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

Insomnia is common among patients who subsequently experience an acute myocardial infarction (MI), and is a major symptom of psychiatric depression. The purpose of this study was to determine what proportion of patients reporting insomnia prior to MI have depression. Of 70 patients with a recent MI, 27 (39%) reported having had insomnia for two weeks or longer prior to their MI, 13 of whom (48%) met diagnostic criteria for a major depressive episode (MDE). MDE accounted for a significant proportion of the patients reporting insomnia prior to MI (p less than 0.0001). Furthermore, those patients with insomnia who did not meet diagnostic criteria for MDE nevertheless had three times as many depressive symptoms, excluding sleep disturbance, as did those patients who did not experience insomnia prior to their MI (p less than 0.0009). The implications of this finding are discussed, as well as possible explanations for the relationship between insomnia, depression, and subsequent MI.
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PMID:Insomnia and depression prior to myocardial infarction. 228

Seventy-three patients successively hospitalized in psychiatry and meeting the criteria of the DSM-III for diagnoses of major depressive episode with or without melancholia (n = 64), dysthymia (n = 5) or adjustment disorder with depressed mood (n = 2) were studied. Of these 73 patients, 50.7% also exhibited, at the time of their hospitalization, panic disorder as defined by the DSM-III criteria (53.4% having exhibited this disorder at some time in their life). Moreover, eight of the 73 patients (11%) exhibited, or had exhibited at some time in their life, a "sub-panic" state characterized by recurring rudimentary attacks, while five of the 73 patients (6.8%) exhibited "permanent panic anxiety" tending to fluctuation rather than paroxysm. These two forms of anxiety raise the question of the limits of panic disorder. The comparison of depressions with and without panic disorder shows an even distribution of endogenous and nonendogenous forms in both groups. Depressions with panic disorder, moreover, registered greater intensity (according to the HDRS score), a higher lever of anxiety (according to the AMDP-AT score), and a higher degree of nervousness (according to the EPI score) than depressions without panic disorder. The study of the chronology of the associations between depressions and panic disorder shows that in more than one-half of the cases these disorders began within one month of each other. In one-third of the cases, panic disorder preceded the depressive episode by more than one month. And finally, in just over 10% of the cases, panic disorder appeared more than one month after the beginning of the depressive episode.
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PMID:[Depression with panic attacks: clinical characteristics and prevalence in hospital]. 231 48

A mother and her six-week-old infant began attending group therapy sessions designed to raise awareness of developmental events. The mother consistently displayed a high degree of responsiveness and sensitivity to the infant's needs; in fact, her behavior served as a model of adaptive interaction for the entire group. After six months of sessions, when the infant manifested full-blown weaning patterns, the mother reported symptoms indicating a major depressive episode, such as pervasive dejection and rejection, listlessness, and anxiety attacks. After several individual sessions, during which discussion focused on the etiology of these emotions, the depression remitted and the mother was able to resume previous adaptive interaction designed to promote the infant's development. This case study reveals that highly adaptive parents may be susceptible to depression when developmental events that signify imminent separation from their infants or a similar dramatic change in their relationship occur.
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PMID:The emergence of psychopathology in a previously adaptive mother-infant dyad. 232 24

This study compared three measures of depression in schizophrenia and their correlation with the Dexamethasone Suppression Test (DST). The degree of overlap of these three measures with negative symptoms was also examined. The Hamilton Depression Rating Scale (HDRS), the depressive syndrome score of the Present State Examination (PSE), and the Scale for the Assessment of Negative Symptoms (SANS) were administered to 50 acutely ill, hospitalized schizophrenics. Patients were diagnosed using DSM-III criteria for schizophrenia. DSM-III criteria were also used to assess the presence of a major depressive episode. Results were that DST nonsuppression was significantly associated with the presence of a major depressive episode, but not with depressive rating scale scores or with negative symptoms. It is concluded that the DST may be of value in differentiating a depressive syndrome from a negative symptom syndrome in schizophrenia.
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PMID:Depression dexamethasone nonsuppression and negative symptoms in schizophrenia. 237 54

Cerebrospinal fluid levels of norepinephrine and six monoamine metabolites were measured in 28 medication-free depressed patients. Patients with a major depressive episode with melancholia (n = 15) had significantly lower levels of the three dopamine metabolites: homovanillic acid (HVA), dihydroxyphenylacetic acid (DOPAC), and conjugated dihydroxyphenylacetic (CONJDOPAC), when compared with a combined group of patients with a major depressive episode or dysthymic disorder (n = 13). In patients with major depressive episode with melancholia, levels of HVA and of the serotonin metabolite 5-hydroxyindoleacetic acid significantly correlated with the severity of depression. In the total group of 28 depressed patients, cerebrospinal fluid (CSF) levels of norepinephrine significantly correlated with symptoms of anxiety. In both patients with major depressive episode and major depressive episode with melancholia, those who were non-suppressors on the dexamethasone suppression test had significantly higher CSF levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol compared to those who were suppressors.
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PMID:Cerebrospinal fluid monoamine and monoamine metabolite concentrations in melancholia. 241 96

