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

Congenital adrenal hyperplasia describes a group of inherited autosomal recessive disorders characterized by an enzymatic defect in cortisol biosynthesis, compensatory increases in corticotropin secretion, and adrenocortical hyperplasia. 21-Hydroxylase deficiency is responsible for more than 95% of cases and is one of the most common known autosomal recessive disorders. The classic or severe type presents in the newborn period or early childhood with virilization and adrenal insufficiency, with or without salt loss; the mild or nonclassic form presents in late childhood or early adulthood with mild hyperandrogenism and is an important cause of masculinization and infertility in women. This wide range of phenotypic expression is mostly explained by genetic variation, although genotype-phenotype discrepancies have been described. Reproductive, metabolic, and other comorbid conditions, including risk for tumors, are currently under investigation in both forms of the disease. A high proportion of patients with adrenal incidentalomas may be homozygous or heterozygous for 21-hydroxylase deficiency. Women with congenital adrenal hyperplasia often develop the polycystic ovary syndrome. Ectopic adrenal rest tissue is often found in the testes of men with congenital adrenal hyperplasia; characteristic clinical and radiologic findings help differentiate this tissue from other tumors. Levels of corticotropin-releasing hormone are elevated in patients with depression and anxiety and are expected to be elevated in patients with congenital adrenal hyperplasia; it is unknown whether patients with 21-hydroxylase deficiency have an increased incidence of these psychiatric disorders. Abnormalities in both the structure and function of the adrenal medulla have been shown in patients with classic congenital adrenal hyperplasia, and the degree of adrenomedullary impairment may be a biomarker of disease severity. The 21-hydroxylase-deficient mouse has provided a useful model with which to examine disease mechanisms and test new therapeutic interventions in classic disease, including gene therapy. Treatment of this condition is intended to reduce excessive corticotropin secretion and replace both glucocorticoids and mineralocorticoids. However, clinical management is often complicated by inadequately treated hyperandrogenism, iatrogenic hypercortisolism, or both. New treatment approaches currently under investigation include combination therapy to block androgen action and inhibit estrogen production, and bilateral adrenalectomy in the most severely affected patients. Other approaches, which are in a preclinical stage of investigation, include treatment with a corticotropin-releasing hormone antagonist and gene therapy.
 ...
PMID:NIH conference. Future directions in the study and management of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. 1184 30

Infertility affects 6 million American women and their partners, about 10% of the reproductive age population. Recent improvements in medication, microsurgery, and assisted reproductive technology (ART) make pregnancy possible for more than half the couples pursuing treatment, yet infertility is more than a medical condition. Infertility touches all aspects of a person's life. It affects how individuals feel about themselves, their relationships, and their life perspective. Stress is only one of a myriad of emotional realities that couples facing infertility deal with, often for extended periods of time. In addition to ongoing stress, infertility creates issues of guilt, anxiety, tension within the relationship, and feelings of depression and isolation. Treating couples and individuals who are involved in the journey of dealing with infertility is an opportunity for clinical specialists in psychiatric mental health nursing. The expertise of clinical specialists both in providing psychotherapy services as well as providing a bridge of understanding of sophisticated medical and surgical procedures places them in a unique position among the various disciplines offering mental health services. This paper provides an overview of the psychological issues that play a role in psychotherapy with this population and suggests specific clinical interventions and potential role expansion for psychiatric clinical specialists.
 ...
PMID:Infertility and the role of psychotherapy. 1188 9

Although a potential relationship between depression and infertility has been described throughout history, only recently has this topic been subjected to systematic investigation, and the literature is often confusing. The present study uses well-established structured psychiatric interviews--Structured Clinical Interview for DSM-III-R (SCID), Beck and Family History-Research Diagnostic Criteria (Fh-RDC)--to investigate the prevalence of major depression in a small group of women with infertility of unknown origin, and a community control sample. There were significantly more women with current depression or a history of depression in the infertile group, and of these women the majority experienced their first depressive episode prior to their diagnosis of infertility.
 ...
PMID:Major depression in unexplained infertility. 1206 Oct 34

