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

Gambling pathology has been associated with elevated levels of distress, depression and impulsivity. The present investigation assessed whether these behavioral features would be evident among problem gamblers as they are among pathological gamblers. As well, given that gambling has been associated with increased life stress, as an objective index of ongoing distress, elevations of morning cortisol levels were assessed in problem and pathological gamblers relative to recreational gamblers, and their relations to depressive symptoms and impulsivity were assessed. Recreational, problem, and pathological gamblers (N = 140) completed the Beck Depression Inventory and the Barratt Impulsiveness Scale-11, and provided saliva samples at awakening, 30 min, 3.5 h, and 5.5 h afterward. Consistent with the view that problem and pathological gambling are associated with elevated life stressors, the rise of morning cortisol from awakening to 30 min following awakening was greater than in recreational gamblers. Heightened impulsivity was evident among both problem and pathological gamblers, whereas depressive symptoms were only evident among pathological gamblers. In neither instance were these psychological indices related to the morning cortisol rise. Indeed, increased depressive symptoms were not evident among problem gamblers, despite the fact that elevated morning cortisol levels were evident. The elevated morning cortisol rise may be secondary to gambling problems or distress related to gambling problems. Furthermore, the sustained morning cortisol elevations may be indicative of allostatic overload, and could potentially be a harbinger for potential health risks among problematic gamblers.
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PMID:Cortisol rise following awakening among problem gamblers: dissociation from comorbid symptoms of depression and impulsivity. 1789 56

Computerized mental health assessment is gaining popularity. It enables the standardization of assessment of clinical problems, increases the capacity to collect sensitive or confidential information, facilitates personal assessment at one's own pace, and offers rapid screening of mental health status. The use of computer technology to conduct mental health assessment was an initiative proposed for two nurse-led integrative health clinics affiliated to a University in Hong Kong. It was intended to provide an efficient screening for depression, anxiety, alcohol abuse, and problem gambling common in the primary health-care settings to facilitate early intervention. This study was conducted to assess the effectiveness of using a computerized health assessment kiosk to perform mental health assessment. The assessment items were derived from an abbreviated World Health Organization Mental Disorders Checklist and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Criteria for Pathological Gambling. The study involved an opportunity sample of 31 subjects who volunteered to complete the computerized mental health assessment during their waiting time in the clinics. The results showed that most subjects had positive feelings about using a computer to perform a mental health assessment and had increased understanding of their mental health. Suggestions made to improve computerized mental health assessments included touch screen, voice instructions, and enlarged print font size.
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PMID:Computerized mental health assessment in integrative health clinics: a cross-sectional study using structured interview. 1799 15

A range of behaviors presumed to be related to dopaminergic medications have been recently recognized in Parkinson's disease (PD). We evaluated 50 consecutive cognitively intact PD patients on stable dopamine agonist and levodopa therapy and 100 healthy controls for compulsive sexual behavior, compulsive buying, or intermittent explosive disorders assessed by the Minnesota Impulsive Disorders Interview (MIDI), pathological gambling (South Oaks Gambling Screen, SOGS), impulsivity (Barratt Impulsiveness Scale), compulsivity (Maudsley obsessional-compulsive inventory), and depression scores (Geriatric Depression Scale). Overall 28% PD (14/50) and 20% healthy controls (20/100) reported at least one abnormal behavior at MIDI or pathological SOGS score. PD patients had higher scores than controls for impulsivity (P = 0.006), compulsivity (P < 0.001), and depression (P < 0.001). There was no correlation between impulsivity, compulsivity, and depression scores in PD. Male gender and higher impulsivity score, but not dose and kind of dopaminergic medications, were associated in PD with increased probability of impulsive disorders at MIDI. Impulse control disorders are also common in the control population. Individual susceptibility factors, such as high impulsivity and depression, underline abnormal behaviors in PD patients treated with stable dopaminergic therapy.
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PMID:The relationship between impulsivity and impulse control disorders in Parkinson's disease. 1806 87

