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

This study assessed the effectiveness of the MMPI in differentiating four clinically relevant types of depression. MMPI profiles of 53 subjects with major depression and personality disorder, 44 subjects with other depression and personality disorder, 27 subjects with major depression without personality disorder, and 20 subjects with other depression without personality disorder were compared via MANOVA, high-point pair analysis, and discriminant analysis. The instrument was found somewhat effective in differentiating the groups at a statistically significant level, but the differences were too subtle to be considered clinically useful. Thus, while the MMPI has some usefulness in the differential diagnosis of depression, it is best used in conjunction with other test data and relevant historical data.
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PMID:Depression and personality disorder: differential diagnosis with the MMPI. 193 13

The authors examined an interview and paper-and-pencil assessment of the DSM-III personality disorders (PDs) in depressed inpatients, and depressed relatives of psychiatric patients and never-ill controls who had a lifetime history of major depression. The rates of PDs according to the Structured Interview for DSM-III Personality Disorders (SIDP) were similar in the two groups, except for borderline PD which was more frequent in the inpatients. Of the individuals with a PD, the patients were more likely than the relatives to have two or more PDs, and the borderline and histrionic patients were more prototypic of these disorders than were the borderline and histrionic relatives. In contrast to the SIDP results, the rates of PDs according to the Personality Disorders Questionnaire (PDQ) were higher in the patient sample. These results thus extend the previously described high rates of PDs in depressed patients to a sample of individuals with a lifetime history of treated or untreated depression, and they suggest that interview assessments of personality may be less sensitive to the state effects of depression than are questionnaires.
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PMID:Major depression and personality disorder. 193 29

The Millon Clinical Multiaxial Inventory, Version 2 (MCMI-II) was released to replace the MCMI-I. Research into the factor structure of the items of the MCMI-I showed components consistent with the underlying construction theory. No such work has been done with the new MCMI-II. For this study, we analyzed the personality disorder and clinical syndrome items across two subject samples. For 579 Veterans Administration patients and 492 normal college students, six personality factors were identified. The samples shared Hostility, Histrionic/Schizoid, Dependent, Compulsive, and a Sadistic variant. For the clinical syndrome items, eight factors were isolated for veterans and seven for normals. Depression, Alcohol Abuse, Drug Abuse, Crying, and Mania were shared factors. Most of the factors were found to be highly consistent with MCMI-II scale keyings.
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PMID:An MCMI-II item-level component analysis: personality and clinical factors. 195 78

Although Osheroff v. Chestnut Lodge never reached final court adjudication, the case generated widespread discussion in psychiatric, legal, and lay circles. The author served as a consultant to Dr. Osheroff and testified that Chestnut Lodge failed to follow through with appropriate biological treatment for its own diagnosis of depression, focusing instead on Dr. Osheroff's presumed personality disorder diagnosis and treating him with intensive long-term individual psychotherapy. The author suggests that this case involves the proposed right of the patient to effective treatment and that treatments whose efficacy has been demonstrated have priority over treatments whose efficacy has not been established.
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PMID:The psychiatric patient's right to effective treatment: implications of Osheroff v. Chestnut Lodge. 240 16

Short-term psychiatric hospitalization, developed during the past 2 decades, needs thorough evaluation with regard to its advantages. It is important to be able to identify those patients who might be aided by such treatment. Therefore the psychiatric emergency room physician should have at hand a model which would enable quick and relatively accurate decisions in identifying such patients. Our work shows that they are either without previous psychiatric history or had been admitted for less than 2 months; that they had suffered from depression, anxiety, personality disorder or addiction; that they had a substantial support system; and that when they had been treated, there had been good compliance with prescribed medication. On the other hand, those who probably would not benefit from short-term psychiatric hospitalization had a history of psychiatric hospitalization of usually more than 2 months; were diagnosed as suffering from schizophrenia or affective disorder; lacked substantial family support; and had poor compliance with medication. This data may aid the physician during the initial interview in the psychiatric emergency room in deciding on further treatment. We also found that psychiatric emergency room diagnoses are usually reliable; and that those whose only diagnosis was "for observation" had a fair chance of a successful result after short-term hospitalization (discharge directly from the emergency room unit). We therefore presume that a sharper characterization of patients referred to the psychiatric emergency room may aid in tailoring the most suitable treatment for any particular patient, thus reserving short-term hospitalization only for those who would benefit the most.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Short-term psychiatric hospitalization in an emergency room unit]. 203 38

