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

This is a clinical study of failed suicides, in order to contribute to the explanation of completed suicides. 423 suicidal patients were admitted to the emergency critical care unit of a metropolitan municipal hospital during 6 years. The catchment area of the unit is the east four wards of Tokyo. Almost all patients who attempted suicide and four who later on completed suicide were interviewed by consultating psychiatrists. The total number of cases thus investigated was 265. Medical and psychiatric charts were retrospectively evaluated for the study. According to the lethality of respective suicidal methods, the 265 cases were divided to the ABSOLUTELY DANGEROUS GROUP (133 patients) and the RELATIVELY DANGEROUS GROUP (132 patients). The former, except for the few patients who later on died, could be considered as "failed suicides"; 75% of these patients were mentally disordered (psychoses, depressive disorders or psychoactive substance use disorders), whereas in the latter group the respective figure was 48%. The rates of each disorder were different in the age classes: younger (below 30), middle aged (30-49), and older (50 and over). In the younger group, psychoses (F2 cord of ICD-10 draft) were the main cause (52%). By contrast, endogenous major depression was the main cause in the older group (48%). The rate of psychoactive substance use disorders was highest (22%) in the middle aged among the three classes. There were 1562 officially recorded completed suicides in the catchment area during the same 6 years. From the distribution of diagnoses in each of the three age classes of the ABSOLUTELY DANGEROUS GROUP and the distribution of age classes in 1562 completed suicides, the rates of mental disorders amongst the completed suicides were estimated as roughly 26% psychoses, 46% depressive disorders and 18% substance use disorders. The total figure was 90% and quite similar to the results of previous studies by psychological autopsies in the western countries. For an attempt to decrease the rates of suicide, the most important point seems to be the prevention of suicides by the mentally disordered. Depression is most prevalent among elderly suicidal patients. In contrast to previous studies, the author found psychoses most often in younger patients. Psychotic symptoms of schizophrenic and of alcoholic suicidal patients were analysed in detail. None of them nor any other patient could be considered as a "rational suicide" case.
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PMID:[Mental disorder as a risk factor of suicide; a clinical study of failed suicides]. 793 8

We investigated the effect of psychoanalytically oriented inpatient psychotherapy on three essential forms of anxiety disorders (classified according ICD-10): 1. generalized anxiety disorder (n = 23), agoraphobia (n = 38) and panic disorder (n = 24). Examinations with psychometric test instruments were performed at beginning of inpatient psychotherapy, at dismissal and 6 weeks after dismissal. At the end of inpatient psychotherapy we judged four clinically relevant criteria of therapy success: at the one side the therapist's judgement of symptomatic and structural improvement of the patients, at the other side the patients' judgement of anxiety and depression diminuation. The results demonstrate that summing up these four success criteria 1.) 40.0% of the patients with anxiety disorders improved, 21.2% failed; 2.) 61.4% of the patients with agoraphobia improved, 6.3% failed and 3.) 52.5% of the patients with panic disorder improved, 6.5% failed. An additional analysis of these results showed that the patients with generalized anxiety disorder were significantly (p < 0.01) more disturbed (according clinical assessment) compared to the other two diagnostic groups. About 60% of these patients exhibited increased anxiety symptoms during the course of inpatients psychotherapy, nevertheless relative to the other success criteria these patients achieved satisfactory outcome results. In the paper the consequences of these findings are discussed especially for inpatient psychotherapy of severely disturbed patients with anxiety disorders.
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PMID:[Inpatient psychotherapy of anxiety disorders--a comparison of therapeutic effectiveness in patients with generalized anxiety disorder, agoraphobia and panic disorder]. 793 67

This paper reviews current evidence in support of dysthymia as a sub-affective disorder that precedes major affective episodes, often by more than a decade. In cases beginning in childhood or adolescence, dysthymia is associated with high familial rates of mood disorders, and a recurrent pattern of superimposed major depression. At least two trait-like markers, sleep electro-encephalographic and thyroid axis abnormalities-similar to those in major affective disorder-have been reported. These data indicate a common pathophysiological substrate for both dysthymia and major depressive illness. All classes of antidepressants-most recently the serotonin re-uptake and the reversible MAO inhibitors-have been shown to be effective. Dysthymia was fairly recently included in the US(DSM) and WHO(ICD) classifications of mental disorders, because it characterises a prevalent clinical presentation of depression in both psychiatric and general medical settings. Patients given this diagnosis, instead of presenting with acute or full-blown episodes, often complain of low-grade chronic affective malaise for as long as they remember, yet without clinically observable signs of depression. As a result, questions have been raised about its validity, but from fundamentally opposite positions: (i) Is dysthymia better conceptualised as a personality (or neurotic) rather than mood disorder? (ii) Can dysthymia be distinguished from major depressive illness? This paper examines these and related questions along both clinical and external validating strategies, and in particular, the more recent accumulated evidence in support of the utility of the concept of dysthymia.
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PMID:Dysthymia: clinical and external validity. 794 64