Pathological gambling is a disorder of impulse control that is gaining more and more attention. This paper reviews diagnostic criteria and screening instruments for pathological gambling, as well as the prevalence rates of this disorder worldwide, with an emphasis on gambling in Brazil. Treatments for pathological gambling are also described, including both psychosocial and pharmacological approaches. Pathological gambling is highly comorbid with other psychiatric disorders, including substance abuse and depression, and few pathological gamblers seek treatment for their gambling problems. Therefore, direct screening for gambling problems is recommended. Increasing education about the disorder, from both the provider and societal perspective, is necessary to reduce the personal and societal consequences of this disorder.
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PMID:[Ludomania: cross-cultural examinations of gambling and its treatment]. 1827 84

Research supports increased risk of problem gambling (PG) and pathological gambling disorder (PGD) among individuals with substance abuse/dependence and psychiatric disorders, but studies considering personality disorder comorbidity have not adjusted for confounding relationships with other Axis I disorders. Using targeted advertising, we enrolled 153 gamblers (55% female; 32% minority; Mean age=47; SD=18.2) in a clinical validation study of the newly developed computerized gambling assessment module (C-GAM). For these analyses, we classified gamblers into three groups based on their endorsement of DSM-IV PGD: Non-gamblers (0 criteria; n=64; 44%); PG (1-4 criteria; n=60; 41%); and PGD (5-10 criteria; n=22; 15%). We evaluated PG and PGD risk associated with personality disorder pathology using the computerized structured clinical interview of DSM-IV Axis II (SCID-II). Using multinomial logistic regression, we found increased odds of PGD among individuals with greater symptoms of borderline personality disorder after adjusting for socio-demographics, substance abuse/dependence and other personality disorders significant at the bivariate level. Yet after adjusting for depressive symptoms, borderline personality disorder criteria were nonsignificant, suggesting a complex relationship between personality pathology, depression, and gambling. These findings bolster the position that further investigation is needed regarding the association of gambling pathology with personality disorders and depressive symptoms.
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PMID:The association between gambling pathology and personality disorders. 1829 35

Knowledge concerning the classification of mental disorders progressed substantially with the use of DSM III-IV and IDCD 10 because it was based on observed data, with precise definitions. These classifications a priori avoided to generate definitions related to etiology or treatment response. They are based on a categorical approach where diagnostic entities share common phenomenological features. Modifications proposed or discussed are related to the weak validity of the classification strategy described above. (a) Disorders are supposed to be independent but the current coexistence of two or more disorders is the rule; (b) They also are supposed to have stability, however anxiety disorders most of the time precede major depression. For GAD age at onset, family history, biology and symptomatology are close to those of depression. As a consequence broader entities such as depression-GAD spectrum, panic-phobias spectrum and OCD spectrum including eating disorders and pathological gambling are taken into consideration; (c) Diagnostic categories use thresholds to delimitate a border with normals. This creates "subthreshold" conditions. The relevance of such conditions is well documented. Measuring the presence and severity of different dimensions, independent from a threshold, will improve the relevance of the description of patients pathology. In addition, this dimensional approach will improve the problems posed by the mutually exclusive diagnoses (depression and GAD, schizophrenia and depression); (d) Some disorders are based on the coexistence of different dimensions. Patients may present only one set of symptoms and have different characteristics, evolution and response to treatment. An example would be negative symptoms in Schizophrenia; (e) Because no etiological model is available and most measures are subjective, objective measures (cognitive, biological) and genetics progresses created important hopes. None of these measures is pathognomonic and most appear to be related to risk factors especially at certain periods when associated with environmental events. One of the major aims for a classification of patients is to identify groups to whom a best possible therapeutic strategy can be proposed. Drugs may improve fear extinction while the genetic and/or acquired avoidance may be called phobia. The basic mechanism and or the corresponding phenotype should appear in the classification. Progresses in early identification of disturbances by taking into account all the information available (prodromal symptoms, cognitive, biological, imaging, genetic, family information) are crucial for the future therapeutic strategy: prevention.
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PMID:Refinement of diagnosis and disease classification in psychiatry. 1834 44