In many skin diseases, itching and scratching is a vicious circle, which prolongs the disease. The aim of this study was to investigate the mechanisms which make itching skin diseases more chronic. The patients consisted of seven diagnostic groups--79 inpatients all together. The dermatoses were: dermatitis herpetiformis, lichen ruber planus, chronic eczema, atopic eczema, neurodermatitis circumscriptus, prurico psychogenous and lichen obtusus corneus. Both psychiatric and dermatological examinations were performed. Psychiatric disturbance was clearly greater than in the average population. The chronifying mechanisms were the following: personality disorder as a treatment problem; emotional infantility, which makes the illness itself an important security factor; itching and scratching as pleasure and content of life; the accumulation of various other diseases, both somatic and psychiatric; and untreated depression. Information was obtained on the possibilities of psychiatric treatment and psychosocial rehabilitation.
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PMID:Assessment of psychiatric and psychosocial factors disposing to chronic outcome of dermatoses. 204 76

The strongest statistical support for the binary view of depression has been provided by factor (principal components) analytic studies which delineate a bipolar factor with features interpreted as reflecting "endogenous depression" and "neurotic depression" at opposing poles. We review the seminal studies to suggest instead that the bipolar factor has generally polarised depression and anxiety, and that no such entity or symptom complex of "neurotic depression" has been isolated. Instead "neurotic depression" has been defined principally by features of anxiety and personality style. We argue that the suggested entity is, in fact, a pseudo-entity, being no more than a residual group of non-depressive features without any significant intrinsic depressive characteristics. We support our interpretation by showing comparable solutions in published studies of depressives alone, contrasted with separate analyses of anxious and depressed patients. We also report two studies in which the "neurotic depressive" pole is made to appear and disappear by the inclusion and exclusion of anxiety items. As factor analytic studies have defined the "residual" pole so variably, we argue that some features held to distinguish neurotic depression are of no utility and that such a diagnosis is meaningless. We suggest that the clinician should not proceed (after excluding endogenous depression) to conclude that the default option is necessarily an entity "neurotic depression" and that instead a heterogeneous group of options (e.g. anxiety, personality disorder) require review. If the "neurotic depressive" type of the multivariate analytic studies is a pseudo-entity, then a modified unitary view of depression may be valid.
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PMID:Depression sub-typing: unitary, binary or arbitrary? 187 52

The clinical significance of chronic mild depression (dysthymia) is well recognized, but has not been the focus of extensive research. In particular, basic research on the phenomenology and treatment of these conditions is limited. Clinical lore suggests that psychotherapy, rather than pharmacotherapy, is the treatment of choice. This is based more on a theoretical understanding of chronic depression as a personality disorder rather than on actual treatment studies. This paper reviews the literature on the pharmacotherapy of dysthymia. The results provide substantial evidence for the efficacy of antidepressants in dysthymia, although the treatment response is less than that typically found in major depression. Furthermore, the findings suggest the possibility that monoamine oxidase inhibitors (MAOIs) may be superior to tricyclic antidepressants (TCAs) in the treatment of dysthymia, although this needs to be more rigorously evaluated. Some of the methodological problems with these studies are discussed. Additional areas of research, including the clinical and biological indicators of drug response, the use of non-TCA, nonMAOI drugs, the effects of pharmacological intervention on the development and maintenance of chronicity, and the comparison of and interaction between pharmacotherapy and psychotherapy are identified and suggested for future study.
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PMID:Pharmacotherapy of dysthymia: a review. 205 46

This article considers the relationship between depression and characterological masochism from a contemporary psychoanalytic perspective. Nosology is discussed historically from Krafft-Ebing to the DSM-III-R category, self-defeating personality disorder. Masochistic character traits are conceptualized as attempts to cope with depressed helpless and hostile feelings that have become part of the core self-concept. Psychotherapeutic strategy for treatment of masochistic patients at different levels of characterological integration is discussed. Many questions about self-defeating personality disorder remain open at present. The need for psychoanalytically informed clinical research on characterological masochism and particularly the relationship between masochism and depression is stressed.
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PMID:The depressed masochistic patient: diagnostic and management considerations--a contemporary psychoanalytic perspective. 206 Nov 39

Two psychotic individuals, who performed acts of genital self-amputation, are presented. One of the patients had self-mutilated with the intention of suicide and had also in the past amputated his hand. Psychotic patients with delusions (often religious), sexual conflict associated with guilt, past suicide attempts or other self-destructive behaviour and depression, severe childhood deprivation, and major premorbid personality disorder, are the group at risk for genital self-amputation. It has been proposed that the eponym, the "Klingsor" syndrome, be applied only to acts of genital self-mutation, involving religious delusions. The author suggests that this syndrome should be expanded to include all cases of genital self-mutation resulting from a psychotic illness.
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PMID:Genital self-amputation and the Klingsor syndrome. 175 Sep 25


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