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

This study examined psychologic distress and immune function in patients with chronic-progressive multiple sclerosis participating in a placebo-control trial of cyclosporine. Immune measures included percentages and absolute numbers of CD2+, CD4+, CD8+, Leu-11-b+, HLA-DR (IA+), and transferrin-receptor-positive cells, which were evaluated by immunofluorescence using monoclonal antibodies. Distress was measured with self-report scales. The Expanded Disability Status Scale assessed neurologic disability. Subjects were followed up for 2 years, and their high-depressed and low-depressed times were compared. Times of greater depression were associated with lower CD8+ cell numbers and CD8+%, and a higher CD4/CD8 ratio. CD4+ cell numbers and percent were also higher when subjects were depressed, but only in the placebo group. There were no differences in Expanded Disability Status Scale when subjects were more depressed. Evaluation of a single subject revealed that Ia+ and transferrin-receptor-positive lymphocytes increased 3 months before distress increased. It was concluded that distress is associated with immune dysregulation in multiple sclerosis, although the mechanisms of this association have yet to be delineated.
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PMID:A prospective study of depression and immune dysregulation in multiple sclerosis. 153 25

Theiler murine encephalomyelitis virus strains are categorized into two groups, a neurovirulent group that rapidly kills the host, and a demyelinating group that causes a generally nonlethal infection of motor neurons followed by a persistent infection of the white matter with demyelinating lesions similar to those found in multiple sclerosis. The three-dimensional structure of the DA strain, a member of the demyelinating group, has been determined at 2.8 A resolution. As in other picornaviruses, the icosahedral capsid is formed by the packing of wedge-shaped eight-stranded antiparallel beta barrels. The surface of Theiler virus has large star-shaped plateaus at the fivefold axes and broad depressions spanning the twofold axes. Several unusual structural features are clustered near one edge of the depression. These include two finger-like loops projecting from the surface (one formed by residues 78-85 of VP1, and the other formed by residues 56-65 of VP3) and a third loop containing three cysteines (residues 87, 89, and 91 of VP3), which appear to be covalently modified. Most of the sequence differences between the demyelinating and neurovirulent groups that could play a role in determining pathogenesis map to the surface of the star-shaped plateau. The distribution of these sequence differences on the surface of the virion is consistent with models in which the differences in the pathogenesis of the two groups of Theiler viruses are the result of differences in immunological or receptor-mediated recognition processes.
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PMID:Three-dimensional structure of Theiler virus. 154 65

Losses are an integral part of chronic illness and disability. The term chronic sorrow, has been used to describe the long-term periodic sadness the chronically ill and their caregivers experience in reaction to continual losses. In this conceptual analysis of chronic sorrow, identified critical attributes are: cyclic sadness over time in a situation with no predictable end; external and internal stimuli triggering the feelings of loss, disappointment, and fear; and, progression and intensification of the sadness or sorrow years after the initial disappointment or loss. Model, borderline, related, contrary, and illegitimate cases illustrate what the concept is and what it is not. The meaning of chronic sorrow is compared to the meaning of unresolvable grief and depression. Chronic sorrow in various stages of life is illustrated in descriptions of: the situation and feelings of parents of handicapped children; multiple sclerosis patients in the middle, productive years; and elderly caregivers of spouses with dementia. Implications for research include the need to study the concept in various populations to determine its prevalence and operation. Through research, the meaning of the concept can be further clarified. This is a beginning step toward developing nursing theory that will give direction for providing care to persons encountering sadness over long periods of time.
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PMID:Chronic sorrow: a lifespan concept. 158 85

We examined the prevalence of sleep problems in a sample of patients with mild but clinically definite multiple sclerosis (n = 143) and sought to determine whether there was a relationship between the presence of sleep complaints and the level of depression. As magnetic resonance imaging scans were available for a subsample of the patients with multiple sclerosis (n = 117), we also wanted to determine whether there was a relationship between the site of the lesion and the presence of sleep difficulties. The prevalence of sleep difficulties was three times higher in the patients with multiple sclerosis than the control group (25.2% vs 8.2%). Moreover, the presence of sleep complaints was associated with higher levels of depression. Three lesion sites that subserve supplemental motor areas were significantly related to the presence of sleep complaints. These findings suggest that, for some patients with MS, sleep disturbance and accompanying increases in depression may be a function of the lesion site resulting in nocturnal spasms.
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PMID:Sleep disturbance, depression, and lesion site in patients with multiple sclerosis. 159

