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

The current and lifetime comorbidity of depressive (i.e., major depressive disorder and dysthymia) with other common mental disorders was examined in community samples of older adolescents (n = 1,710) and adults (n = 2,060). Current and lifetime histories of depression in the adolescents were highly comorbid with several other mental disorders. The adults had a lower but statistically significant degree of comorbidity, primarily with substance use disorder. Depression in both groups was more likely to occur after the other disorder rather than to precede it. Comorbidity did not affect the duration or severity of depression. Comorbidity in the adolescents was associated with greater frequency of suicidal behavior and treatment seeking. The findings suggest that early-onset depression is associated with a greater degree of comorbidity and may represent a more serious form of the disorder.
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PMID:Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults. 204 Jul 73

Recent research has enabled clinicians to reclassify many patients who formerly were diagnosed as having personality disorders as instead suffering from chronic depression. The American Psychiatric Association now recognizes two subtypes of such depression: (1) residual (partly remitted) major depression and (2) dysthymia. As a result of these developments, an increasing number of psychiatrists now treat selected chronically depressed patients with full trials of a broad range of thymoleptic agents, thus alleviating the suffering of many patients who had previously been deemed refractory. The author summarizes his research efforts to establish the clinical legitimacy of chronic depression and suggests that supportive psychotherapeutic and psychoeducational approaches can enhance the therapeutic gains achieved through pharmacotherapy.
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PMID:Chronic depression. 204 95

The clinical significance of chronic mild depression (dysthymia) is well recognized, but has not been the focus of extensive research. In particular, basic research on the phenomenology and treatment of these conditions is limited. Clinical lore suggests that psychotherapy, rather than pharmacotherapy, is the treatment of choice. This is based more on a theoretical understanding of chronic depression as a personality disorder rather than on actual treatment studies. This paper reviews the literature on the pharmacotherapy of dysthymia. The results provide substantial evidence for the efficacy of antidepressants in dysthymia, although the treatment response is less than that typically found in major depression. Furthermore, the findings suggest the possibility that monoamine oxidase inhibitors (MAOIs) may be superior to tricyclic antidepressants (TCAs) in the treatment of dysthymia, although this needs to be more rigorously evaluated. Some of the methodological problems with these studies are discussed. Additional areas of research, including the clinical and biological indicators of drug response, the use of non-TCA, nonMAOI drugs, the effects of pharmacological intervention on the development and maintenance of chronicity, and the comparison of and interaction between pharmacotherapy and psychotherapy are identified and suggested for future study.
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PMID:Pharmacotherapy of dysthymia: a review. 205 46

Antecedents of depressive tendencies at age 18 were longitudinally evaluated using data from nursery school through high school. Depression was measured by CES-D scores from which the contribution of self-reported anxiety was partialed. As early as age 7, boys who subsequently acknowledged dysthymia were aggressive, self-aggrandizing, and undercontrolled whereas girls with later depressive tendencies were intropunitive, oversocialized, and overcontrolling. Similar gender differences were observed in pre- and early adolescence. At age 14, dysthymic boys were more likely to use both marijuana and harder drugs whereas dysthymic girls showed no tendency to use marijuana but did show a marked tendency to experiment with hard drugs. These girls also displayed low self-esteem. Preschool IQ correlated positively with dysthymia in girls and negatively in boys. The psychodynamics of gender differences in depressive affect were discussed.
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PMID:Personality antecedents of depressive tendencies in 18-year-olds: a prospective study. 207 53

Tianeptine, a new antidepressant, has a tricyclic molecular structure. Its main biochemical activity consists of an increase in the reuptake of 5 HT both in men and animals, after acute and chronic administration. Tianeptine demonstrated its antidepressive clinical efficacy in several double-blind versus reference drug trials. A multicentre open trial, including depressed patients enabled us to evaluate the safety of tianeptine and to control the maintenance of the therapeutic efficacy in the course of its long-term prescription. Depressed patients included showed a major depressive episode, single (296.22) or recurrent (296.32) without melancholia or psychotic features, or a dysthymic disorder (300.40), according to DSM III criteria. A minimum MADRS score of a least 25, and the informed consent of the patients were required. The dose of tianeptine was 3 tablets per day (12.5 mg/tablet) with the possibility of increasing to 4 or decreasing to 2 tablets per day, depending on the symptomatology. Therapeutic efficacy was evaluated by item 1 and 2 of the Global Clinical Impression (CGI), the Montgomery and Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HARS) and the Hopkins Symptom Check-List (HSCL). Clinical and paraclinical safety were evaluated by CGI item 3, standardized ratings of patients' complaints (CHESS 84), interruption for side effects, evaluation of blood pressure, weight, biological parameters, EKGs. This intermediate evaluation concerns the first 170 depressed patients treated over a one-year period as well as the total group of patients included (n = 447).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tolerability of tianeptine in 170 patients with depression treated during one year]. 210 83

