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

The validity of the dexamethasone suppression test (DST) as an indicator of endogenous depression has been most frequently tested by examining its relationship to operational criteria of endogenous depression. However, these criteria sets themselves have not been empirically validated. We examined the DST in terms of a series of hypotheses and predictions that are consistent with the theoretical construct of endogenous depression. In a consecutively admitted sample of 187 primary unipolar depressed inpatients, the DST nonsuppressors were older, had less premobid personality disorder, better social support, less frequent marital separations or divorces, fewer nonindependent stressful life events during the year prior to admission, made fewer nonserious suicide attempts during the index episode, had fewer dysfunctional attitudes, and had a lower rate of treated alcoholism and antisocial personality in their first-degree relatives. The only clearly negative finding was the lack of association between DST results and family history of depression. Our results strongly support the construct validity of the DST as a marker of endogenous depression.
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PMID:The validity of the dexamethasone suppression test as a marker for endogenous depression. 395 57

The authors conducted a study of psychiatric consultation in a Chinese general hospital. Seventy-five inpatients (0.74% of the patients in the hospital) were referred by different services over a 1-year period. Internal medicine referred the most patients, and organic brain syndromes were the most common diagnoses. Depression was not a frequent diagnosis, but neurasthenia was a fairly common one. None of the referred patients had a diagnosis of alcoholism, drug abuse, or personality disorder. The authors compare these data with those of Western studies and discuss the possible factors influencing psychiatric consultation in China.
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PMID:Patterns of psychiatric consultation in a Chinese general hospital. 402 29

This is a longitudinal study of all patients seen in the first five years of a private psychiatric practice. At the present time, it is believed to be the only known complete study of patients in a typical private practice. The data from 486 patients has been collected and analyzed and some of the results have been compared to those obtained in other studies. Some significant findings emerged. Depression is the single commonest condition and its frequency was similar to that found in other studies. Psychoses were rare. A large category of patients was described as having a Personality Disorder. The implications of these and other findings are discussed. The data are relevant to aspects of clinical psychiatry, to the teaching of psychiatry, and to the financial insurance coverage of medical services.
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PMID:Private practice: the first five years. 408 93

There is a large body of evidence implicating a genetic factor in major affective disorder, particularly bipolar type. Studies of family risk, of twin concordance, and of adoptees and their families have contributed to this consensus. In the case of suicide, completed or attempted, the evidence is less clear. Twin studies have been based on a small number of pairs and have been inconclusive, and family and adoption studies have not yet satisfactorily separated suicide risk from risk for depression. Biological studies involving neurotransmitter levels suggest that suicide even without depression may be uniquely characterized, and there have been reports of associated brain-wave dysfunction. The interacting role of psychological or biological precipitating factors with the genetic component of psychosis or personality disorder still needs further clarification.
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PMID:Genetic factors in depression and suicide. 620 37

We studied 78 inpatients with DSM-III major depression. Forty-one (53%) had a concurrent personality disorder (PD) according to a detailed structured interview for DSM-III personality disorders. The patients with depression plus PD differed from patients with depression alone on numerous measures. The PD patients had earlier onset; higher HRS scores; poorer social support; more life stressors; more frequent separation and divorce; more frequent nonserious suicide attempts, less frequent dexamethasone nonsuppression; poorer response to antidepressant medication; and higher risk for depression, alcoholism and antisocial personality among first-degree relatives. The PD subgroup shares many attributes with Winokur's subtype of depression spectrum disorder and Akiskal's character spectrum disorder. An attempt to identify a subgroup of personality disorders which might be an atypical affective disorder was inconclusive. However, patients in DSM-III cluster III were similar to the patients with no-PD on the dexamethasone suppression test, response to treatment, and familial risk for depression and antisocial personality.
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PMID:The implications of DSM-III personality disorders for patients with major depression. 624 Dec 12

