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

In a discussion of the article on genetic determinants of borderline conditions by Siever and Gunderson, a phenotypic continuum between pure schizotypal and pure affective conditions is postulated. Many "borderline" cases are seen as attenuated forms of schizophrenia, schizoaffective psychosis, or manic-depression. A Venn diagram illustrates differences among syndromes described by Gunderson, Kernberg, Spitzer, and Klein ("hysteroid dysphoria"). Evidence is presented suggesting that Gunderson's borderline syndrome contains more schizotypal individuals than Kernberg's, whereas hysteroid dysphoria is nearer the affective pole of the continuum. A second diagram illustrates how the strength and nature of the genetic factors vary according to the syndrome.
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PMID:Assessing vulnerability to schizophrenia or manic-depression in borderline states. 44 84

The relation of specific MMPI scores to attention, concentration, and memory was assessed in an inpatient psychiatric sample diagnosed by DSM-III-R criteria as having schizophrenia, chronic undifferentiated type (n = 22); schizophrenia, paranoid type (n = 17); and schizoaffective disorder (n = 20). MMPI indices that are used widely to infer cognitive efficiency--including Scales 2 (Depression), 8 (Schizophrenia), SC-PT, D4 (Mental Dullness), SC2A (Lack of Ego Mastery, Cognitive), PSY (Psychoticism) and ORG (Organic Symptoms)--were investigated in relation to actual performance on Digit Span and subtests of the Wechsler Memory Scale (WMS, Russell's Revision). Weak correlations emerged (maximum r = .31, p less than .05), which suggests that scores on these MMPI measures may not provide a reliable basis for inferring attention and memory functioning.
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PMID:MMPI interpretation of psychiatric inpatients: caution in making inferences about concentration and memory. 135 92

The historical antecedents of the current diagnostic criteria for mania involve the German phenomenologic descriptions of the late 1800s, the introduction of lithium for treatment and prevention of mania (which broadened the definition of mania in this country), the attempts to subclassify bipolar disorder into at least two subtypes, and the differentiation of patients with mania and hypomania from those with depression alone. Current diagnostic criteria for bipolar disorder are delineated in DSM-III-R. The differential diagnosis of bipolar disorder includes other conditions that may have manic-like symptoms, including organic mood disorders such as endocrine or metabolic conditions, drug intoxications, and tumors. Mania occurring in the context of substance abuse would be called a secondary mania. In addition, schizoaffective disorder can be diagnosed if there is a manic syndrome superimposed in the context of schizophrenia. Because of the absence of duration criteria for mania in DSM-III-R, the differential diagnosis within the bipolar disorders is largely based on severity and duration of depression. A problem in studying mania at present is that the prototypic cases have largely disappeared from treatment centers because of the success of lithium maintenance treatment. Patients available for study at psychiatric treatment facilities are largely treatment resistant, atypical, and likely to have experienced considerable amounts of substance abuse in their histories. Among the changes being considered for DSM-IV are to include duration criteria for mania, to separate bipolar II patients (depression and hypomania) from bipolar not otherwise specified, to refine the criteria for hypomania, and to add rapid cycling to the list of parenthetical modifiers for bipolar disorder with mania and bipolar disorder with hypomania.
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PMID:Differential diagnosis of bipolar disorder. 154 21

Studies on the response of schizoaffective patients to somatic treatments are reviewed. Research suggests that in many cases the response of schizoaffective disorder to pharmacological intervention is similar to that of primary affective disorder. However, it is necessary to take into account the heterogeneity of the category when treating patients. The drugs used most frequently are lithium, neuroleptics (antipsychotics), antidepressants and anticonvulsants. Often a combination of drugs is found to be more effective than a single drug. Electroconvulsive therapy has been found to be very effective in the treatment of schizoaffective depression.
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PMID:A review of schizoaffective disorder: II. Somatic treatment. 163 58

The authors used a randomized, placebo-controlled design to assess the therapeutic efficacy of adjunctive imipramine, added to fluphenazine decanoate and benztropine, among well-stabilized, negative-symptom schizophrenia and schizoaffective disorder patients who additionally met operationalized criteria for postpsychotic depression. The outcome of the imipramine-treated group was superior in both global ratings and a specific negative-symptom scale. Exacerbation of psychotic symptomatology was not found to be problematic. The implications of this study are discussed in terms of a potential strategy for pharmacotherapy among certain negative-symptom patients and in terms of its relevance to a possible pathophysiological basis for the negative-symptom state.
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PMID:The use of antidepressants for negative symptoms in a subset of schizophrenic patients. 177 7

