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

Depressive disorders in women are commonly associated with reproductive events. This association may be due in part to the changing balance between estrogen, progesterone, and other hormones that affect neurotransmitter function throughout a woman's lifecycle. Alternatively, they may be related to psychosocial events surrounding these pivotal times or to both sets of conditions. Some data suggest that depression in women tends to respond differently to antidepressant treatment than depression in men, underscoring the need to examine the risk and treatment of depressive disorders in males and females separately. Women have benefited considerably from serotonin reuptake inhibitor anti-depressants that are currently available. These agents appear to be more effective than the older tricyclic antidepressants in treating various depressive disorders that occur commonly or exclusively in women. Additionally, serotonin reuptake inhibitors have increased tolerability in women, who generally experience more adverse effects from tricyclics and monoamine oxidase inhibitors than do men. Estrogen appears to enhance antidepressant response in postmenopausal women receiving estrogen replacement therapy. More research is needed, however, that examines how the balance between estrogen, progesterone, and other hormones affects neurotransmitter function.
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PMID:Special issues related to the treatment of depression in women. 1470 Apr 49

Depressive disorders are of great medical and political significance. Despite improvements in the treatment of depressive patients, the potential for guideline-oriented diagnosis and therapy as well as better co-operation between different levels of care is evident. This study is part of the German Research Network on Depression and Suicidality. The study is conducted in Southern Baden, North Rhine and Munich. The objective is to develop a quality management program for primary care physicians and psychiatrists. A comprehensive continuous medical education concept as well as quality management measures were developed, implemented and evaluated. A total of 66 physicians (43 primary care physicians and 23 psychiatrists) participated. They documented the diagnostic and treatment measures provided to depressive patients before and after the intervention that had been implemented in the intervention regions of Southern Baden and North Rhine. Effects regarding guideline orientation and implementation of stepped-care treatment are analysed with an intervention/control group design and prepost data measurement.
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PMID:[Comprehensive ambulatory care quality management for patients with depressive disorders]. 1471 Jun 64

The overall prevalence of psychiatric disorders in epileptic patients is estimated between 19 and 62%. Depressive disorders may be the most common psychiatric disorders and the main reason for psychiatric hospitalisation and taking psychotropic drugs. The underdiagnosis and undertreatment of depressive disorders among epileptic patients represent a problem of considerable magnitude. The aim of the present study was to evaluate the prevalence of depressive disorders among patients with primary epilepsy and to determine the risk factors of the occurrence of the depressive illness. The survey was conducted in a outpatient epilepsy clinic in the Ibn Rochd University Hospital Centre in Casablanca. All patients with idiopathic or cryptogenic epilepsy aged 15 Years and above, were eligible, except for patients with severe physical and mental disabilities. Neurologists diagnosed the epilepsy based on clinical criteria with electroencephalograms data. The depressive disorders met a psychiatrist's evaluation of an ICD-10 criterion. Ninety-two subjects participated in the survey, 57.6% were men and the mean age was 30.3 +/- 10.8 Years. The epilepsy age of onset was 16.3 +/- 11.4 Years with an average duration of 14.1 +/- 9.2 Years. The prevalence of depressive disorders among epileptic patients in our survey was 18.5%. According to sex, the prevalence was 23.1% in women and 15.1% in men. The depressed patients were compared with the remaining patients without depression with regard to seizure variables and sociodemographic characteristics. The epilepsy-depression and epilepsy-control groups did not differ significantly in the duration of epilepsy or in the type of anticonvulsant therapy (mono versus polytherapy). Three variables were significantly different between the two groups. The mean age in the epilepsy-depression group was significantly higher (34.4 +/- 9.6 Years versus 29.4 +/- 10.9, p<0.03), the mean age of epilepsy age of onset was also higher in the epilepsy-depression group than in the epilepsy-control group (21.8 +/- 11.9 Years versus 15.04 +/- 11.0, p<0.03) and the seizure frequency per week was more important among depressed epileptic patients (2.4 + 5.2 seizures versus 0.4 + 1.5, p<0.007). The present survey confirms the findings of previous studies that the prevalence of the comorbidity between epilepsy and depression is common in specialised outpatient units. The detection and the treatment of depressive disorders among the epileptic patients remains a very great challenge in the management of the epileptic illness. It will improve the quality of life of these patients. A closer involvement of psychiatric and psychological treatment in patient management is necessary.
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PMID:[Depressive disorders among epileptic patients attending a specialised outpatient clinic]. 1502 75

