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

Secondary depression is a depression in an individual who has one or more preexisting, nonaffective psychiatric disorders or an incapacitating or life-threatening medical illness which precedes and parallels the symptoms of depression. Secondary depression is commonly seen in patients presenting to psychiatric facilities. For every 5 patients who are seen with a diagnosis of depression, approximately 2 should be classified as secondary. A patient with secondary depression is more likely to be younger, male, and to have a family history of alcoholism. His first diagnosis is most likely to be alcoholism; however, the preceding diagnosis varies depending on the setting in which the patient is seen. Hysteria, sociopathy, drug abuse and anxiety neurosis are also common. The symptom picture of secondary depression is almost indistinguishable from primary depression. One important reason a patient enters psychiatric treatment is that he develops a coexistent depression.
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PMID:The significance of secondary depression. 645 56

One hundred and eight women with bulimia were evaluated for affective disorder and alcohol or drug abuse, by means of the DSM-III diagnostic criteria. In this sample, 43.5% had a history of affective disorder and 18.5% had a history of alcohol or drug abuse. Approximately 56% of the bulimia patients scored within the moderate to severe range of depression on the Beck Depression Inventory.
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PMID:Affective disorder and substance abuse in women with bulimia. 659 58

Anorexia nervosa is a disease of increasing frequency with serious medical and psychological consequences. The presentation is one of significant weight loss. The initial assessment of such a patient must differentiate between an underlying systemic medical illness and an eating disorder. This paper will review the more common medical conditions causing weight loss and their distinguishing characteristics, including malignancy, inflammatory bowel disease, infections and metabolic disorders. Once an organic disease is ruled out, anorexia nervosa must then be differentiated from other eating disorders such as bulimia or other psychological diseases such as depression, schizophrenia, drug abuse, conduct disorders, and anxiety reactions. The pathogenesis of anorexia nervosa includes complex societal, family, and individual factors which require evaluation in the treatment process.
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PMID:Differential diagnosis and pathogenesis of anorexia nervosa. 659 95

In the management of depression only two forms of the condition need consideration: psychotic depression (usually severe) requiring treatment with antidepressants, ECT or both; and 'other' depressions, for which psychotherapy is the treatment of first choice. The selection of therapy depends on the personality integration of, and the stresses on, the patient. General practitioners are encouraged to understand and use crisis intervention and supportive therapy techniques. If the depression does not respond to these techniques within a few weeks the diagnosis should be reviewed for physical illness, psychosis and drug abuse. Trial of antidepressant drug therapy may be warranted before referral.
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PMID:Treatment of depression in general practice. 666 76

Psychosocial stressors are commonly classified according to such recent life events (RLE) as arguments and exits. Based on retrospective studies, exit events, e.g., deaths and marital separations, are generally believed to precede the onset of depression. We are reporting the first prospective study of RLE in 123 addicts, who were evaluated for depression using the Beck Inventory, then treated for drug abuse and reevaluated 6 months later for depression and the occurrence of intervening RLE. During the 6 months, only 31 per cent (38) of the addicts either remained (26) or became depressed (12), but 98 per cent (120) had RLE with a mean of 6.3 +/- 2.9. Both "normals" (1.1) and primary depressives (3.4) have fewer RLE. Among the 36 addicts with low numbers of RLE (zero to four), 25 per cent either remained or became depressed, while among the 26 addicts with high numbers of RLE (nine to 15), 50 per cent either remained or became depressed. When RLE were categorized into exit and argument events, arguments had a stronger relationship than exits to depression. Furthermore, only arguments showed the expected relationship to recovery from depression, that is, addicts who recovered from depression were less likely to have argument events than addicts who remained depressed. Thus, among the 58 addicts who had argument RLE, 45 per cent either remained or became depressed, 36 per cent recovered from depression, and 19 per cent remained asymptomatic; among the 60 addicts who had exit RLE, 36 per cent either remained or became depressed, 40 per cent recovered from depression, and 23 per cent remained asymptomatic. When the post-therapeutic analysis included several outcome events other than depression, argument RLE were most strongly related to depression and exit RLE to resumption of illicit drug use during treatment. We conclude that recovery from depression in addicts is related to negative RLE such as arguments and that treatment should focus on helping addicts control their response to these RLE to facilitate recovery from depression.
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PMID:Relationship of depression to psychosocial stressors in heroin addicts. 682 25