To evaluate the persistence of depression in alcoholic women, depressive symptomatology was assessed systematically via the Beck Depression Inventory at intake, 3, and 6 months of treatment. Fifty-five female alcoholics were diagnosed for concurrent psychiatric diagnosis. Results revealed differences in the course of depression for female alcoholics with (a) no concurrent diagnosis, (b) dysthymic disorder, and (c) personality disorder. Despite a decrease in depression for the sample as a whole, dysthymic alcoholics were consistently more depressed than the other two subgroups and remained depressed during the first 6 months of treatment. Depression did not significantly remit with sobriety.
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PMID:Six-month course of depression in female alcoholics. 213 22

Depression is a common problem in medical outpatients, yet primary care physicians recognize the disorder in only about half of their depressed patients. We compared physician recognition of depression (defined by chart notation or prescription of antidepressants) with diagnoses generated by the Diagnostic Interview Schedule (DIS) in 265 medical outpatients. Using DIS criteria, diagnoses of major depression in the past year or dysthymia (chronic minor depression) were made in 70 patients. Physicians recognized as depressed only 25 (35.7%) of the 70 DIS-depressed patients. However, 36 patients who were not depressed according to DIS were "recognized" as depressed by physicians. Patients misdiagnosed as depressed by physicians were older, less educated, had more outpatient visits, and were prescribed more medications. Receiver operating characteristic curves of two self-report depression scales suggest that these scales may assist physicians in recognizing depressed outpatients. We conclude that physicians underrecognize and misdiagnose depression in medical outpatients.
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PMID:Depression in medical outpatients. Underrecognition and misdiagnosis. 233 Dec

Some forms of anxiety and affective disorder, such as panic disorder and major depression, appear distinct, while other forms, such as generalized anxiety disorder and chronic depression or dysthymia, may lie on a continuum and blend with each other. However, even panic disorder and major depression have many common features. Moreover, for reasons not yet clear, they occur together frequently, and their combined occurrence in the same patient has been associated with greater severity and chronicity, decreased treatment responsiveness, and, possibly, increased familial prevalence of anxiety and/or depression. Finally, studies of primary care patients suggest the frequent occurrence of a mixed anxiety-depressive disorder that may often be subsyndromal by DSM-III-R criteria but is nevertheless associated with prominent distress and/or impairment.
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PMID:Anxiety and depression: discrete diagnostic entities? 219 2

Current and lifetime rates of Diagnostic and Statistical Manual (rev. 3rd ed.) disorders were compared in 86 older adults caring for a spouse with a progressive dementia and 86 sociodemographically matched control subjects. Dementia caregivers were significantly more dysphoric than non-care givers. The frequencies of depressive disorders did not differ between groups in the years before care giving, and there were no group differences in first-degree relatives' incidence of psychiatric disorder. During the years they had been providing care, 30% of care givers experienced a depressive disorder (major depression, dysthymia, or depression not otherwise specified) versus 1% of their matched controls in the same time period. Only two care givers who met criteria during care giving had met criteria for a depressive disorder before care giving, and family history was not even weakly related to the identification of at-risk care givers. In contrast to these group differences in depressive disorders, there were no significant differences in other Axis I disorders either before or during care giving. Thus, the chronic strains of care giving appear to be linked to the onset of depressive disorders in older adults with no prior evidence of vulnerability.
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PMID:Chronic stress and depressive disorders in older adults. 221 79

Among a sample of 767 high utilizers of health care, 51% were identified as distressed by an elevated score on the SCL anxiety and depression scales, the SCL somatization scale, or by their primary-care physician. These distressed high utilizers were found to have a high prevalence of chronic medical problems and significant limitation of activities caused by illness. In the prior year, they made an average of 15 medical visits and 15 telephone calls to the clinic. The Diagnostic Interview Schedule was completed on 119 distressed high utilizers randomly assigned to an intervention group in a controlled trial of psychiatric consultation. The following DSM-III-R disorders were most common: major depression 23.5%, dysthymic disorder 16.8%, generalized anxiety disorder 21.8%, and somatization disorder 20.2%. Two thirds had a lifetime history of major depression. The examination resulted in an improved diagnostic assessment for 40% of intervention patients and a revised treatment plan for 67%.
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PMID:Distressed high utilizers of medical care. DSM-III-R diagnoses and treatment needs. 224 19


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