Suicide is distinct from suicide attempt, in terms of male predominance (2:1), presence of serious psychiatric morbidity, and in the choice of rapidly effective means which will not be interrupted. However 1 per cent per year, and 10 per cent overall, of those attempting will progress to completed suicide. Communication of intent is the most significant and frequent danger signal of suicide, and the attempt may be such a communication. Useful prognostic features of the attempt are the medical seriousness of the act (overdose accounts for 90 per cent of attempts, and only 25 per cent of suicides), and the psychiatric seriousness of the patient's mental state. Suicide in the absence of psychiatric illness is rare. Depression is the most common associated illness, and whereas the distinction between major and minor is probably not prognostically significant, the presence of current depression is. The lifetime risk of suicide in depressive illness is 15 per cent. The second largest contributor is alcoholism, in particular alcoholics who have experienced loss of a close personal relationship. Other significant psychiatric diagnoses include schizophrenia, organic brain syndrome and personality disorder. Suicide rates differ internationally, but the identification of significant socio-cultural risk factors is hampered by the official differences in ascertainment which exist. Although suicide rates increase with each decade of life, there has been a steady recent rise in suicide rates in many countries, which has been occurring disproportionately among the group aged 15-34.
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PMID:Problems in studying suicide. 637

As systematic interviewing has become more widespread, it has been possible to identify significant populations of children and adolescents who meet adult criteria for depression. The difficulties associated with identifying correctly the phenomenology of major depression in children are reviewed. The significance of separation anxiety, anorexia, attention deficit and conduct disorder, as 'depressive equivalents' is discussed, although a change in mood or ability to experience pleasure appear to carry greater diagnostic weight. While the identification of mania and hence of bipolar disorder in children is more difficult, the appearance of a definite maniac syndrome in preadolescence is relatively uncommon. Data are reviewed suggesting the existence of an alternative and more common form of bipolar disorder in childhood, characterized by affective lability, irritability and explosive behavior. However, available data do not support the view that attention deficit disorder and 'emotionally unstable character disorder' are variants of bipolar syndromes.
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PMID:Classification issues of bipolar disorders in childhood. 644 29

Factors associated with chronicity in 137 probands with 2 or more years of low-grade intermittent depression were evaluated in a naturalistic setting. Four groups were tentatively identified and chronicity related to: (1) early onset (less than 25 years) intermittent subsyndromal or dysthymic depressions with positive family history for both unipolar and bipolar illness; (2) a spectrum of 'unstable' characterologic disorders with history for childhood object loss; (3) pre-existing non-affective psychiatric or incapacitating medical disorders, especially in combination; (4) incomplete remission from late-onset primary unipolar episode(s) with strong familial background for affective illness, multiple object losses, alcohol and sedative hypnotic dependence, superimposed incapacitating medical disorders, use of depressant antihypertensive agents, disabled spouses, and 'marital deadlock'. Beneficial effects of thymoleptic drugs and practical psychotherapy occurred in 45% of the total sample and were largely limited to groups 1 and 4. These findings argue against a common clinical stereotype that equates all chronic depressions with character disorder.
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PMID:Chronic depressions. Part 1. Clinical and familial characteristics in 137 probands. 645 96

The childhood antecedents of psychiatric disorder in adult life are reviewed with regard to four groups of conditions that show sharply contrasting patterns of linkage between childhood and adult life. For emotional disorders the links are weak and the mechanisms largely unknown. About half of schizophrenic psychoses are preceded by non-psychotic abnormalities of behaviour in childhood; the processes involved are probably largely constitutional. Affective disorders only infrequently begin in childhood and the behavioural precursors of adult depression do not constitute a clearly recognisable pattern. However, adverse experiences in childhood may create a vulnerability to later depression. The child-adult linkages are strongest with conduct disturbance in childhood and adult personality disorder; the mechanisms in this continuity are probably both constitutional and environmental.
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PMID:Psychopathology and development: I. Childhood antecedents of adult psychiatric disorder. 659 53

A feasibility study is presented which describes a cohort of 102 chronic psychiatric patients. The cases were selected on the criterion of four or more new admissions to psychiatric services in the Hamilton-Wentworth region during the year 1977. The group was predominately in the age 20-39 year range and both sexes were represented about equally. The diagnostic labels were personality disorder, schizophrenia, depression and alcoholism in descending order of frequency. The large majority were socially isolated and had contact with social agencies and the police. Seven deaths occurred in the cohort during the year of study.
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PMID:Chronic psychiatric patients in the community. 666 12


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