The authors have conducted a longitudinal survey for a period of 14 years with 171 patients suffering from multiple sclerosis. In each case, therapeutic and diagnostic procedures were in accordance with the latest development. In almost half of the cases with a duration of illness up to 20 years the degree of impairment can be regarded as minimal, which can be used as an argument in favour of conscientious and continuous rehabilitative measures, including psychotherapy (this in opposition to a "rehabilitative pessimism"). Two thirds of the patients have been in employment with full working capacity during the first ten years of their illness. The consequences for social medicine and social policy are self-evident and imperative. In accordance with earlier studies, motor pareses are predominant among the first symptoms of multiple sclerosis, whereas disorders of cranial nerves, of urinary excretion and of cerebral function appear later in the course of the disease. Factor analysis did not yield any clues with respect to the predictability of the development of illness. Psychoreactive depression is relatively common in the earlier stages, later we can find somatogenic (psycho-organic) depressions, which respond relatively poor to treatment. Among the diagnostic tool, analysis of the critical flicker fusion frequency (CFFF) has proved to be very sensitive, by far not as cumbersome as visually evoked potentials and at least as reliable as the later. Therapeutic strategies should include: early treatment of any acute attack, consequent long-term care with modern nursing methods and rational concomitant medication, prophylaxis against infection. Multiple sclerosis represents itself as a problem of long-term rehabilitation, thus emphasizing the necessity of increased commitment to rehabilitation within a general framework of health care, which should include: a) better representation of rehabilitation as a discipline at the universities. b) systematic concomitant research in rehabilitation, c) legal and administrative adaptations, d) the development of a general "rehabilitation mentality" (as we have come to call it), which means involvement with the patient and his environment throughout his entire life-span.
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PMID:[15-year-factor analysis of multiple sclerosis]. 176 12

Twenty multiple sclerosis (MS) patients admitted to the hospital for treatment of exacerbation of their disease were asked to identify stressors and the coping mechanisms they employed to deal with stressors. They completed the MS Stressor Scale (a twenty item Likert-type scale) and the Jalowiec Coping Scale (sixty-item Likert-type scale). Disability level was measured using the Barthel Index. Results showed an overall mean stress score of 1.49 on a scale of 1 to 3. The most stressful items identified were feeling tired, inability to walk and uncertainty about the future. The most prevalent coping theme used was self-reliance and the most prevalent individual coping responses were a sense of humor and trying to learn more. A positive correlation was found between uncertainty about the future and fatalistic coping, and a negative correlation between depression and optimistic coping. No relationship was found between degree of disability and stressors.
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PMID:A correlational study of disabilities, stressors and coping methods in victims of multiple sclerosis. 183 85

To better understand the nature of the memory deficit in patients with multiple sclerosis, we designed a study to compare automatic vs effortful memory processes. Forty-one patients with definite multiple sclerosis and 45 demographically matched normal control subjects were administered two tasks designed to assess both automatic (monitoring frequency and modality) and effortful (free and cued-recall) processing. Results indicated that patients with multiple sclerosis, as expected, were significantly impaired on memory measures requiring effort, but performed normally on automatic measures. Performance on the memory indexes did not correlate with self-reported depression. The implications of these findings for delineating the locus of the memory impairment in multiple sclerosis is discussed.
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PMID:Automatic memory processes in patients with multiple sclerosis. 192

Previous frequency estimates of cognitive dysfunction in multiple sclerosis have ranged from 54 to 65 percent. These studies may overestimate the frequency in the general MS population, since the patients in these studies were recruited from clinic populations. In the present study, we administered a comprehensive neuropsychological test battery to 100 community-based MS patients and 100 demographically matched healthy controls. Of 31 cognitive test indices examined, 48 MS patients and five controls were impaired on four or more test indices, yielding an overall frequency rate of 43% for the MS group. The pattern of cognitive decline was not uniform: MS patients were more frequently impaired on measures of recent memory, sustained attention, verbal fluency, conceptual reasoning, and visuospatial perception, and less frequently impaired on measures of language and immediate and remote memory. We developed a brief (20-minute) screening battery empirically by selecting the four most sensitive test indices from the comprehensive battery. The brief battery yielded a sensitivity value of 71% and a specificity value of 94% in discriminating cognitively intact from impaired MS patients, as defined by the comprehensive battery. Cognitive impairment was not significantly associated with illness duration, depression, disease course, or medication usage, but was significantly (albeit weakly) correlated with physical disability.
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PMID:Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. 182 86

A consecutive sample of 50 patients with a diagnosis of definite multiple sclerosis was evaluated by means of the Clinical Interview Schedule (CIS) and other psychopathological instruments. A global prevalence of psychopathology of 54% was found, with the prevalence of depression being 22%. Moreover, 46% of the sample presented signs indicative of neuropsychological deterioration in the Benton Visual Retention Test. The association between the presence of psychopathology and the social and neurological characteristics of the sample was also investigated, with results of low significance.
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PMID:Psychiatric aspects of multiple sclerosis. 174 95

The diagnostic evaluation of dementia is directed toward the identification of treatable causes. It can be facilitated by classification of the dementia into one of four categories: attentional, amnestic, cognitive, and intentional. Intentional dementia reflects dysfunction of frontal lobe systems, components of which include the frontal cortex, basal ganglia, thalamus, limbic structures, and subcortical white matter. Disorders that affect one or more of these components and produce intentional dementia include Binswanger's disease, Parkinson's disease, Huntington's disease, HIV infection, closed head injury, normal pressure hydrocephalus, neoplasms, syphilis, vitamin B12 deficiency, multiple sclerosis, and a number of uncommon degenerative and acquired syndromes. Depression may resemble intentional dementia. Guidelines for diagnosis and management are discussed.
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PMID:Multi-infarct dementia, subcortical dementia, and hydrocephalus. 203 8


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