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

Men with primary and secondary unipolar major depression were divided into those with and without antisocial personality (ASP). The ASP depressives had a higher rate of alcoholism than the nonASP depressives, and among the nonASP depressives, those with drug abuse had a higher rate of alcoholism than those without drug abuse. The course of depression appeared to be related to the presence of nonaffective psychopathology. Depressed men with additional nonaffective disorders had fewer, but larger episodes than depressed men without, and depressed men with alcoholism had a higher risk of suicide. Our results confirm the close association of alcoholism and ASP and highlight the importance of recognizing nonaffective syndromes in the depressed patient.
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PMID:Alcoholism in antisocial and nonantisocial men with unipolar major depression. 293 59

The agonist/antagonist analgesics, butorphanol (Stadol) and nalbuphine (Nubain), are being increasingly employed as intravenous sedation agents; nalbuphine will be available in the future as an oral analgesic. The drugs possess numerous pharmacologic similarities and some dissimilarities. Both are equianalgesic (and nalbuphine is equipotent) with morphine parenterally and codeine orally. Their pharmacokinetics are similar; nalbuphine has a longer duration of action. Both may precipitate an abstinence syndrome in narcotic-dependent persons and will probably be associated with low-level drug abuse potential. They are both agonists of the kappa opioid receptor and partial agonists of the mu receptor. Butorphanol is a partial agonist of the sigma receptor responsible for psychotomimetic effects. The incidence of adverse effects is low, sedation being the most common. In cardiac-risk patients, nalbuphine does not increase cardiac work or oxygen requirements; nor do increasing doses of nalbuphine increase the duration of respiratory depression. Both drugs possess plateau respiratory depressant actions.
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PMID:Butorphanol and nalbuphine: a pharmacologic comparison. 298 81

Many adolescent affective disorders are rooted in biological vulnerability to stress and a predisposition to mood variations that are latent in childhood. As these stress-sensitive children encounter the normative helplessness and struggle for autonomy of adolescence, they may use violence, explosive rage, self-starvation, grandiose self-idealization, drug abuse, and suicidal behavior to relieve psychological helplessness and tension. They may begin a lifelong cycle of failure, disruption, and rejection by family and schools. The author describes adolescent depression and its biological underpinnings, deprivation syndromes, and manic-depressive illness, as well as the concept of affective violence in organic affective syndromes and episodic dyscontrol syndromes. These disorders call for multimodal treatment in which appropriate medication facilitates psychosocial intervention.
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PMID:Affective disorders and violence in adolescents. 301 50

The possibility of a rise in rates of depression among adolescents and young adults was first reported in the 1970s. Particular note was taken of the emergence of childhood depression and the increase in suicide attempts and death among adolescents and young adults. Data from large-sample family studies and community epidemiological surveys have been reviewed and reanalysed, using life-table statistical methodology. Evidence for secular trends are presented, and the problems of disentangling period and cohort effect are discussed. It appears that the 'baby boomers' - those born in the years after World War II - have had increased rates of depression and other related illnesses, including drug abuse and alcoholism. The theoretical aspects of this are discussed, particularly for gene-environment interactions.
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PMID:The current age of youthful melancholia. Evidence for increase in depression among adolescents and young adults. 316 77

The MMPI and MCMI were administered to 163 former opiate addicts who were being maintained in a methadone program affiliated with an urban hospital. Highest group mean MMPI scores were found for Psychopathic Deviate, Depression, Hypomania, and Hysteria. For the MCMI, highest group mean clinical syndrome scores were found for Drug Abuse, Alcohol Abuse, Anxiety, and Dysthymia; highest personality disorder scores were found for Antisocial, Narcissistic, Histrionic, and Paranoid. The MCMI Drug Abuse Scale identified only 49% of subjects as having a recurrent or recent history of drug abuse. Frequency and factor analyses documented the heterogeneity of the population with respect to clinical syndromes, as well as the prevalence of personality disorders (86% had elevations on MCMI Personality Scales). Factor and correlational analyses did not provide strong evidence of similar factor structure or convergent validity of the MMPI and MCMI with this population.
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PMID:Psychopathology of opiate addiction: comparative data from the MMPI and MCMI. 321 33