This is a prospective study to assess the psychiatric morbidity in Chinese infertile women who underwent treatments with assisted reproductive technology and also the impact of treatment failure. The 30-item General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) were employed before and 3 weeks after the assisted reproductive technology treatment. Data from 372 patients who completed the questionnaires and failed the treatment were analyzed. Before treatment, 33% of the participants scored above the GHQ cutoff, and 8% had a BDI score of 20 or above, signifying moderate to severe depression. Following failed treatment, 43% scored above GHQ cutoff, and 8% had BDI scores 20 or above. The posttreatment GHQ and BDI scores were significantly higher than the corresponding scores at baseline (p < 0.001). About 13% of the participants reported self-harm ideas. The severity of depression following a failed treatment was positively associated with the duration of infertility (p < 0.05), but not with the posttreatment BDI scores, age, education, and number of previous treatment episodes. Our results show that one third of the women who sought infertility treatment had an impaired psychological well-being. Following failed treatment, there was a further deterioration in mental health, and about 10% of the participants were moderately to severely depressed. Proper psychological care and counseling should be an integral part of infertility management among the Chinese population.
 ...
PMID:Psychiatric morbidity amongst infertile Chinese women undergoing treatment with assisted reproductive technology and the impact of treatment failure. 1218 82

Female genital mutilation is associated with immediate, long-term, pregnancy-related, and psychosexual complications. Immediate complications can cause death and include severe pain, shock, hemorrhage, tetanus or sepsis, urine retention, ulceration of the genital region, and injury to adjacent tissues. Long-term complications include formation of cysts, abscesses, and keloid scars, damage to the urethra resulting in incontinence, painful sexual intercourse, sexual dysfunction, recurrent urinary tract infections, chronic pelvic inflammatory disease, and infertility. During child birth, survivors of female genital mutilation may require Cesarean section or suffer obstructed labor leading to fetal death and/or vesico-vaginal fistulae and large perineal tears. The psychological consequences of female genital mutilation may involve loss of trust and confidence in care-givers, feelings of incompleteness, anxiety, depression, chronic irritability, and sexual problems. In many women, flashbacks of the infibulation process are triggered by touch. Deinfibulation must be accompanied by adequate pain relief, but the use of local or epidural anesthesia is not appropriate.
 ...
PMID:Consequences of genital mutilation. 1222 23

This is a case report of a 35-year old man whose fertility status was severely impaired by a past history of bilateral testicular torsion, use of numerous psychotropic drugs, and the presence of a left varicocele. A moderate improvement in the semen quality occurred following discontinuation of the medications, but a significant reponse was not evident until a varicocelectomy was performed. Thereafter, repeated semen analyses revealed normal findings except for a marked depression of sperm motility when the patient took Norpramin, a psychoactive drug. Seminal factors were consistently normal when this medication was withheld. Ultimately, when the patient agreed not to take the Norpramin for 9 months, his semen quality remained normal and his wife conceived and delivered a normal male child.
Infertility 1978
PMID:Psychotropic drug induced male infertility: a case report. 1226 6

Female circumcision is practiced in some parts of Africa, the southern part of the Arabian Peninsula, Malaysia, and Indonesia. 95% of a sample of 2000 Egyptian women were circumcised, an operation attended by a high incidence of complications: immediate and late, physical and psychosexual, minor and serious, even fatal. The causes are the type of operation and the operator. In a mild form, the prepuce of the clitoris only is removed, with the posterior larger parts of the labia minora. An extensive operation common to Sudan consists of removal of the whole clitoris, the whole of the labia minora, and part of the labia majora. Complications common with pharaonic or Sudanese circumcision include painful scarkeloid formation, labial adhesions, cysts of the clitoris, vulval disfigurement, vaginal calculi, tight circumcision, infertility, and urinary complications. Psychosexual complications include a feeling of reduced feminity; diminished desire for coitus; diminished coital frequency; dyspareunia, apareunia or vaginismus; lack of orgasm; anal intercourse; depression and psychotic states; and, social problems. With infibulation come obstetric complications. Vaginal examination during labor may be difficult; catheterization of bladder is difficult; second stage of labor is delayed; tearing or splitting of the circumcison scar is unavoidable; injury of the vagina, cervix, and fetal scalp; and, soft-tissue obstruction by the vulval skin diaphragm contributes to the production of a vesicovaginal fistula.
 ...
PMID:Medical dangers of female circumcision. 1233 39