Pathological gambling symptoms (PGS), that is, the subjective urge to gamble and the actual gambling behaviors, are currently acknowledged as relatively common symptoms among Western countries, with an estimated point prevalence of 0.6-1.1% in the general population. Converging evidence suggests that PGS are overrepresented in patients with neurological conditions affecting dopaminergic reward pathways, and can be expressed in both impulse control disorders and obsessive-compulsive spectrum disorders. This study explored the clinical correlates of PGS in patients with epilepsy. Eighty-eight consecutive adult outpatients recruited at three epilepsy clinics in northern Italy were assessed using the Gambling-Symptom Assessment Scale (G-SAS), along with a battery of psychometric instruments to index depression (Beck Depression Inventory [BDI]), anxiety (Spielberger State-Trait Anxiety Inventory [STAI]), and obsessionality (Yale-Brown Obsessive Compulsive Scale [YBOCS]) symptoms. On the G-SAS, patients with a diagnosis of temporal lobe epilepsy (TLE) reported a mean [sd] G-SAS score of 2.0 [5.7], significantly higher than patients with frontal lobe epilepsy (FLE) (0.6 [1.7]) and idiopathic generalized epilepsy (IGE) (0.4 [1.4]). Moreover, multiple regression analysis showed that G-SAS scores were selectively predicted by YBOCS scores, thus suggesting an association between the expression of obsessional spectrum symptoms and PGS in patients with TLE. Alterations in the mesolimbic reward system could represent the putative neuropathological substrate for this multifaceted clinical picture.
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PMID:Clinical correlates of pathological gambling symptoms in patients with epilepsy. 1847 2

Pathological gambling (PG) has been identified in patients with Parkinson's disease (PD) treated with dopamine agonists suggesting that dysregulation of brain dopaminergic activity may contribute to the development of gambling problems. The current study was undertaken to further establish the prevalence of problem and PG in patients with PD, identify any clinical correlates, and determine if psychiatric or substance use co-morbidity contributes to the increased prevalence of problem and PG. A cross-sectional survey of 140 serially recruited moderate to severe PD patients was undertaken utilizing the Canadian Problem Gambling Index, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test, Beck Depression Inventory, Beck Anxiety Inventory, and Mini-Mental State Exam augmented by chart review, completed over an 8 month period. The 12 month prevalence of problem and PG in PD was 9.3% compared to 1.6% in the general population within a comparably aged sample. The increased prevalence of problem and PG in the PD group was related to dopamine agonist use and younger age, but not co-morbidity. Most subjects with problem and PG reported their gambling increased after being diagnosed with PD and starting treatment. The results suggest that brain dopaminergic activity is involved in the underlying neurobiology of problem and PG.
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PMID:Prevalence of problem and pathological gambling in Parkinson's disease. 1856 Oct

There is evidence that young people are at high risk of developing gambling disorders. The prevalence and correlates of gambling among youth therefore merit closer study. During spring 2004, a sample of 1,351 boys and girls (aged 16-19 years) from 151 high-school classes (clusters) participated in an internet survey about gambling. The response rate was 69.8%. The instruments used in the survey were the Hospital Anxiety and Depression Scale, the Alcohol Use Disorders Identification Test and the Massachusetts Adolescent Gambling Screen, in addition to questions about demography. Controlling for the design effect, the estimated prevalence rate was 2.5% for pathological gambling and 1.9% for problem gambling. In all, 7.3% of the boys and 0.6% of the girls fulfilled the criteria for pathological or problem gambling. The results of item analysis of the DSM-IV subscale of MAGS provide support for differential item functioning between boys and girls. A multiple logistic regression analysis revealed that gender (male: OR = 9.09), depression (OR = 9.23), alcohol abuse (OR = 3.62), and dissociation (OR = 1.96) were related to problem and pathological gambling. These results support the view that gambling disorders are best understood as part of an addictive behavior spectrum (Jacobs, 2000).
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PMID:Prevalence and correlates of gambling among 16 to 19-year-old adolescents in Norway. 1856 20

Parkinson's disease is a neurodegenerative disorder characterized by bradykinesia, rigidity, postural instability, and resting tremor. Increasingly, Parkinson's disease has been associated with a broad spectrum of non-motor symptoms, such as olfactory loss, sleep disorders, autonomic dysfunction, cognitive impairment, psychosis, depression, anxiety, and apathy. In addition, a minority of Parkinson's disease patients develop compulsive behaviors while receiving dopamine-replacement therapy, including medication hoarding, pathological gambling, binge eating, hyperlibidinous behavior, compulsive shopping, and punding. These behaviors may result in psychosocial impairment for patients and therapeutic challenges for clinicians. This article reviews the anatomic substrates, behavioral spectrum, associated factors, and potential treatments for dopamine-replacement therapy-related compulsions in Parkinson's disease.
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PMID:Impulse-control disorders in Parkinson's disease. 1870 24


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