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

Prostate cancer is diagnosed in 220,900 men per year and 28,900 died from the disease in 2003 (American Cancer Society, 2003). It is a serious illness that affects the patient, as well as his partner, spouse, or significant other. In addition to the initial diagnosis of cancer, many of the treatment options for prostate cancer can lead to issues that affect a couple and their relationship. Such issues include sexual dysfunction, incontinence, loss of self-esteem, depression, the possibility of death, and various other emotional, physical, and experiential responses. It is important for health care providers to understand the perceptions of patients' loved ones, as they are likely the most supportive individuals available to the patients. A model of care based on the review of literature and designed specifically to highlight issues for the partners of prostate cancer patients is presented.
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PMID:Including partners into the diagnosis of prostate cancer: a review of the literature to provide a model of care. 1505 7

Disabilities caused by behavioral problems can be potentially devastating in cognitively impaired patients. These behavioral symptoms can be a major cause of stress, anxiety, and concern for caregivers. While psychotropic drugs are frequently used to control these symptoms, they can be accompanied by significant side effects, which include sedation, disinhibition, depression, falls, incontinence, parkinsonism, and akathisias. Agitation is a major problem in older patients with dementia. Agitation and aggression have always been difficult behaviors to manage, and when it is severe, agitation can be a behavioral emergency that requires urgent and immediate intervention. This six-month study included a group of 94 outpatients (48 men and 46 women) who had a diagnosis of subcortical vascular dementia (VaD). To be eligible for the study, patients needed a score of at least 3 for agitation/aggression on the Neuropsychiatric Inventory (NPI), suggesting at least moderate frequency and/or severity, and 0 for delusions and hallucinations. Patients were divided into two homogenous groups. Group A received olanzapine (2.5-5 mg/day) and Group B received bromazepam (0.25 percent, 15 drops, three times per day). Patients in both groups were allowed to continue any previous therapy. Patients receiving olanzapine at an average dose of 3.21 +/- 1.02 mg/day showed statistically significant improvement on the anxiety rating compared with those receiving bromazepam. Our patients had a host of medical conditions and received numerous concomitant medications. Given the potential complications associated with these therapeutic agents, these patients tolerated olanzapine quite well. It appeared that adverse events, particularly somnolence, postural instability, and postural hypotension, were mild and transient. Moreover, no anticholinerigic effect was registered. These findings suggest that olanzapine could be a safe and effective treatment for anxiety in cognitively impaired patients.
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PMID:Olanzapine as a possible treatment for anxiety due to vascular dementia: an open study. 1510 88

Urinary incontinence creates a tremendous hardship on older women and results in social isolation, anxiety, low self-esteem, depression, and decreased life satisfaction. Stress, urge, overflow, and functional incontinence can be treated by behavioral methods, medications, or invasive techniques. The nurse should complete a health history before making an informed decision with the older women about the most appropriate treatment plan. There can be improved quality of life for women with incontinence if health care providers focus on this problem.
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PMID:Urinary incontinence in a vulnerable population: older women. 1512 4

Anxiety, shame, guilt, and depression accompany the absence or loss of urinary sphincter control at both ends of the life cycle. The economic costs are high when one reflects that incontinence limits access to child-care facilities and thus the mothers return to gainful employment. It is often the prime reason for admission to nursing home care for the grandmother. Poise and increased self-esteem go along with "being dry." Dysuria accompanying acute or interstitial cystitis also interferes with personal peace and the ability to work productively. A psychoanalytic review of developmental stages and their constellation of affects and defenses in regard to "wetness" will be discussed as well as when to refer, clarify, or make or receive a urological referral for your patient, their child, or parent.
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PMID:Mysteries of the void: an analyst's view of female urination. 1513 87

Urinary incontinence (UI) has been related to lower quality of life. However, the research has generally been cross-sectional, and causal relationships have not been determined. This research was a secondary analysis of a 6-year longitudinal study of chronic illness and psychological well-being in older (mean age = 73 at Time 1), community-dwelling women (n = 103). Over time, women with UI reported significantly lower subjective health, purpose in life, affect balance, personal growth, positive relations with others, and self-esteem and higher scores for depression, compared to women without UI. Incontinence had broad effects on multiple domains of psychological well-being that persisted over time and need to be addressed by clinicians.
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PMID:Effects of urinary incontinence: psychological well-being and distress in older community-dwelling women. 1515 44

