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

Combined monoamine oxidase (MAO) inhibitor-tricyclic antidepressant therapy and electroconvulsive therapy (ECT) were compared in a population of refractory depressive patients. Seventeen patients were randomly assigned to either of the treatment groups, and an independent observer was used to rate overall progress. Between four and ten ECTs or a combination of phenelzine and amitriptyline were administered. Assays for MAO activity and plasma levels of amitriptyline and nortriptyline were performed. In both psychotic and neurotic depression, ECT was superior. When depression was accompanied by character disorder, the response was generally poor. Adequate levels of MAO inhibition were obtained, but tricyclic antidepressant levels were low. Electroconvulsive therapy is still considered to be the treatment of choice for severe depression, whereas the combination of low doses of phenelzine and amitriptyline are ineffective. This treatment modality needs further investigation.
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PMID:A comparison of electroconvulsive therapy and combined phenelzine-amitriptyline in refractory depression. 72 3

A clearly differentiated episode of depression in the aftermath of acute psychosis reportedly occurs in approximately 25 percent of all patients hospitalized with a diagnosis of acute schizophrenia. A comparison of premorbid functioning, symptomatology, and clinical course in patients with a postpsychotic depression following acute schizophrenic episodes and patients in the depressed phase of bipolar depressive illness suggests a high congruence between the two disorders. The results support the growing evidence that bipolar depressive illness is frequently misdiagnosed as acute schizophrenia.
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PMID:The diagnostic ambiguity of postpsychotic depression. 73 59

Synthetic salmon calcitonin was administered subcutaneously to 12 inpatients with several primary psychotic diagnoses. Increases in serum total calcium and inorganic phosphorus levels and decreases in CSF calcium level had earlier been observed during periodic psychotic agitation or mania. By contrast, calcitonin, which decreased serum calcium and phosphorus levels and increased CSF calcium level, appeared to produce transient (24-hour) increases in depression and decreases in arousal in this double-blind placebo-controlled trial. Quantitative activity monitoring confirmed the rater's impression that this agent had tranquilizing or depressant effects in such patients. When given in the evening, this polypeptide also appeared to delay sleep onset, as demonstrated both by nurses' 30-minute sleep checks and by the same longitudinal activity record. A decreased hypocalcemic response to calcitonin was noted in the agitated patients, which might explain the increases in serum calcium level described at the "switch".
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PMID:Use of calcitonin in psychotic agitation or mania. 76 Jun 98

Several authors have described a severe depression in patients emerging from psychotic states. The clinical picture usually resembles that of a retarded depression with strong neurasthenic and schizoid components. It frequently emerges after a patient has been discharged from the hospital and may often go unnoticed. When manifest, the syndrome is usually stable phenomenologically, is often lengthy, and may be resistant to all modalities of treatment. Postpsychotic depression is a relatively neglected clinical area despite the risk of suicide and prolonged suffering. Therapeutic perseverence purportedly can improve the patient's long-term prognosis, and the phenomenon itself may be favorable prognostic sign. We present here a review and reformulation of this syndrome.
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PMID:Postpsychotic depression in schizophrenia. 76 20

The suicide rate is higher among those who suffer from a physically based psychosis than among the average population. The proportion of endogenous psychoses in suicides is assessed at about one third, and in attempted suicide about 15 per cent. Of the endogenous psychoses, schizophrenia and depression are the principal diseases causing suicidal actions, of the physically based psychoses, all diseases which cause disturbances of this kind, cerebral vascular sclerosis and epilepsy being particularly frequently represented.
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PMID:[Psychotic acts of suicide (author's transl)]. 80 94

