Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic fatigue syndrome (CFS) is an illness characterized by disabling fatigue associated with complaints of fevers, sore throat, myalgia, lymphadenopathy, sleep disturbances, neurocognitive difficulties, and depression. A striking feature of CFS is its sudden onset following an acute, presumably viral, illness and the subsequent recurrent "flu-like" symptoms. It has been speculated that both CFS and debilitating chronic fatigue (CF) that does not meet strict criteria for CFS may be the direct or indirect result of viral infections. We therefore tested 548 chronically fatigued patients who underwent a comprehensive medical and psychiatric evaluation for antibodies to 13 viruses. Our objectives were to compare the seroprevalence and/or geometric mean titer (GMT) of antibodies to herpes simplex virus 1 and 2, rubella, adenovirus, human herpesvirus 6, Epstein-Barr virus, cytomegalovirus, and Cox-sackie B virus, types 1-6 in patients with CF to healthy control subjects. Other goals were to determine if greater rates of seropositivity or higher GMTs occurred among subsets of patients with CFS, fibromyalgia, psychiatric disorders, a self-reported illness onset with a viral syndrome, and a documented temperature > 37 degrees C on physical examination. Differences in the seroprevalence or GMTs of antibodies to 13 viruses were not consistently found in those with CF compared with control subjects, or in any subsets of patients including those with CFS, an acute onset of illness, or a documented fever. These particular viral serologies were not useful in evaluating patients presenting with CF.
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PMID:Viral serologies in patients with chronic fatigue and chronic fatigue syndrome. 889 37

Forty-four fibromyalgia patients were followed through 4.5 years to assess the extent to which symptom duration, physical activity level, disability pensions, and the occurrence of critical life events would predict long-term outcome. Outcome measures included pressure tenderness (dolorimeter score), work capacity (ergometer cycle test), global subjective improvement (verbal rating scale), and visual analogue scale ratings of pain, disturbed sleep, lack of energy, and depression. Significant outcome predictors were identified by means of separate multiple regression analyses on each outcome measure at follow-up, using symptom duration, physical activity level, disability pension status, and occurrence of critical life events as independent variables, together with baseline symptom intensity and age, which were adjusted for. An adequate physical activity level and increasing age predicted a positive outcome, while receiving a permanent disability pension or having experienced an excess of major negative life events predicted a negative outcome. Symptom duration did not affect outcome.
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PMID:Fibromyalgia outcome: the predictive values of symptom duration, physical activity, disability pension, and critical life events--a 4.5 year prospective study. 891 Feb 46

The stress system is controlled by brain nuclei at the hypothalamus and brainstem. These nuclei interact with each other and control the HPA axis and sympathetic nervous systems, respectively. Major inputs to the stress system arise from the cerebral cortex and subcortical systems, the sensory organs and nerves, and the endocrine and immune systems. The major peripheral effectors of the stress system are glucocorticoids and the catecholamines. Pathological hypoactivity of the stress system has been associated with atypical depression, the chronic fatigue/fibromyalgia syndromes and autoimmune inflammatory disease; hyperactivity with melancholic depression and anxiety disorders. The stress system responds in a quantitatively and qualitatively specific fashion to different stressors. A major role of the HPA axis is to restrain the immune system and prevent tissue damage. Reciprocal interactions between the HPA axis and immune system constitutes a new endocrine feedback loop that has given rise to the field of neuroendocrine immunology. Gonadal axis hormones directly, and indirectly via the HPA axis, alter the tone of the immune system and the quality and quantity of the inflammatory responses. Effects of the HPA axis on the gonadal axis are consistent with conservation and redirection of valuable resources towards homeostasis during times of stress. These complex interactions between the HPA axis, immune and the gonadal systems may prove to be fundamental in the genesis and perpetuation of autoimmune disease.
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PMID:The three-way interactions between the hypothalamic-pituitary-adrenal and gonadal axes and the immune system. 891 46

There is a general tendency to restrict the notion of sleep disorders to insomnia and consequently to limit treatment to the prescription of hypnotics. However, it is very often of benefit to prescribe psychotropic agents, in particular antidepressants, not only in insomnia but also in certain cases of hypersomnia, parasomnia and dysomnia associated with organic diseases. In some conditions, however, antidepressants may either induce or aggravate sleep disorders. This is the case with a number of psychostimulants that occasionally induce insomnia. It is also true of the tricyclic antidepressants, which may worsen or even induce a restlessleg syndrome that is often associated with periodic movement syndrome. On the other hand, the antidepressants may play a therapeutic role in certain sleep disorders : - depression-related insomnia is of course the << primary >> indication for antidepressants. Furthermore, certain antidepressants exhibit a sedative action resulting in a hypnogenic-type effect which appears well before the antidepressant effect; - the other types of insomnia may also often be treated with antidepressants : not acute reactional insomnia, against which hypnotics are remarkably effective, but chronic insomnia. In addition, all antidepressants may eventually correct depressive hypersomnia, but in these cases, it is evidently preferable to prescribe non-sedative drugs. Although some tricyclic antidepressants have been proposed for use in hypersomnia due to sleep apnea, their therapeutic interest is minor compared with mechanical and surgical treatment. In contrast, antidepressants play an important role in the treatment of narcolepsy, particularly for the correction of attacks of cataplexy. Antidepressants have also been used for some time in the treatment of parasomnia related to slow deep sleep (night terrors and sleepwalking), but the antidepressants may also be used in enuresis and in parasomnia related to REM sleep : nightmares, sleep paralysis, behavioral problems associated with REM sleep. Antidepressant (mainly serotoninergic drugs) are often used in the treatment of fibrolitis syndrome. Finally, antidepressants (particularly the serotoninergic antidepressants) play an important role in the drug treatment of fibromyalgia.
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PMID:[Use of antidepressants in sleep disorders: practical considerations]. 892 78

