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

Of thirty six children with new-onset inflammatory bowel disease given a Kiddie-SADS interview, five children were depressed and ten had some depressive symptoms. Depressed children had less severe illness, and were more likely to have a maternal history of depression, more life events, and families characterized by less cohesion and more conflict.
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PMID:Correlates of depression in new onset pediatric inflammatory bowel disease. 808 23

After the development of monophasic combined oral contraceptives (COCs), containing a fixed dose of estrogen and progestogen, biphasic and triphasic COCs were introduced in the 1980s; in these the dose of ethinyl estradiol and progestogen changes during the pill cycle. In the so-called every day pills, the 21 pills of active steroid combination are followed by 7 inactive pills containing starch, iron, or bran. Method failures of OCs are among the lowest ranging from 0.2-1/100 woman-years. User failures can be as high as 6.2/100 women-years. The individual difference in peak plasma levels of estrogens in women taking identical OCs can be 10-fold. Conditions that affect the bioavailability of contraceptive steroids are: 1) drug interaction (vitamin C, drugs that induce liver enzymes, and antibiotics); 2) vomiting; 3) vegetarianism; 4) missing pills; and 5) malabsorption. Metabolic effects of COCs pertain to carbohydrate metabolism, lipid metabolism, hemostasis, and vitamins. Prescribing of COCs involves counseling clients about contraindications to COCs, starting routines, and the pill-free interval, as well as follow-up and monitoring, the problem of missing pills, and selection criteria for OC use. Medical conditions in which COC use requires special consideration are sickle cell disease, trophoblastic disease, HIV disease, gallstones, epilepsy, valvular heart disease, oligomenorrhea/amenorrhea, inflammatory bowel disease, and surgery. Side effects of COCs may include depression, nausea, vomiting, headaches, urinary tract infection, and lower genital tract infections. 6 months after stopping the OC 1% of users become amenorrheic. Many of the common causes of amenorrhea, such as weight loss amenorrhea and polycystic ovarian disease, may be treated with the COC until the couple desires to have a baby. The new progestogens desogestrel, norgestimate, and gestodene are highly selective compared to first and second generation progestogens.
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PMID:Combined oral contraceptives: acceptability and effective use. 832 4

This article describes a study designed to examine the coping behaviors, personality, and mood characteristics of 150 nonhospitalized adults with inflammatory bowel disease (IBD). Self-report questionnaires and interviews were used to collect the data. Coping responses were measured with the Jalowiec Coping Scale. The Eysenck Personality Questionnaire (EPQ) and Beck Depression Inventory (BDI) were used to ascertain other characteristics. Data were analyzed using analysis of variance (ANOVA), Pearson's correlation coefficient (r), and descriptive statistics. IBD patients scored significantly higher on using problem-oriented coping patterns than on using affective-oriented methods. The results suggest that coping patterns in IBD patients are remarkably effective in contributing to lifestyle satisfaction. It can be inferred that adaptive efforts of IBD patients can be enhanced if health professionals consider coping patterns in the assessment process and if they actively support a sense of control in these patients.
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PMID:Coping patterns and related characteristics in patients with IBD. 843 Feb 57

A group of 104 patients with inflammatory bowel disease (IBD) was followed longitudinally for 6 months. While anxiety and depression scores were influenced over time by changes in the level of disease activity, there was no significant change in alexithymia scores. The findings support the contention that alexithymia is a stable personality characteristic in some IBD patients, in contrast to anxiety and depression which are state phenomena influenced by the level of disease activity.
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PMID:A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease. 903 20