The cerebrospinal fluid levels of norepinephrine and six monoamine metabolites were measured in 23 patients meeting DSM-III criteria for major depressive episode, 15 of whom also met criteria for melancholia. Life events during the six-month period before the onset of depression were recorded using Paykel's method. There was no difference in Hamilton depression ratings between patients with life events and those without. However, depressed patients who did not have a life event in the six months before the onset of depression had significantly lower levels of the dopamine metabolite homovanillic acid and the serotonin metabolite 5-hydroxyindoleacetic acid than those with life events. The incidence of nonsuppression on the dexamethasone suppression test was also greater in patients with a major depressive episode who did not have an undesirable life event than in those who did. Thus, the presence or absence of life events led to a separation into biologically distinct groups.
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PMID:Cerebrospinal fluid monoamine and monoamine metabolite levels and the dexamethasone suppression test in depression. Relationship to life events. 242 Mar 2

Regional cerebral blood flow (rCBF) was measured during rest and cognitive activation in 21 patients with a major depressive episode and 21 healthy subjects. Depressive patients had significantly lower rCBF during rest in the right global, frontal, parietal, occipital and temporal regions and in the left global and frontal regions. During mental activation patients showed significantly lower values in all right and left parietal regions. rCBF was correlated with the scores of the Brief Psychiatric Rating Scale (BPRS), the parietal regions. rCBF was correlated with the scores of the Brief Psychiatric Rating Scale (BPRS), the Bech-Rafaelsen Melancholia Scale (BRMS), the Hamilton Depression Scale (HAM-D) and the Hamilton Anxiety Scale (HAM-A). The most significant negative correlations were obtained with the BPRS. Correlation analyses between each single item of the BPRS and CBF values revealed the strongest associations between emotional withdrawal and decreased CBF. Patients with 'reactive' features had higher CBF than patients without 'reactive' symptoms. Only patients without 'reactive' symptoms had a lower CBF than controls. 'Endogenous' features had no impact on CBF.
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PMID:Regional cerebral blood flow in depression: associations with psychopathology. 252 89

To explore and to compare hypothalamic-pituitary-somatotropic (HPS), hypothalamic-pituitary-thyroid (HPT) and hypothalamic-pituitary-adrenocortical (HPA) axis function in depression, 30 subjects (15 patients with a major depressive episode and individually matched controls) received 50 micrograms growth hormone-releasing hormone-44 amide at 9:00, 200 micrograms thyrotropin-releasing hormone (TRH) at 9:00 and 100 micrograms human corticotropin-releasing hormone (CRH) at 18:00 on consecutive days as an i.v. bolus dose. Compared with controls, depressed patients showed blunted growth hormone (GH) responses to GHRH, decreased TRH-induced thyrotropin (TSH) release and reduced corticotropin (ACTH) but normal cortisol secretion following CRH. ACTH secretion following CRH and TRH-induced TSH release were positively correlated across depressed patients and controls but no significant correlations between GH responses to GHRH and TRH-induced TSH release or ACTH and cortisol secretion following CRH administration were demonstrated. Our findings suggest that altered HPT and HPA axis function associated with depression are triggered by factors that are at least partly different from those that cause HPS system dysfunction. We conclude that the pathophysiological process resulting in aberrant neuroendocrine secretory dynamics associated with depression may primarily occur at a suprapituitary site, and that HPS, HPT and HPA axis dysfunction may be precipitated by complex central and peripheral regulatory mechanisms involving largely independent factors.
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PMID:Endocrine responses to growth hormone-releasing hormone, thyrotropin-releasing hormone and corticotropin-releasing hormone in depression. 254 70

The authors report on 404 Southeast Asian refugees seen at a community clinic. Approximately three-quarters of these patients met DSM-III criteria for major depressive episode, and 14% had posttraumatic stress disorder. Complaints of pain and sleep disturbances were the predominant presenting symptoms. Most of the men were married, but more than 40% of the women were widowed. Between 15% and 30% of the patients reported specific traumatic experiences either in their homeland or during their escape. Widowhood and such traumatic experiences were positively correlated with more symptoms of depression and anxiety.
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PMID:Depression and posttraumatic stress disorder in Southeast Asian refugees. 258 53

In the random sample of 18 patients (10 female and 8 male) with the symptoms of the major depressive episode, V/296, DSM-III the author examines the questions of the aetiology, aim, form and mechanisms or aggression by the psychoanalytically oriented individual psychotherapy. The author finds that the aetiology of aggression in patients with depression arises not only from the biological basis but also from the dynamic psychopathological constellations of the personality structure and the configuration of the unconscious. The aggression aim in these patients is the protection of the fulfillment of the primary narcissism pathological needs. Among other things the author finds that their narcissism looks for cosmic spaces and that it breaks under the laws of the natural constants and relativity, whereas the loss of space and the flow of time have the meaning of the sequestrations of their self and the cognition of the crushing defeat. Their basic mechanism is masochistically sadistic. The psychotherapy of these patients requires big efforts, the control of the countertransfers and the adaptation of techniques.
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PMID:[Aggression in depression]. 263 5


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