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

In DSM-III (1980), depressive states of neurosis and those of manic-depressive illness (melancholia or endogenous depression) were combined into the single category "major depression," which is the progenitor of "major depressive disorder" in DSM-IV-TR (2000). According to Hamilton, the word "depression" is used in three different ways. In common speech, it is used to describe the state of sadness that all persons experience when they lose something of importance to them. In psychiatry, the word is used to signify an abnormal mood, analogous to the sadness, unhappiness, and misery of everyday experiences. Moreover, the depression discussed in psychiatry often has another quality that makes it distinctive, and this quality appears to be related to an inability to experience any pleasure (anhedonia) regardless of experience. Accordingly, we classify these three uses of the term "depression" into sadness, depression, and melancholia in order of appearance within this paper. According to DSM-IV-TR criteria for major depressive disorder, depression corresponds closely to A1 "depressed mood", while melancholia is roughly compatible with A2 "markedly diminished interest or pleasure." Depression and melancholia differ in terms of origin, psychopathology, and therapy. Before DSM-III, depression had not been considered as a diagnosis, but was a ubiquitous symptom that was seen in such conditions as neurasthenia, psychasthenia, nervousness, and neurosis. Melancholia has a history that reaches back to Hippocratic times. Its modern meaning was established based on Kraepelin's manic-depressive illness. Depression is a deepened or prolonged sadness in everyday life, but melancholia has a distinct quality of mood that cannot be interpreted as severe depression. In modern times, depression has been treated with a diverse range of methods, including rest, talk therapy, amphetamines (1930s), meprobamate (1950s), and benzodiazepines (1970s). Melancholia has primarily been treated with somatic therapy, such as electroconvulsive therapy, and tricyclic antidepressants. When preparing diagnostic criteria for DSM-III, Spitzer referred not to DSM-II but to Feighner's (1972) criteria as a model because Feighner's operational criteria were considered to be effective in establishing inter-rater reliability. At the outset, Spitzer established Research Diagnostic Criteria (RDC, 1975), which he revised in 1978. In the first edition of RDC, Spitzer adopted most of the Feighner criteria, including essential criteria A "dysphoric mood" and eight optional criteria (B1-B8). However, he reduced the minimal morbid duration for diagnosis. Moreover, for the purpose of excluding neurosis from the diagnostic criteria, Spitzer eliminated the distinction between primary and secondary depression, which had been used to differentiate melancholia from depression. In the revised RDC, Spitzer upgraded optional criteria B5 "loss of pleasure or interest" to one of the essential criteria A with "dysphoric mood." This revision reflects the fact that "loss of pleasure or interest" has been designated as an essential feature of Klein's concept of "endogenomorphic depression" (1974), which is equivalent to melancholia or endogenous depression. At that time, depression and melancholia were completely amalgamated into a single category. DSM-III followed almost all of the revisions in the revised RDC and accepted the bipolar-unipolar dichotomy. However, Klein's endogenomorphic depression was downgraded to the specifier "with melancholia", which has been used only rarely. Thus, as depression and melancholia were fused into major depressive disorder, we have only limited evidence of the efficacy of pharmacotherapy and psychotherapy. DSM-IV divided major depression into major depressive disorder and bipolar II disorder. Consequently, some depression and some melancholia were moved from unipolar depression to bipolar disorder, although the bipolar-unipolar dichotomy was proposed for manic-depressive illness and recurrent unipolar melancholia, but not depression. Therefore, we suspect that we will not obtain strong therapeutic evidence for bipolar II disorder as well. Our proposals are as follows: give up the unitarian view of depression and melancholia and accept the binarian view; and restrict the bipolar-unipolar dichotomy to manic-depressive illness and unipolar melancholia.
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PMID:[The difference between depression and melancholia: two distinct conditions that were combined into a single category in DSM-III]. 2301 51

Neurasthenia remains an important health problem in certain Asian populations, both in Asia as well as in a diasporic context. An anachronistic disease for Western observers, it has become an exotic culture-bound syndrome as well as a somatoform disorder too often hiding much more serious issues of depression. This article approaches this 'problematic' health issue from a historian's point of view and offers a colonial genealogy that will discuss neurasthenia's outline in French Vietnam. By retracing and analysing the different mentions, definitions, and uses of the term neurasthenia in the interwar period, it aims to better understand certain historical realities that might have shaped the local identity and spatiality of this problem (concentrated in colonial cities in which social change and modernity were expressed in their most salient forms), and perhaps even identify reasons that facilitated its post-colonial survival.
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PMID:Colonised and neurasthenic: from the appropriation of a word to the reality of a malaise de civilisation in urban French Vietnam. 2306 5