From the time of Hippocrates, the problem of persistently depressed mood has been recognised clinically. The first modern description of dysthymia was by Kahlbaum, who distinguished it from the fluctuating mood of cyclothymia. However, there has been continuous difficulty in separating low-grade depressive disorder from an abnormal personality trait. DSM-II defined chronic depression as a personality disorder, but Akiskal subsequently reclassified it as a mood disorder. In DSM-III, all chronic depression lasting more than two years was defined as 'Dysthymic disorder'. DSM-III-R brought together dysthymic and cyclothymic disorders into an affective category. ICD-10 dysthymia subsumes a number of categories which include recurrent depression of mood. The primary distinction between Dysthymia and Major Depressive Disorder is that Dysthymia is chronic, but symptomatically less severe. A number of unresolved problems remain in relation to its nosological status.
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PMID:Historical and nosological aspects of dysthymia. 794 68

A randomized double-blind, multicenter 6-week study was undertaken in 80 depressed patients to compare the effects of moclobemide, a selective and reversible monoamine oxidase-A inhibitor (300 mg daily), and maprotiline (75 mg daily). Efficacy was assessed by Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI). Tolerability was assessed by adverse events reports. After 6 weeks of therapy, both groups of patients showed significant improvement in HDRS and CGI. Speed of onset of action was faster with moclobemide (significant difference at week 3, p = 0.025). There was a significant reduction of depression ratings (HDRS) in both the moclobemide and maprotiline group in all types of depression according to ICD-9 criteria (major depressive disorder, neurotic depression and adjustment-prolonged depressive reaction). Significantly fewer patients in the moclobemide group reported adverse events (28.9% compared with 70.2%) including weight gain (2.6% compared to 21.6%). Anticholinergic side effects were less frequent with moclobemide. It is concluded that both drugs are at least equivalent in terms of therapeutic efficacy, but moclobemide is better tolerated.
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PMID:Multicenter double-blind study of moclobemide and maprotiline. 795 83

Depressive syndromes in schizophrenia are reported in the prodromal stage of the early course, during the first or later psychotic episodes, but also after the fading out of an acute episode and as a precursor of relapse. According to these multiple conditions several explanations also exist as to how to understand depression in schizophrenia. Some authors interpret it as an elementary part of the schizophrenic symptomatology, which is only masked by positive symptoms (revealed depression). However, it can also be understood as a reactive depression or as caused by neuroleptic treatment, as part of the negative syndrome or as co-morbidity. In the ABC-Schizophrenia-Study, depression in the early course was analysed for patients in their first psychotic episode at index admission and an ICD-9 diagnosis of schizophrenia (ICD 295). In 81% of this sample depression was observed, beginning on average 4.3 years prior to index admission. In 42% of the patients depression began in the prepsychotic phase. In 18% the positive and the depressive syndrome developed within one month, and in 21% depression started after the first positive symptom occurred. We could only observe a clear sequence of depressive, negative and positive symptoms in the subgroup characterised by prepsychotic depression. A clear order of negative and positive symptoms was not observed in the other groups. Patients without depression in the early course have lower symptom levels at index admission. They present less positive symptoms (CATEGO-subscore DAH), fewer behavioural disturbances (subscore BSO) and also lower scores of non-specific symptoms (subscores SNR and NSN). More than 80% of the patients with depression in the early course also had a simple depression (as defined by the CATEGO-syndrome SD). Contrary to this, only 20% of the patient group without depression in the early course have positive SD values. Comparable percentages of males and females have depression in the early course, but in females depression begins more frequently in the prepsychotic phase, whereas in the male subgroup it more often starts postpsychotically, i.e. after the onset of the first psychotic symptom.
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PMID:[Depression in the early course of schizophrenia]. 795 15