The authors studied the familial occurrence of fibromyalgia (FMS) to determine a possible role of genetic and familial factors in this syndrome. Fifty-eight offspring aged 5 to 46 years (35 males and 23 females) from 20 complete nuclear families ascertained through affected mothers with FMS were clinically evaluated for FMS according to the ACR 1990 diagnostic criteria. FMS symptoms, quality of life, physical functioning, and dolorimetry thresholds were assessed in all subjects. Sixteen offspring (28%) were found to have FMS. The M/F ratio among the affected was 0.8 compared with 1.5 in the whole study group. Offspring with and without FMS did not differ on anxiety, depression, global well-being, quality of life, and physical functioning. A high prevalence of FMS was observed among offspring of FMS mothers. Because psychological and familial factors were not different in children with and without FMS, the high familial occurrence of this syndrome may be attributable to genetic factors.
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PMID:Familial aggregation in the fibromyalgia syndrome. 898 5

Fibromyalgia represents one of the most frequent musculoskeletal problems. This condition, associated with widespread pain, is characterized by a number of specific tender points, as well as symptoms such as tiredness, limb stiffness, depression and a lack of refreshing sleep. Patients suffering from fibromyalgia can also demonstrate the same clinical features as temporomandibular disorders or myofascial pain. Dentists should be aware that certain dental treatments will not be effective in patients suffering from temporal and masseter pain if fibromyalgia has been diagnosed.
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PMID:[Fibromyalgia in dentistry]]. 899 95

We report the effect of a single daily dose of ketamine in a 54 year old woman with fibromyalgia and severe post-traumatic neuropathic pain. A number of different approaches for pain relief had been tried with little effect. An intramuscular test dose of 0.4 mg/kg ketamine combined with 0.05 mg/kg midazolam lead to analgesia which lasted for almost two days. Long-term analgesia was also obtained by 250 mg/kg ketamine hydrochloride taken orally in the form of capsules every night at bedtime. The patient has now used this dose for nine months. Ketamine is an NMDA receptor antagonist. A single sub-anaesthetic dose of ketamine causes a long-term depression of pain intensity in some, but not in all, patients suffering chronic pain. This effect is distinctly different from the short-lasting (10-30 min) analgesic effect in cases of acute nociceptive pain. The long-term depression of the intensity of chronic pain states may be due to a reversal of NMDA receptor-dependent long-term potentiation of synapses in central pain pathways. By giving ketamine as a single dose at night the mental side-effects are reduced or avoided.
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PMID:[Analgesic effect of ketamine in a patient with neuropathic pain]. 899 75

Fibromyalgia is a form of nonarticular rheumatism characterized by musculoskeletal aching and tenderness on palpation. The role of psychological factors in fibromyalgia has been controversial. The aim of this study was to evaluate the relationship of fibromyalgia to the intensity of anxiety and depression and to determine the correlation between psychological disturbances with disease duration and pain severity. Thirty-nine patients with fibromyalgia and 36 healthy controls were included in this study. Beck depression inventory, State and trait anxiety inventory and Beck hopelessness scale were used to evaluate psychological disturbances. Visual analog scale was used to determine pain intensity. We found a significant difference in the psychological status between patients with fibromyalgia and control subjects as measured by Beck depression inventory and trait anxiety inventory; 35.9% of the patients scored higher than the cut-off score on the Beck depression rating scale. Pain severity was found to be correlated with trait anxiety inventory scores. These results suggest that somatic expression of depression is an important difference between fibromyalgia and control groups. The difference between state and trait anxiety inventory reflects that current anxiety is not secondary to pain but trait anxiety is possibly causally related to pain.
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PMID:Psychological disturbance in fibromyalgia: relation to pain severity. 909 1

The degree of symptomatic overlap between fibromyalgia and major depression should be estimated by assessing the amount of local tenderness and the frequency and severity of depressive and functional symptoms. Tender points were assessed by palpation and symptoms by psychometric scales in 30 patients with fibromyalgia and 26 patients with major depression. The patients with fibromyalgia had markedly more tender points (16.5) than the depressive patients (1.3). In contrast, depressive and functional symptoms were present in both groups of patients, and some depressive patients (26%) also suffered from clinical pain. An increased sensitivity to pressure pain clearly distinguishes fibromyalgia from depression even if there is an overlap of other symptoms.
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PMID:Tender points, depressive and functional symptoms: comparison between fibromyalgia and major depression. 913 30

Individuals suffering from chronic pain are of concern to social workers because such pain disrupts job, family, and overall social functioning and can lead to depression, excessive health concerns, and withdrawal from activities. This article discusses a project developed to gain understanding of the experiences of people suffering from fibromyalgia, a chronic pain condition with no visible symptoms, and to test the use of narrative approaches in group work with this population. The study used a qualitative ethnographic approach as the primary method and also used some quantitative measures to assess the usefulness of the approach. Both qualitative and quantitative findings suggest that narrative approaches helped participants find their own strengths and means of coping and helped them find identities other than as patients.
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PMID:Coping with chronic pain: assessing narrative approaches. 915 95


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