This article aims at giving a general view of fatigue syndromes, their description, and their differentiation. The syndromes neurasthenia, chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and burnout are discussed. First, the historical background of fatigue classification is shortly reviewed. Each syndrome is introduced in terms of definition and classification as well as differentiation from each other. The article discusses the differentiation of the syndromes from each other as well as differentiation of CFS/ME and burnout from depression. We conclude that it is difficult to differentiate criteria due to insufficient empirical evidence. More research is needed concerning integration of the diagnoses in classification systems as well as differentiation between syndromes. High comorbidity of depression with CFS and Burnout can be shown, but diagnoses also comprise distinct symptoms.
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PMID:[Fatigue syndromes--an overview of terminology, definitions and classificatory concepts]. 2340 1

Marcel Proust (1875-1922), the son and brother of famous physicians, had close and continuous contact with medicine and doctors in connection with chronic asthma, neurasthenia, medical 'tourism', and self-medication. This proximity to medical issues is obvious in his work, particularly his novel In Search of Lost Time, which today is still considered one of the most important literary works ever. In this novel, medicine, patients, and doctors are everywhere, and it can be claimed that while it is often considered to be the great novel of memory, medicine in itself also can be seen as a true character of the story, in which Proust displays surprisingly extensive knowledge. Neurasthenia and asthma (i.e. Proust's diseases), as well as specific neurological disorders, such as stroke, migraine, epilepsy, and dementia, appear in the novel. The disease of the narrator's grandmother remains a piece of anthology, and probably remains the best literary report of a progressive stroke leading to death. Proust also quoted neurological conditions which were virtually unreported in his time, such as phantom limb syndrome and poststroke depression associated with aphasia in Baron Charlus. Doctors are nearly systematically depicted as incompetent and superficial, characteristics which appear to increase with academic titles and glory. The main physician of the novel, Professor Cottard, even ends up writing fake certificates for his rich friend Mrs. Verdurin during World War I so that she can obtain fresh croissants for breakfast, while poor people around her are starving. When called to examine a dying patient, one of the real doctors of the novel, Professor Dieulafoy, says and does nothing except ask for his fees. This defiance and criticism of physicians were indeed those of Proust in real life.
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PMID:Marcel Proust's fictional diseases and doctors. 2348 6

The present mixed methods study developed a comprehensive measure and a screening scale of depression for Chinese American immigrants by combining an emic approach with item response analysis. Clinical participants were immigrants diagnosed by licensed clinicians who worked in the community. Qualitative interviews with clinicians and clinical participants (N = 63) supported the definition of the construct of depression-which guided scale development-and a 47-item pilot scale. Clinical and community participants (N = 227) completed the pilot scale and measures of neurasthenia and acculturative stress, and the Patient Health Questionnaire Depression Module (PHQ-9). A Rasch Partial Credit Model of 42-items-representing psychological, somatic and interpersonal domains of distress-best fit the data. Twenty-three items overlapped with the DSM-IV symptoms of major depression. Twenty-seven items were biased by acculturation-related variables. Nine items appropriate for self-report screening in primary care and community organizations were chosen to form a brief scale. Both measures showed strong reliability and concurrent and convergent validity. The 9-item scale had better content validity than the PHQ-9. Implications regarding the impact of culture for assessment are highlighted.
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PMID:Culturally Sensitive Depression Assessment for Chinese American Immigrants: Development of a Comprehensive Measure and a Screening Scale Using an Item Response Approach. 2350 3

Depression is among the most common psychiatric conditions in primary health care, and constitutes an important part of the global disease burden. However, it is difficult to obtain comparable data on depression worldwide and models for treatment and intervention need to be locally adapted. We conducted a narrative review of research literature on factors that influence depression screening, diagnosis and treatment among the Vietnamese population. This explorative approach included studies describing: a) culturally or contextually specific risk-factors for depression; b) any depression treatment seeking or treatment acceptability/adherence aspects or; c) depression screening among Vietnamese patients. We searched the PubMed and Cinahl databases, as well as relevant Vietnamese peer-reviewed journals and this produced 20 articles that were included in the review. Our findings indicate the importance of considering somatic symptoms when screening for depression in Vietnam as well as the use of culturally adapted and dimensional screening instruments. Our study confirms that depression reflects chronic social adversity, and thus an approach to mental health management that focuses solely on individual pathology will fail to address its important social causes. Further studies should elucidate whether neurasthenia is a commonly used illness label among Vietnamese patients that coincides with depression. The tendency among Vietnamese to seek traditional Vietnamese medicine and meditation practice when experiencing emotional distress was supported by our findings.
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PMID:A narrative review of factors influencing detection and treatment of depression in Vietnam. 2364 77