Sexual attitudes and behavior of adolescent females have been the topic of much interest over the past decade. Feelings about contraception, conception, and abortion have been described in relation to the adolescents' beliefs about the possibility of becoming pregnant, who will or will not "protect" them, and the influence of significant others on their decision making. This study explores differences in 35 women who had abortions during their teenage years with 36 women whose abortions occurred after the age of twenty. A demographic questionnaire, the Millon Clinical Multiaxial Inventory, and the Beck Depression Inventory were completed by women who were members of a patient-led support group. Premorbid psychiatric histories, the decision-making process itself, and distressing symptoms postabortion are reported. Specific differences in perceptions of coercion, preabortion suicidal ideation, and nightmares post-abortion were found in the adolescent group. Antisocial and paranoid personality disorders as well as drug abuse and psychotic delusions were found to be significantly higher in the group who aborted as teenagers. Hypotheses regarding the influences of adolescent development on mother/child relationships, power struggles, and the use of fantasy as a coping device are explored.
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PMID:Abortion in adolescence. 323 70

The blind test-retest reliability of lifetime prevalence and age of onset of psychiatric diagnoses, based on the SADS-L interview and RDC over a three-to-five year period, was examined in 143 probands and their relatives. Reliability of lifetime prevalence of major depression was excellent; reliability of antisocial personality, panic disorder, drug abuse, GAD, depressive personality, and alcoholism was good; reliability of obsessive-compulsive disorder and phobia was acceptable but lower. The reliability of hyperthymia or cyclothymia was not acceptable. Reliability for major depression did not vary substantially by age or sex of the informant, but recall of major depression was significantly higher in the probands than in their relatives. The test-retest reliability for the age of onset of major depression and panic disorder was excellent, and for phobia, GAD and alcoholism, was acceptable. Both probands and relatives recalled the age of onset of their depression fairly accurately. However, there was a reduction in agreement over time. Recall after 3-4 yr was better than 5-6 yr. There was a tendency for older respondents to systematically increase the age of onset of their depression across the two interviews, although the increase was only a few years. Recall of age of onset did not differ significantly by sex of respondent or whether the respondent was a proband or relative. These findings are discussed in light of several available studies of reliability of lifetime prevalence of psychiatric diagnoses.
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PMID:Lifetime prevalence and age of onset of psychiatric disorders: recall 4 years later. 326 42

Alcoholic men (N = 241) were administered a criterion-referenced, structured, DSM-III compatible, diagnostic interview while hospitalized and again 1 year later as outpatients. This interview independently evaluates the lifetime prevalence of 15 major psychiatric disorders. In addition to alcoholism, the most frequently occurring coexisting disorders were depression, antisocial personality and drug abuse. After 1 year, the number of positive syndromes declined slightly (chi = 2.0 to 1.8). However, the absolute and relative number of additional psychiatric syndromes remained stable over 1 year for the entire sample. Across individuals, the overall rates of agreement for the 15 syndromes ranged from a high of 100% to a low of 85%. Similarly, the agreement for the current and lifetime diagnoses ranged from 86 to 99%. These data indicate that a substantial portion of male alcoholics experience symptoms that are common to other psychiatric disorders. They also suggest that the endorsement of multiple psychiatric symptoms is not due simply to the acute emotional and physical distress that often accompanies a recent hospitalization for alcoholism treatment. Instead, for many male alcoholics, the symptom patterns appear to reflect additional psychiatric disorders that are stable over time and a potential target of treatment.
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PMID:The stability of coexisting psychiatric syndromes in alcoholic men after one year. 277 54

Physicians may have the opportunity to prevent suicide. An awareness of suicide risk factors, such as depression, alcoholism, drug abuse, schizophrenia, and chronic pain or disease, may facilitate suicide prevention. Recognition of acute and chronic suicidal vulnerability occurs through direct questioning. Psychiatric consultation is indicated for patients exhibiting clear self-injury risk, as exemplified by expressed suicide intent, an overt plan for death, or a "gesture." Hospitalization is usually recommended for socially isolated patients presenting with overt suicidal ideation, complicated by injurious self-harm, encephalopathy, or substance abuse. Family involvement and a "no-suicide" contract with the patient, coupled with close outpatient follow-up appointments, should suffice for those exhibiting milder or transient thoughts of suicide without manifest intent to die.
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PMID:A preventive approach to the suicidal patient. 327 11

American Indians are the most severely disadvantaged of any population within the United States. By adolescence, Indian children show higher rates of suicide, alcoholism, drug abuse, delinquency, and out-of-home placement. School achievement is severely compromised, and many youths drop out before graduation from high school. The Indian child understands the environment through intuitive, visual, and pictorial means, but success in the Anglo school is largely dependent on auditory processing, abstract conceptualization, and language skills. This difference compounds existing problems of poverty, dislocation, alienation, depression and intergenerational conflict and can partially account for the higher rate of emotional and behavioral problems among Indian adolescents.
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PMID:Current status and future directions of research on the American Indian child. 330 62


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