The aim was to assess the occurrence and type of psychiatric disorders of patients with medically intractable epilepsy in relation to surgical treatment, with special reference to amygdalohippocampectomy (AHE). The design was a retrospective psychiatric interview study, including Present State Examination (PSE) and diagnostic classification according to the International Classification of Diseases--8th revision (ICD-8) and ICD-10. Forty seven (94% of total) patients operated on between 1987 and mid-1991 in the Danish epilepsy surgery programme were studied. The main group of interest included 37 patients treated by AHE. The presence of psychiatric disorders before and after operation was assessed by PSE (including the Catego classification) and by ordinary clinical procedures, making use of all available information (hospital case notes and presurgical psychiatric assessments independent of the study). Four patients in the AHE group developed depressive disorders of various durations and severity after operation (in three (8%) patients these occurred de novo). One other patient with AHE with a presumed personality disorder who underwent AHE developed a severe depression, as did one patient after a lesionectomy. No patients developed new paranoid hallucinatory psychoses. No association was found between presence of psychiatric disorders and neither right sided cerebral dominance nor histopathological findings. In conclusion, the postoperative psychiatric morbidity in this sample of patients treated with AHE is of the same magnitude as described in recent series of patients undergoing temporal lobe resection for medically intractable epilepsy. Likewise, affective disorders (depressive conditions) constitute the most prominent psychiatric problem after surgery for epilepsy.
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PMID:Psychiatric morbidity after surgery for epilepsy: short-term follow up of patients undergoing amygdalohippocampectomy. 796 15

Case records of 404 elderly patients (aged 65 years or more) who were admitted for the first time to the Psychiatric Hospital in Aarhus, with a diagnosis of dementia were investigated retrospectively. In 315 patients the diagnoses were confirmed as senile dementia (290.09) or arteriosclerotic dementia (293.09) according to ICD-8. Eighty-seven patients had their diagnosis changed in the course of the case review. When case records of these 87 patients were investigated for the second time, four patients were diagnosed as demented: 66 patients were admitted because of confusion, 26 patients were diagnosed depressive, 10 of these manic-depressive. This investigation shows uncertainty and a tendency to overdiagnose of dementia, especially in the early stages. A wrong diagnosis may lead to therapeutic nihilism, especially when the patient suffers from confusion and/or depression.
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PMID:[Diagnosis of dementia--an objective examination or a subjective evaluation?]. 800 55

A French version of the Canberra Interview for the Elderly (CIE) was developed. This instrument is designed for lay administration and, using a computer algorithm, produces diagnoses of dementia and depression according to ICD-10 and DSM-III-R criteria. The reliability of this French version was found to meet or exceed the English version in a test-retest design. Validity, established by comparison with diagnoses made by an experienced clinician, was also found to be acceptable. The CIE is thus an appropriate instrument for the epidemiological study of these disorders in French-speaking populations.
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PMID:The reliability and validity of the French version of the Canberra Interview for the Elderly. 802 94

A complex antiaging formula--Antagonic-Stress--was investigated vs. placebo (PL), meclofenoxate (MF)--neurometabolic nootropic and vs. nicergoline (NE)--cerebral vasodilator by comparative multiple trials (double-blind, randomized, and parallel) in gerontopsychiatry (DSM-III-R, 1987 and ICD-10, 1992 criteria). AS vs. PL studies in organic mental disorders--amnestic, depressive, anxiety, associated with axis III physical disorders or conditions, and in multiinfarct dementia were followed by AS vs. MF or NE investigations in senile dementia of Alzheimer's type. A total of 343 old people, distributed in 4 PL groups, 1 MF group, 1 NE group, and 5 AS groups were studied. Multiple investigations, before and after three-month treatments were made: psychometric evaluation by Sandoz Clinical Assessment-Geriatric, Self-Assessment Scale-Geriatric and their 5 subscales; psychopathological rating by Hamilton Depression and Anxiety Scales; as well as psychometric testing by digit symbol of WAIS, Wechsler Memory Scale and Wechsler Adult Intelligence Scale (WAIS). Except PL, prolonged and large dose treatments with these cerebral activators (MF, NE and especially AS) reduced the psychogeriatric-psychopathological scores and the deterioration index, and improved cognitive performance. The therapeutical effectiveness of AS multiple formula in gerontopsychiatry and its superiority vs. monotherapy (MF or NE) are discussed in connection with its complex neurometabolic and synergetic composition, multiple antioxidative combinations, free radical scavengers, lipofuscinolytic agents, the antiischemic action of antioxidants, multivitamin and multimineral supplementation, and with the better efficacy of multitherapy vs. monotherapy in geriatrics.
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PMID:Antagonic-stress. A new treatment in gerontopsychiatry and for a healthy productive life. 803 Aug 48


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