The aim of the present study is to gather data on the influence of certain personality factors an adjustment to chronic hemodialysis. One hundred thirty-six patients underwent predialysis personality assessment by clinical evaluation and all those who survived at least 6 months on dialysis were followed up. The follow-ups were carried out by a nephrologist and a psychiatrist 6 months (100 patients), 12 months (87 patients), 24 months (51 patients), and 36 months (28 patients) after commencement of dialysis. The main findings confirmed the assumption that it is possible to predict, at a highly significant statistical level, all of the major aspects of adjustment: compliance with the diet, rehabilitation, and the patients' psychological condition was reflected by four aspects--depression, suicidal tendencies, anxiety, and psychotic complications. A slight tendency was found to overestimate patients' adjustment potential. The possibility that this was due to stresses not taken into account, e.g., the threat of death, is discussed. Analysis of the limited data of our own unit compared with the rest of the group seems to indicate that our patients fulfilled their potential for adjustment to a higher degree than those in other units, especially in regard to compliance and lack of depression. The presence of a psychiatrist and a social worker on the team may have improved adjustment prospects. The question was raised whether this phenomenon is the result of psychotherapy with the patients or of indirect service, e.g., a psychiatrist on the team promoting the development of a realistic team attitude and reducing physicians' denial. Understanding the specific personality traits that cause specific maladjustment may provide a rational basis for focus-oriented psychotherapeutic intervention, while enabling the planning of optional treatment methods for terminal renal failure.
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PMID:The influence of patient's personality on adjustment to chronic dialysis. 81 93

An analysis of the result of administering electroconvulsive therapy (E.C.T.) to 292 patients suffering predominantly from psychosis and depression is presented. The results show that the courses of E.C.T. administered range from three to twenty-five. The most frequently administered course was six to eight. Favourable response to treatment was reported in all diagnostic groups immediately after completing the course but less so in cases of depression and paranoid schizophrenia. The reasons thought to account for this were discussed. It is concluded that there is need for careful selection of patients for E.C.T.
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PMID:Electroconvulsive therapy in Ibadan. 82 7

Normal pressure hydrocephalus (NPH) may suggest its presence by behavioral symptoms. Initally, the symptoms often manifest themselves as depression with marked psychomotor retardation. Older patients without a prior psychiatric history who have soft, nonlocalizing neurological signs and fluctuating cognitive and memory deficits in association with prominent affective and/or psychotic symptomatology of recent onset, such as the case reported here, should raise the clinician's index of suspicion. In such cases, the Halstead-Reitan neuropsychological battery may be helpful in differentiating an underlying dementia from a primary psychological dysfunction. When the presence of a dementing process is suspected, etiological diagnosis should be vigorously pursued with a CAT scan and, as indicated on clinical grounds, confirmatory and further delimiting studies such as pneumoencephalography, ventriculography, RISA scanning, electroencephalography, constant-infusion manometric testing, and/or angiography. Treatment of NPH includes one of several forms of shunting procedures and appropriate neuroleptic therapy for behavioral symptoms. Althoug there is a substantial risk (40 to 50 percent)ioral symptoms. Although there is a substantial risk (40 to 50 per cent) of shunt-related complications, as many as 60 per cent of operated patients will show objective imprvement, making the diagnosis of and referral for appropriate surgical treatment of NPH an important challenge for the psychiatrist.
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PMID:Psychiatric and behavioral manifestations of normal pressure hydrocephalus. A case report and brief review. 83 Aug 2

Recent losses occurring in the two years before onset of depression in women are distinguished from past losses occurring at any time before this. Of past losses only loss of mother before II is associated with greater risk of depression--both among women treated by psychiatrists and among women found to be suffering from depression in a random sample of 458 women living in London. Past loss of a father or sibling before 17 (or a mother between II and 17), or a child or husband, is not associated with a greater chance of developing depression. However, among patients all types of past loss by death are associated with psychotic-like depressive symptoms (and their severity) and other types of past loss with neurotic-type depressive symptoms (and their severity). It is argued that these associations probably reflect direct causal links, and a sociopsychological theory to explain them is discussed.
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PMID:Depression and loss. 83 1

The author, who considers postpsychotic depression as a reaction to psychosis, illustrates some of the dynamics involved in the development and persistence of the state with letters from a patient. Among other dynamic and psychotherapeutic considerations, the need for self-realization and meaning in everyday life merits special emphasis in the treatment of those for whom escape from psychosis has meant not only deliverance from terror, but also a loss of grandeur and significance.
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PMID:Postpsychotic depression and the need for personal significance. 84 33


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