Opportunistic infections and unusual tumors have been reported in an unprecedented outbreak of community-acquired cellular immune deficiency among homosexual and drug-abusing men. We report five women with the same syndrome. The women were residents of metropolitan New York City closely associated with drug abuse either by personal use (our patients) or close sexual contact with an abuser (one patient). One patient was bisexual. All five patients developed Pneumocystis carinii pneumonia as well as combinations of other opportunistic infections including oral candida, disseminated mycobacteria, and ulcerative herpes simplex infections. All patients had marked depression of cellular immune function. Three patients died. The appearance of this syndrome in women has important implications with regard to the epidemiology and etiology of this emerging syndrome.
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PMID:Opportunistic infection in previously healthy women. Initial manifestations of a community-acquired cellular immunodeficiency. 698 14

Over 2300 patients referred to a geriatric outreach program were evaluated for the relationships between diagnosis and (1) referral reason, (2) referral source, and (3) age. Referral reason was only a clue to the eventual diagnosis. Patients referred for depression received a diagnosis of depression in only 46 per cent of such referrals, and patients referred for forgetfulness or confusion received a diagnosis of dementia in only 37 per cent of these referrals. Families were most likely to refer demented patients, and health agencies to refer depressed patients. Apartment managers and housing authority representatives were least likely to refer depressed patients and most likely to refer paranoid patients. The rate for diagnosis of dementia increased with age, whereas the rates for diagnoses of depression and alcohol/drug abuse decreased with age.
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PMID:Psychiatric diagnoses among geriatric patients seen in an outreach program. 709 55

Two groups of infants born to drug-addicted mothers were evaluated in a prospective controlled study and compared with a third control group. Group I infants (N = 39) were born to mothers on well-controlled low-dose methadone maintenance. Group II infants (N = 19) were born to polydrug-abusing mothers, and group III infants (N = 27) were born to control mothers who had no history or evidence of drug abuse. All three groups were matched for maternal factors that might affect neonatal outcome. Group I infants were significantly smaller than control infants for all growth measurements and had a significantly smaller head circumference than group II infants. Utilizing the Brazelton Neonatal Behavioral Assessment Scale, group I infants showed more depression of interactive behaviors and state controls than group II infants, who in turn were more depressed than group III infants. The effects of nonnarcotic drugs on intrauterine growth and neonatal behavior appear to place the polydrug-addicted newborn in an intermediate zone of deficit between normal and opiate-addicted newborns.
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PMID:Polydrug- and methadone-addicted newborns: a continuum of impairment? 709 86

Patients on methadone maintenance were studied to determine which factors influence the continuation of heroin-free treatment, as opposed to the return to drug abuse. Psychosocial data, a Zung Depression Scale, and the Social Readjustment Rating Scale (SRRS) were collected on those patients who returned to heroin use while on a methadone maintenance program during the one year of study (n = 48); they were compared to a control group as well as to themselves during a heroin-free maintenance period. The group of patients returning to heroin use showed the existence of such events as recent loss, depression, and exacerbation of intense affect coinciding with the occurrence of heroin use. Furthermore, their SRRS scores and number of SRRS items were significantly higher than those of the control group and than their own steady-state scores. The number and magnitude of stressful life events seem significantly related to patients' not adhering to methadone maintenance and returning to heroin use. The understanding of the importance and adaptive function of drugs to the addict in regulating and ameliorating otherwise overwhelming and catastrophic affective states is underscored otherwise overwhelming and catastrophic affective states is underscored by this study. The total number of life stress events as well as the specificity of meaning to the patient are both emotionally important in understanding, intervening, and treating these patients.
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PMID:Stressful life events and the return to heroin use. 726 85

This study examined characteristics of 296 alcohol and/or drug abuse clients assigned to either (1) in-patient programmes, (2) out-patient programmers, or (3) a lower cost primary care alternative. Multivariate analysis indicated that clients admitted for in-patient care reported greater alcohol consumption and associated problems, fewer community supports and more severe symptoms such as depression and anxiety. They tended to be more frank about their problems while defence mechanisms were more apparent in clients admitted to out-patient and primary care programmers. In general, out-patients ahd more favourable prognostic indicators, such as higher social stability and lower level of alcoholic involvement. The differences among treatment programmers were along quantitative dimensions of problem severity. In particular, the alcohol dependence syndrome was a major discriminating dimension.
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PMID:Comparison of clients assigned to in-patient and out-patient treatment for alcoholism and drug addiction. 727 32


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