The purpose of this research was to explore the following objectives for infertile couples receiving infertility treatment: Differences between wives and husbands in their emotional reactions and coping behaviors. This research, using structured questionnaires, was based on 120 infertile couples attending the Intrauterine Insemination (IUI) or the In Vitro Fertilization-Embryo Transfer (IVF-ET) program. The research instruments consisted of Demographic Data Form, Profile of Mood States (POMS), and Ways of Coping Questionnaire. The research results showed that infertile wives experienced more emotional disturbance than husbands did, as shown in the four subscales of Tension-Anxiety, Depression-Dejection, Anger-Hostility, and Fatigue-Inertia, as well as the total scale of POMS. It was also shown that wives adopted more coping behaviors to deal with infertility and treatment than husbands did, as revealed in the subscales of Self-Controlling, Seeking Social Support and Escape-Avoidance and the total scale of the Ways of Coping Questionnaire. All of the above reached significant statistical differences. The emotional reactions of infertile couples varied with the differences in education levels, duration of treatment, number of treatments received, and numbers of existing children. The emotional reactions of infertile husbands had a significantly positive correlation with the factors Confronting, Accepting Responsibility, and Escape-Avoidance. The emotional reactions of wives had a significantly negative correlation with Positive Reappraisal. The research results can provide clinical staff with a correct understanding of the differences between husbands and wives in emotional reactions and coping behavior, as well as related factors, to help them to provide better medical treatment.
 ...
PMID:Evaluations of emotional reactions and coping behaviors as well as correlated factors for infertile couples receiving assisted reproductive technologies. 1252 42

The prevalence of obesity is increasing worldwide. In the United States, in 1999, 27% of adults had a body mass index >30 kg/m(2), almost double the prevalence of 20 years earlier. The estimated mortality from obesity-related diseases in the United States is approximately 300,000 annually and growing. In the future, mortality related to obesity is expected to exceed that of smoking. Numerous diseases are caused or made worse by obesity. These include type 2 diabetes; hypertension; dyslipidemia; ischemic heart disease; stroke; obstructive sleep apnea; asthma; nonalcoholic steatohepatitis; gastroesophageal reflux disease; degenerative joint disease of the back, hips, knees, and feet; infertility and polycystic ovary syndrome; various malignancies; and depression. Type 2 diabetes is perhaps the most visible obesity-related problem. Present in at least 14 million Americans, it leads to serious complications and premature death. It is largely caused by obesity, and is generally cured by weight loss. The quality of life of the obese is markedly reduced, and the costs to health care systems are great. Preventive programs have yet to affect the rising prevalence. An effective solution is needed.
 ...
PMID:The extent of the problem of obesity. 1252 43

Because studies examining the emotional impact of infertility-related stress generally focus on individuals, there has been little research examining how relationship and individual variables are linked. The purpose of this study was to explore the impact of congruence (e.g., agreement) between partner's perceived infertility-related stress and its effects on depression and marital adjustment in infertile men and women. Couples referred for infertility treatments at a University-affiliated teaching hospital completed the Fertility Problem Inventory (FPI), the Beck Depression Inventory (BDI), and the Dyadic Adjustment Scale (DAS) 3 months prior to their first treatment cycle. Study findings show that men and women in couples who perceived equal levels of social infertility stress reported higher levels of marital adjustment when compared to men and women in couples who perceived the stress differently. In addition, women in couples who felt a similar need for parenthood reported significantly higher levels of marital satisfaction when compared to women in couples where the males reported a greater need for parenthood. While couple incongruence was unrelated to depression in males, incongruence over relationship concerns and the need for parenthood was related to female depression. These findings provide initial support for the theory that high levels of agreement between partners related to the stresses they experience help them successfully manage the impact of these stressful life events. Possibilities for future research examining the construct of couple congruence are discussed.
 ...
PMID:Examining congruence between partners' perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. 1269 99


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>