Children and adolescents with inflammatory bowel disease (IBD) present unique challenges to physicians and all health-care providers. The most important aspect is that children are not small adults. They are characterized by a highly dynamic state of growth and physical change as well as a constant alteration in psychological status. It will not be difficult to recognize IBD, even in children, when it presents with classical symptoms such as bloody diarrhoea, abdominal pain and weight loss. However, some children will present with abdominal pain and depression. Not infrequently these children are diagnosed as being depressed and are seen and treated by psychologists and psychiatrists for different periods of time. In addition, several children will be initially diagnosed as having a bacterial gastroenteritis with a proven positive faecal culture. It seems to be the triggering event in these children, and if adequate therapy fails, colonoscopy is indicated. Recently, Beattie et al. showed that in children seen for chronic abdominal pain simple routine blood tests including full blood count and erythrocyte sedimentation rate are almost always abnormal in children with IBD. But most importantly, growth retardation is common in children with IBD and is more often found in Crohn's disease (CD) than in ulcerative colitis (UC). Faltering growth is a sign of a catabolic situation. Therefore, it is essential to follow the growth of children at the beginning and during treatment of IBD. Growth retardation can be the first symptom of IBD and is often already present before other symptoms of IBD become apparent. Rarely, extra-intestinal manifestations, particularly arthritis, can be the first and sometimes only initial symptom for months to years in children with IBD. About 2% of all patients with IBD present before the age of 10 years, but 30% present between the age of 10 and 19 years. A significant proportion of young patients with IBD will develop the disease just prior to or during puberty. Adolescent growth is characterized by rapid accumulation of lean body mass and any inflammatory disease occurring at this time is likely to have a major impact on nutritional status and growth. This rapid growth requires an appropriate increase in nutritional substrates and failure to achieve catch-up growth may ultimately lead to poor cumulative growth over time. Most of the growth retardation is seen in children with CD, approximately 30%. However, also in UC 15% will show a reduction in growth. The higher percentage in CD could be due to the disease itself or to the relative subtlety of the intestinal manifestations of CD, mainly abdominal pain and general malaise. Not only growth, but also delayed puberty, is a sign of an ongoing disease that most likely needs more intensive treatment. It has been shown that the severity of disease activity plays a more important role in the occurrence of growth retardation than steroid treatment. Therefore in paediatrics it is important to state that growth retardation during medical treatment equals undertreatment. In contrast to adults, the potential benefit of nutritional therapy should be seriously considered in addition to aggressive medical therapy including steroids and other immunosuppressive agents such as azathioprine. The most convincing evidence that malnutrition is primarily responsible for growth failure is based on depletion studies. The malnutrition itself is caused by ongoing inflammation and loss of appetite. Recommendations for nutritional therapy include an increase in energy and protein intake to 150% of recommended daily allowances for height and age. Some studies have shown the benefit of nocturnal nasogastric infusion as supplements of daily intake. Importantly, nutritional support has been shown to be as effective as steroids in achieving remission of disease in children. Furthermore, no significant differences have been shown in studies using elemental versus polymeric diets.
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PMID:Problems in diagnosis of IBD in children. 905 Mar 26

1. Since intermittent ischaemia may play an important role in the aetiology of Inflammatory Bowel Disease, particularly Crohn's Disease, a pharmacological model of neuronal ischaemia was applied to guinea-pig isolated intestinal preparations to mimic the acute effects of reduced blood flow on intestinal motility. 2. Neuro-effector transmission and smooth muscle performance were examined in myenteric plexus-longitudinal muscle preparations of guinea-pig ileum exposed to sodium cyanide (NaCN), in order to inhibit oxidative phosphorylation, or to iodoacetic acid (IAA), to block glycolysis. Comparisons were made with the effects due to simple deprivation of oxygen or glucose. 3. Depression of cholinergic neuro-effector transmission induced by hypoxia or NaCN (effective concentration range 0.1-3 mM), given as separate treatments, singly or repetitively over 60-90 min, were apparent within 30 s and were reversible. The maximum inhibition was 90% and the IC50 for NaCN was 0.3 mM. A conspicuous component of these inhibitions was prejunctional. 4. Non-cholinergic neuro-effector contractions were inhibited by up to 90% by anoxia or NaCN but recovery was incomplete and slower than with cholinergic contractions. 5. Glucose-free solutions also caused a reversible failure of cholinergic neuro-effector transmission but of slower onset. In contrast, IAA (0.06-1 mM) abolished contractions irreversibly, apparently by a direct depressant effect on smooth muscle contraction. Unlike NaCN, IAA caused an initial potentiation of electrically-induced contractions, partly by a prejunctional potentiation of cholinergic neuro-effector transmission. 6. It is concluded that a disruption of intestinal activity in pathological conditions associated with intestinal ischaemia may result from disturbances in the function of enteric neurones.
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PMID:Depressant effects of hypoxia and hypoglycaemia on neuro-effector transmission of guinea-pig intestine studied in vitro with a pharmacological model. 911 84

