm, 311 (84%) attempted suicide. Suicide attempters were younger and diagnosed more often with comorbid substance abuse than patients without self-harm. Depressive disorders were found in 59% and substance abuse disorders in 46%. Comorbid depression and substance abuse was the most frequent category in suicide attempters, i.e., in 37%. Self-reported suicide intent was associated with increasing age, male gender, and comorbid depression and substance abuse. The suicide rate in suicide attempters was 322 per 100,000 patient-years, and 131 per 100,000 in consultation patients without self-harm. It is concluded that comorbid depression and substance abuse is associated with attempted suicide in psychiatric consultation patients. Suicide attempters should be thoroughly assessed for substance abuse. The increased suicide rate in psychiatric consultation patients with and without suicide attempts warrants further research.
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PMID:The association of suicide attempts and comorbid depression and substance abuse in psychiatric consultation patients. 1093 36

Examined the relation of the depression aspect of the tripartite model of depression and anxiety to the diagnostic status and future symptoms of two samples that included 74 child and adolescent psychiatric inpatients, ages 7 to 17 years (M = 13.57, SD = 2.39), some with either internalizing or externalizing diagnoses. The tripartite model suggests that anhedonia (low positive affect, or PA) differentiates depression from other conditions, whereas generalized negative affect (NA) also characterizes depression but is not specific to it. In this study, differences among children in PA and NA were associated with depressive versus externalizing diagnostic status and with future symptoms of depression. Depressive disorder diagnoses were associated with the combination of low levels of PA and high levels of NA. Changes over time in depression, but not in anxiety, also were associated with the combination of low PA and high NA. Results provide support for the applicability, clinical utility, and extension of the tripartite model with children.
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PMID:Tripartite model of depression and anxiety in youth psychiatric inpatients: relations with diagnostic status and future symptoms. 1096 21

The purpose of this study was to investigate the determinants and maintenance factors of depression in patients undergoing coronary artery bypass graft (CABG) surgery. Fifty CABG candidates were selected randomly for evaluation before and after surgery. Depressive disorders occurred in 22.0% of the patients preoperatively and 21% postoperatively. Irritability as a symptom was more prevalent in depressed than nondepressed patients preoperatively (P=.04) and postoperatively (P=.006). Although depression was the most prevalent diagnosis in the patients' psychiatric histories and evaluations, benzodiazepines were prescribed more frequently than antidepressants (70% vs 3%). Cardiologists should consider that the irritability in some patients undergoing CABG may obscure the diagnosis of depression. The correct recognition of depression is essential to reduce inappropriate benzodiazepine prescription and to apply appropriate treatment.
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PMID:Depression with irritability in patients undergoing coronary artery bypass graft surgery: the cardiologist's role. 1102 May 43


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