Of the few studies published on poststroke emotional incontinence (PSEI), none has investigated a consecutive stroke cohort in a Chinese patient population. The objective of this study was to examine the frequency and the clinical and radiological correlates of PSEI in Chinese stroke patients in Hong Kong. Three months after their admission, a psychiatrist interviewed 127 stroke patients who were consecutively admitted to the medical wards of a university-affiliated regional hospital. The presence of PSEI was defined according to both Kim's and House's criteria. The frequency of PSEI was 17.9% according to Kim's criteria and 6.3% according to House's criteria. The kappa between the two sets of criteria was 0.34. Univariate analysis found that PSEI was associated with a younger age, previous history of depression, a higher National Institute of Health Stroke Scale total score and cortical infarcts. Multivariate logistic regression suggested that past history of depression and cortical infarcts were independent predictors for PSEI. In conclusion, PSEI is relatively common among Chinese stroke survivors. A previous history of depression or cortical lesions were independent predictors for PSEI. There is a need for a revision of the diagnostic criteria for PSEI.
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PMID:Emotional incontinence in Chinese stroke patients--diagnosis, frequency, and clinical and radiological correlates. 1525 91

Disorders of micturition and other symptoms in the area of the lower urinary tract are frequent in gynaecological consultation. The uro-gynaecological clinical symptoms and diseases refer to the following syndromes: irritable bladder, recurrent cystitis, interstitial cystitis, urinary retention and forms of incontinence. In view of the great aetiological importance of depression and its psycho-neuroendocrine associations with urge symptoms correlating with oestrogen deficiency, the option of employing newer approaches, and also psychopharmacological approaches, must be considered. In the pathogenesis, the stress and conflict model offers approaches to explanation and treatment. The psychosomatically oriented diagnosis and treatment of symptoms and disorders of the lower urinary tract in women is primarily the task of the gynaecologist, who has to go beyond investigations for organic diseases and must also clarify and treat the psychological dimensions. If there is major psychiatric comorbidity, referral to a doctor specialising in psychotherapeutic medicine and psychotherapy is required, or to a specialist in psychiatry and psychotherapy in the case of clinical and neurophysiological implications and symptoms from the depressive spectrum.
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PMID:[Psychosomatic aspects of urogynaecology: model considerations on the pathogenesis, diagnosis and therapy]. 1538 74

Fall Risk Factors have been analysed (RAI-MDS-System) in a population of patients, who were hospitalised between 1995 and 2000 in a geriatric department of a community hospital. In multivariate analysis, viseral-problems, incontinence and depression were fall-protective factors, whereas problems with transfer, the use of assistive walking-aids, female gender and age were fall risk-factors. No independent contribution to the fall-risk was delivered by memory-impairment, problems in decision-making, low body-mass-index, the use of more than three medications and the use of restraints. Fall injuries were analysed in a patient population (n = 218), that was hospitalized in the year 2001 in the geriatric department of a community hospital after a fall. The analysis showed an enormous heterogenicity of the injury-patterns: 58.7% of the fall-patients suffered from a fracture, 10.6% of them had more than one fracture, 34% suffered from other injuries. 77 surgical interventions were performed. The mean length of stay of the fall-patients was 4.5 days higher than the mean of all geriatric patients.
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PMID:[Fall risk factors and fall injuries in hospitalized elderly patients]. 1545 31

Although people age at different rates, changes to the composition of the human body are a hallmark of aging. As a result of such changes, disease can present differently in a person over 65 years old than it would in a younger adult or child. This article identifies the critical indicators of underlying conditions, including changes in mental status, loss of function, decrease in appetite, dehydration, falls, pain, dizziness, and incontinence. It also describes the presentation of diseases common to older adults, including depression, infection, cardiac disease, gastrointestinal disorders, thyroid disease, and type 2 diabetes.
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PMID:Presentation of illness in older adults. 1549 36

Under-nutrition and protein-energy malnutrition are seen at alarmingly high rates in institutionalized elderly and in patients admitted to hospitals. A combination of immobility and loss of lean body mass - which comprises muscle and skin - and immune system challenges increases the risk of pressure ulcers by 74%. The development of pressure ulcers in the hospital affects 10% of admissions, with the elderly at the highest risk. Common causes of malnutrition in the elderly involve: decreased appetite, dependency on help for eating, impaired cognition and/or communication, poor positioning, frequent acute illnesses with gastrointestinal losses, medications that decrease appetite or increase nutrient losses, polypharmacy, decreased thirst response, decreased ability to concentrate urine, intentional fluid restriction because of fear of incontinence or choking if dysphagic, psychosocial factors such as isolation and depression, monotony of diet, and higher nutrient density requirements along with the demands of age, illness, and disease on the body. All have been found to delay healing and increase the risk of pressure ulcer development. In addition, what is ingested should contain nutrients to support health and healing. The financial impact of malnutrition is high and the consequences for patient morbidity and mortality are severe. Practical suggestions to improve the nutritional status of long-term care residents include liberalizing previous diet restrictions where safe and appropriate, addressing impairments to dentition and swallowing, addressing physical and/or cognitive deficits, encouraging family and friends to provide favorite foods, auditing/addressing specific food under-consumption, and providing prudent nutrient supplementation. Clinicians must be aware of the numerous factors in play with regard to nutrition and its impact on not only general well-being but also on wound care. Nutritional intervention in pressure ulcer management is truly "healing from the inside out."
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PMID:Malnutrition in the institutionalized elderly: the effects on wound healing. 1550 82


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