A man with severe inflammatory bowel disease suffered from chronic abdominal pain and depression. A transdermal amitriptyline gel preparation was compounded since he was unable to take drugs orally Serum concentrations of amitriptyline and its active metabolite nortriptyline were measured over 24 hours. Symptoms of depression were monitored before starting transdermal therapy and at the end of 6 weeks. Pain symptoms and amitriptyline adverse drug events were monitored daily Steady-state serum concentrations of drug and metabolite were within the therapeutic range over 24 hours. The patient reported that his mood was improved but his abdominal pain remained unchanged. Transdermal amitriptyline gel was well tolerated and is an alternative delivery system in patients unable to take drugs orally.
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PMID:Use of transdermal amitriptyline gel in a patient with chronic pain and depression. 1003 Jul 76

Psychoneuroimmunology is the scientific field that investigates linkages between the brain, behavior, and the immune system and the implications of these linkages for physical health and disease. Recent evidence suggests that both naturalistic and laboratory stressors can alter enumerative and functional aspects of the human immune system. Chronic stress may increase vulnerability to infectious disease; however, the role of stress in the course of inflammatory bowel disease remains unclear. Because there are large individual differences in psychological response to stress, it is important to consider the role of cognitive and affective responses to stress. Depression has been associated with functional immune decrements and immune overactivation. Cognitive states such as perceived control, views of the self, and views of the future have been associated with immune parameters and health in some studies. Very few controlled clinical trials have been conducted to determine if psychosocial interventions can impact the immune system and the progression of medical conditions. There is suggestive evidence for the health benefits of relaxation training, cognitive-behavioral stress management, and support groups; but, there is little research on many other psychosocial interventions in widespread use for medical conditions. An evidence-based discussion of this research literature with interested patients may help them make informed decisions regarding adjunctive treatments.
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PMID:Psychoneuroimmunology update. 1006 69

Defining and measuring quality of life is a relatively new dimension of health care for many clinicians. The traditional method of evaluating clinical status and response to treatment has been to look at disease-specific symptoms, global assessments (e.g., impressions of the good, better, or worse condition of a patient), days missed at school, and a variety of disease activity scores. These impressions and techniques may or may not reflect how patients are functioning day to day and how they feel about the illness. To address these issues, health-related quality of life questionnaires have been developed to measure the functional effect of an illness and its treatment on a patient, as perceived by the patient. There are four broad domains that are considered part of a health-related quality-of-life questionnaire: 1) physical and occupational function, 2) psychologic state, 3) social interaction, and 4) somatic sensation. In the case of children, the perception of parents or caretakers may be added to complete the picture. Significant social and psychiatric problems have been described in children with IBD, including absenteeism from school, depression, suicide, and major disruption of family patterns. To understand fully the impact of inflammatory bowel disease and its treatment on patient and family function requires one or more quality-of-life instruments that are sensitive to the full range of symptoms, growth and development, and response (including side effects) to many new therapies.
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PMID:Quality of life in inflammatory bowel disease: background and definitions. 1020 18

Improvement of health-related quality of life (HRQOL) is a major determinant in decision-making for surgery in patients with Crohn's disease (CD). This study was designed to investigate the short- and long-term effect of surgical resection for CD on HRQOL. Sixteen patients were investigated within one week before surgery and 3, 6, and 24 months postoperatively. Besides the Crohn's disease activity index (CDAI), four instruments: the time trade-off technique (TTO), the direct questioning of objectives (DQO), the rating form of inflammatory bowel disease patients concerns (RFIPC), and the Beck depression inventory--were used for assessment of HRQOL. CDAI decreased significantly after operation and 10 patients remained in remission for 24 months. Two patients had postoperative relapses and went into remission after prednisolone treatment. Four patients developed chronic active disease. HRQOL was significantly improved in all patients three and six months postoperatively. Except for the four patients with chronic active disease, all other patients (N = 12) had also significantly improved HRQOL after 24 months. In conclusion, surgical resections in CD lead to a long-term improvement of HRQOL with the exception of patients with chronic active disease. This finding might be taken in consideration for the indication of surgery in CD.
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PMID:Health-related quality of life in patients with Crohn's disease: influence of surgical operation--a prospective trial. 1023


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