Depressive disorders are among the most frequent psychiatric diseases in the Western world with prevalence numbers between 9% and 18%. They are characterized by depressed mood, a diminished interest in pleasurable activities, feelings of worthlessness or inappropriate guilt, decrease in appetite and libido, insomnia, and recurrent thoughts of death or suicide. Among other findings, reduced activity of monoaminergic neurotransmission has been postulated to play a role in the pathogenesis of depression. Consistent with this hypothesis, most antidepressive drugs exert their action by elevating the concentration of monoamines in the synaptic cleft. However, it is not the enhancement of monoaminergic signaling per se, but rather long-term, adaptive changes that may underlie the therapeutic effect. These include functional and structural changes that are discussed later. In addition, in the last years, evidence has emerged that remissions induced in patients using lithium or electroconvulsive therapy are accompanied by structural changes in neuronal networks thereby affecting synaptic plasticity in various regions of the brain.
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PMID:New insights into the mechanisms of antidepressant therapy. 1505 98

Depression in elderly persons is widespread, often undiagnosed, and usually untreated. The current system of care is fragmented and inadequate, and staff at residential and other facilities often are ill-equipped to recognize and treat patients with depression. Because there is no reliable diagnostic test, a careful clinical evaluation is essential. Depressive illness in later life should be treated with antidepressants that are appropriate for use in geriatric patients. A comprehensive, multidisciplinary approach, including consideration of electroconvulsive treatment in some cases, is important. The overall long-term prognosis for elderly depressed patients is good.
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PMID:Depression in later life: a diagnostic and therapeutic challenge. 1516 57

Alexithymia is a multidimensional concept associating an emotional component focused on the difficulty in identifying and describing feelings and a cognitive one centred on the use of a concrete and poorly introspective way of thinking. Alexithymia can be assessed by self-assessment instruments and in particular by the 20 items version of the Toronto Alexithymia Scale (TAS-20). Depressive disorders have complex relationships with the construct of alexithymia and there exist few experimental works on the subject. Epidemiological studies frequently raise an overlap between alexithymia and depression, in particular in the context of addiction. The main aim of this study was to confirm the high prevalence of alexithymia among drug addicted patients taking into account socio-demographic variables (sex, age, social and economic categories). The second aim of the study was to investigate the relationships between alexithymia and depression among drug addicted patients. A sample of 128 drug addicted patients answering DSM IV criteria of dependence to a psycho-active substance (alcohol excluded) was paired according to socio-demographic variables to a control sample of 128 normal subjects. Diagnostic assessment was made using the Mini International Neuropsychiatric Interview (MINI). Alexithymia and depression were assessed with the TAS-20 and with the short version of the Beck Depression Inventory (BDI-13). The results confirm the high prevalence of alexithymia among drug addicted patients (43.5%) compared to controls (24.6%). This difference is based namely on the emotional component of alexithymia, the cognitive component failing to show any difference between the two samples. Moreover, alexithymia appears to be independent from socio-demographic variables in our sample of drug addicted patients; 66.4% of drug addicted patients presents a depressive symptomatology (which is significantly more important in female patients), compared to 26% of the controls. Studies using the TAS and the BDI with 21 items have shown that from 10 to 20% of the variance of alexithymia is explained by depression. Our own results show a shared variance of 20% between the TAS-20 and the BDI, going in the direction of a moderated correlation between alexithymia and depressive symptomatology. Moreover, when we retain only subjects without depressive symptomatology at BDI, drug addicted (n=42) are not any more alexithymic than controls (n=114). Our results plead for a positive association between depression and alexithymia in drug addicted, depressed or healthy subjects. Alexithymia and depression would be two associated dimensions, the emotional component explaining alone this association. The emotional component of the alexithymia would be thymo-dependent, whereas the cognitive component (externally oriented thought) would be independent and constitute a stable clinical feature. These results are concordant with other studies in the literature suggesting that alexithymia in its emotional component is supported by depression. Alexithymia thus did not appear as an autonomous dimension which would discriminate between drug addicted and controls, independently of the absence of a depressive state. The Authors discuss the complexity of the relationships between alexithymia and depression and the correlations between TAS and BDI scales especially for the factor Difficulty Identifying Feelings. These results deserve further studies. The cross-sectional nature of this study do not allow to establish if alexithymia is a subjacent and preexistent in the form of a psychopathological dimension in addictive behaviours, so supporting its emergence, and/or if it develops once the dependence is installed and chronicized. Longitudinal studies remain to be realised.
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PMID:[Alexithymia, depression and drug addiction]. 1523 17

Depressive disorders are a leading cause of morbidity and mortality worldwide. Current antidepressant drugs targeting monoamine neurotransmitter systems have a delayed onset of action, and fewer than 50% of the patients attain complete remission after therapy with a single antidepressant. A large body of preclinical and clinical evidence points to a key role of the corticotropin-releasing hormone (CRH) receptor 1 subtype (CRHR1) in mediating CRH-elicited effects in anxiety, depressive disorders and stress-associated pathologies. Genetic modification of CRHR1 function in mice by the use of conventional and conditional knockout strategies enables further analysis of specific elements in the CRH circuitry. The recent characterisation of several selective small-molecule CRHR1 antagonists offers new possibilities for the treatment of anxiety and depression.
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PMID:Getting closer to affective disorders: the role of CRH receptor systems. 1531 Apr 62