A total of 402 patients were followed up for, on average, 25 years after the onset of their illness. The diagnoses, made longitudinally, were as follows: schizophrenic disorder (n = 148); schizoaffective disorder (n = 101); affective disorder (n = 106). The remaining 47 patients did not fulfil the criteria for any of these diagnoses. A distinction was made between "episode" (cross-sectional diagnosis) and "illness" or "disorder" (longitudinal diagnosis). The "episodes" (cross-sectional diagnosis) were classified according to slightly modified DSM-III criteria into schizophrenic, affective (melancholic, manic, manic-depressive mixed), schizoaffective (schizodepressive, schizomanic, schizomanic-depressive mixed) and non-characteristic episodes. The criteria for the episodes are: Schizophrenic episode: criteria of DSM-III, slightly modified. Melancholic episode: according to "Major Depression, Melancholic Type" of DSM-III-R. Manic episode: according to the criteria of DSM-III, slightly modified. Manic-depressive mixed episode: Presence of manic and depressive symptomatology during one episode. Schizodepressive episode: Presence of schizophrenic and depressive symptomatology during one episode. --Schizomanic episode: presence of schizophrenic and manic symptomatology during one episode. Schizomanic-depressive mixed episode: Presence of schizophrenic, manic and depressive symptomatology during one episode. The diagnosis of an "illness" or "disorder" (longitudinal diagnosis) took account of all the kinds of episodes that occurred during the whole course. The final diagnosis (longitudinal diagnoses) were defined as follows: Schizophrenic disorder: only schizophrenic episodes during the whole course Affective disorder: only affective episodes during the whole course (melancholic, manic, manic-depressive mixed episodes). Schizoaffective disorder: at least one schizoaffective episode during the course (schizodepressive, schizomanic, schizomanic-depressive mixed episode), independently of the type and number of other episodes, or sequential manifestation of schizophrenic and affective episodes. The principal instruments of investigation and evaluation were: Global Assessment Scale (GAS); Disability Assessment Schedule (WHO/DAS); Psychological Impairment Rating Schedule (WHO/PIRS); Present State Examination (PSE); Criteria for social class and social mobility according to Kleining and Moore (also transferred to the criteria of Hollingshead and Redlich) - A pool of items based on WHO instruments for social parameters; Items for pharmacological treatment and prophylaxis.
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PMID:[Affective, schizoaffective and schizophrenic psychoses. A comparative long-term study]. 179 61

This is a preliminary report from a prospective study of the influence of psychosocial stressors on post-natal relapse in women at high risk of psychiatric disorder after childbirth. Forty-three index subjects with a previous history of psychosis or severe depression were compared with 45 pregnant control subjects without any previous psychiatric disorder. After delivery 51% of index subjects relapsed (RDC diagnoses): 28% were categorised as psychotic and 23% non-psychotic. All psychotic relapses were in women with a previous history of bipolar or schizoaffective disorder (46% of this subgroup). Only the non-psychotic post-partum relapses (mostly depressions) were associated with an increased likelihood of a severe life event in the 12 months preceding illness onset.
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PMID:Life stress and post-partum psychosis: a preliminary report. 184 Jul 44

Among 193 inpatients with Research Diagnostic Criteria (RDC) major psychiatric disorders, the scores in Hamilton's Rating Scale for Depression (HRSD) were higher among those patients with RDC schizoaffective disorder depressed type and major depressive disorder, whereas the scores in the Scale for Assessment of Negative Symptoms (SANS) were higher among patients with these two disorders, as well as those with RDC nonaffective psychoses (schizophrenia and unspecified functional psychosis). The HRSD and SANS items were factor-analyzed, yielding nine factors that discriminated depressive and negative symptoms. These findings suggest that although depressive and negative symptoms frequently coexist, they constitute discrete syndromes.
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PMID:Depressive and negative symptoms in major psychiatric disorders. 200 26

A dexamethasone suppression test (DST) was performed on 8 schizoaffective depressed men. Cross-sectional comparisons were made with three groups: schizophrenics (n = 10), unipolar major depressives (n = 23) and healthy controls (n = 43). All were drug-free and similar in age and body weight. Evaluations utilized the Research Diagnostic Criteria (RDC) for diagnosis, and the Hamilton Rating Scale for Depression for depressive symptom rating. DST nonsuppression, defined as a blood cortisol level of greater than or equal to 5.0 micrograms/dl at 16.00 h postdexamethasone, was observed in 43.5% of the major depressive disorder patients. This was different from the other three groups: 12.5% in schizoaffective depressed, 10.0% in schizophrenics and 9.3% in healthy controls (p less than 0.01, p less than 0.01, and p less than 0.001 respectively). Although schizoaffective depressed patients were significantly different from major depressive disorder patients in their DST responses, both groups were similar in their total HRSD scores and different from the schizophrenics (p less than 0.01 for each). These results, together with others previously reported by us on the thyrotropin-releasing hormone challenge in the same diagnostic groups, may be taken to mean that schizoaffective disorder, depressed type, is biologically distinct from major depressive disorder but not schizophrenia. On the other hand, until further corroborated, they should probably be considered a reflection of the heterogeneity of the schizoaffective syndrome and the nonspecificity of the DST.
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PMID:The dexamethasone suppression test in a group of research diagnostic criteria schizoaffective depressed men. 209 69

Biological tests may help clarify the relationship of schizoaffective disorder to major depressive disorder (MDD) and schizophrenia (SCZ). Thyrotropin-releasing hormone (TRH), 500 micrograms, was administered intravenously to eight schizoaffective depressed (SD), ten SCZ, 23 MDD patients and 43 healthy controls (HC), all males, ages 20-66 years and drug-free. Research Diagnostic Criteria (RDC) were utilized for establishing diagnoses, Hamilton Rating Scale for Depression (HRSD) total scores were used for assessing depressive symptoms. There were no differences in dmax PRL (post-TRH prolactin peak minus baseline, mean +/- SD) amongst SD, SCZ and HC groups (27.3 +/- 5.2, 28.8 +/- 5.4 and 31.5 +/- 5.6 ng/ml respectively). Mean dmax PRL in MDD was significantly lower than each of the other three groups (17.1 +/- 2.2 ng/ml, P less than 0.05 for all). The essentially normal PRL response to TRH in SD, significantly different from MDD but similar to SCZ parallels our previous observations on the pattern of thyrotropin (TSH) response to TRH in the same diagnostic groups. These biological findings may be taken to indicate that schizoaffective disorder, depressed subtype, is closer to schizophrenia than to major depressive disorder. However, they cannot be considered definitive evidence to that effect since schizoaffective disorders are known to be quite heterogeneous, and since the utilized biological tests lack specificity.
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PMID:Prolactin response to thyrotropin-releasing hormone in schizoaffective depressed compared to depressed and schizophrenic men and healthy controls. 212 54


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