Revision of ICD-11 will be submitted for approval at the general assembly in 2015. The influence of the ICD revision will be marked in the field of psychiatry. The trend in developing ICD-11-PHC is promoting cooperation with primary carers. The goals of the revision of ICD-11-PHC are as follows: 1) To produce a classification system that corresponds more closely to common mental disorders encountered in general medical practice; 2) The "co-morbidity" we want practitioners to recognize is that between physical and psychological disorders; 3) To allow dimensions of severity of some common disorders to be recognized, rather than case/non-case distinctions. The ICD-11-PHC draft consists of 28 categories and detailed clinical descriptions. The number of categories has increased in the ICD-11-PHC draft in comparison with ICD-10-PHC. Anxiety disorders such as neurasthenia, and phobic disorders and panic disorder have been deleted. On the other hand, new diagnostic categories such as autistic spectrum disorder, PTSD, and personality disorder have been introduced. Furthermore, name changes such as anxious depression, bodily stress syndrome, health anxiety, and persistent psychotic disorders have been suggested. We should be aware of such new diagnostic concepts. In addition, it is thought that it is necessary for us to deepen our understanding of ICD-11, which will be important in the future.
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PMID:[Trend in ICD-11 primary health care version--possibility of introducing new psychiatric diagnosis categories]. 2464 May 53

Chronic fatigue or chronic fatigue syndrome (CFS) is not a new disease, yet in recent years it has become increasingly important as an evaluation problem. It coincides with the well-known clinical picture of neurasthenia, shows extensive overlap with symptoms of depression and, finally, to the current concept of "burnout". Regarding the etiology there is fierce controversy between the representatives of a somatic and a psychological etiology. As reviewers you will be guided by the assessment criteria for somatoform disorders, especially because objectified findings are lacking. CFS can be independently encoded as neurological diagnosis G 93.3 according to ICD-10, although never objectified neurological deficits were detected, as well as neurasthenia F 48.0 or accompanying physical symptoms as somatization disorder F 45.0.
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PMID:[Medical certification of chronic fatigue syndrome]. 2597 Nov 44

Depressive syndromes are a group of heterogeneous disorders. Atypical depression (AD) with reversed vegetative signs, such as hyperphagia or hypersomnia, is traditionally neglected, demonstrated by the fact that in the most widely used depression scales, such as the Hamilton Depression Scale (HAMD), melancholic symptoms have a specific weight, while, by contrast, reversed vegetative signs are not included. However, epidemiologically and phenomenologically related disorders to AD do exist, such as somatoform disorders, neurasthenia (chronic fatigue syndrome) and fibromyalgia (FM). In this spectrum, here called the AD spectrum, instead a decrease in hypothalamus-pituitary-adrenocortical (HPA) axis activity seems to exist. This has similarities to Cushing's disease, where a suppression of central HPA system activity is accompanied by features of AD and somatization in a considerable number of patients. Opposite vegetative features might therefore be related to the opposite dysregulation of the HPA system. The psychopharmacological intervention in the AD spectrum should therefore differ from that used in typical major depression. MAO inhibitors, low-dose tricyclic antidepressants and 5-HT3 antagonists demonstrated therapeutic efficacy, but the existing studies focused on different aspects. Hypericum extracts might be an alternative pharmacological intervention, which demonstrated therapeutic efficacy in the symptom range of the spectrum.
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PMID:Atypical depression spectrum disorder - neurobiology and treatment. 2698 70

The relationship between the two syndromes neurasthenia and depression is of interest in the context of burnout, which, although not a diagnosis, is often treated in psychiatry. This study defines major depressive episodes according to DSM-5 and neurasthenia by ICD-10 symptom criteria, and both syndromes on the basis of a 2-week minimum duration. The study includes all subjects of the Zurich epidemiological study who had taken part in the last five interviews (1986-2008) and compares three groups, pure depression, pure neurasthenia and their combination (neurasthenic depression), applying nonparametric statistics. The three groups did not differ in common validators: age of onset, course, a family history for depression and anxiety/panic. Psychiatric comorbidity was also very similar, with the exception of suicide attempts and substance abuse, which were less frequent in the pure neurasthenic group. Somatic comorbidity was also highly comparable, except for stomach problems, which were more common in subjects with neurasthenic syndromes. Surprisingly, the well-known preponderance of depression in women was explained by the association with neurasthenic syndromes. The proposed new diagnosis of neurasthenic depression could help diagnose subjects treated for burnout but needs replication by other representative studies.
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PMID:Two-week neurasthenic major depression. 2709 93


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