Depressive disorders are chronic conditions that produce both emotional and physical symptoms. Increasing evidence suggests that in some patients with depressive disorders a neurodegenerative process may occur, highlighting the importance of early and aggressive intervention. Serotonin (5-HT) and norepinephrine (NE) neurotransmitter systems influence neuroplasticity in the brain, and both are involved in mediating the therapeutic effects of most currently available antidepressants. Some dual-action antidepressants have been shown to be effective in managing the pain symptoms associated with depression. These agents may have advantages over others by treating a wider array of physical symptoms. Additionally, these agents may also have a role in modulating neurogenesis and other neuroplastic changes, thereby leading to more complete recovery in patients suffering from the emotional and physical symptoms of chronic depression.
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PMID:Common pathways of depression and pain. 1531 73

Depression is a common mental disorder associated with poor health outcomes. The purpose of this study is to examine the prevalence of depression, mental health comorbidity, illness variables, and quality of life in a sample of military veterans serving during the first Gulf War. The Iowa Gulf War Case Validation Study involved face-to-face evaluations in 1999--2002 of 602 military personnel--either deployed ("deployed veterans") or eligible but not deployed ("non-deployed veterans") to the Gulf. Subjects were sampled by conducting a series of case-control studies nested within a population-based survey of 4,886 military personnel. All subjects were interviewed using the Structured Clinical Interview for DSM-IV (SCID-IV), and a series of semi-structured interviews and validated questionnaires. Best estimate psychiatric diagnoses were assigned based on all available data. One-hundred-ninety-two (32%) of the 602 surveyed veterans met criteria for a current or lifetime depressive disorder (major depression, dysthymia, depressive disorder--not otherwise specified). Depressed non-deployed veterans were more likely to be female and to have served in the Air Force than depressed deployed veterans. There were few significant differences between the depressed deployed veterans and the depressed non-deployed veterans. Depressed deployed veterans had significantly higher lifetime rates of comorbid cognitive dysfunction (55% vs. 35%), and anxiety disorders (59% vs. 33%)--mainly accounted for by specific phobias (12% vs. 2%) and posttraumatic stress disorder (33% vs. 10%)--than did depressed non-deployed veterans. Lifetime substance use disorders were significantly more frequent in deployed veterans than non-deployed veterans (70% vs. 52%), particularly alcohol disorders (68% vs. 52%). There were no differences in rates of personality characteristics, family psychiatric history, stressors, hypochondriasis, and level of functioning between the two study groups showed no significant differences. Depressive illness is frequent in military samples, as it is in the general population. The prevalence, pattern of comorbidity, and illness features were similar in deployed veterans and non-deployed veterans, suggesting that the depression suffered by both groups of veterans is qualitatively comparable. The main difference between study, groups was that depressed deployed veterans had higher rates than depressed non-deployed veterans of comorbid anxiety disorders, hypothesized to be part of the stress-related syndromes seen in those who experience combat.
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PMID:Depression in veterans of the first Gulf War and comparable military controls. 1532 98

Depressive illness is generally associated with cognitive impairment. Serotonergic selective antidepressant drugs, fluoxetine (FLX), sertraline (SER) and tianeptine (TIA), are claimed to have less or no effect on cholinergic system, the key system involved in memory. In the present study, these drugs were evaluated for their influence on cognitive behavior in both depressive and non-depressive animals. Depression was induced by two models, (i) 60 days social isolation of litter; and ii) by applying chronic unpredictable mild stress for 21 days. Depression in the rats was confirmed by behavioral despair test. Transfer latency on elevated plus maze and inflexion ratio in passive avoidance step through behavior were employed to assess learning and memory. The results indicated that administration of fluoxetine; sertraline and tianeptine attenuated the cognitive deficits observed in depressive rats. In non-depressive rats these drugs produced retention deficit, which was found to be parameter and model dependent. Data suggested that, FLX and SER (SSRI's) effectively attenuated the isolation-induced depression and cognitive deficit, whereas TIA (SSRE) produced better effect in stress-induced depressive conditions. It was concluded that behavioral profiles of fluoxetine, sertraline and tianeptine on cognition were model and parameter dependent.
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PMID:Evaluation of cognitive function of fluoxetine, sertraline and tianeptine in isolation and chronic unpredictable mild stress-induced depressive Wistar rats. 1533 95


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