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

In the National Institute of Mental Health Collaborative Study of the Psychobiology of Depression, six-month follow-up evaluations are available for 24 patients with schizoaffective disorder (depressed type), 56 with psychotic depression, and 274 with nonpsychotic major depression. Outcome for patients with schizoaffective depression was significantly worse than for patients with nonpsychotic depression. The psychotic depression group held an intermediate position on most outcome measures and on psychosocial measures had outcomes significantly worse than those of the nonpsychotic group. Recovery rates assumed a very similar pattern in another cohort admitted more than 40 years ago and followed up without somatic treatment. Follow-ups of 12, 18, and 24 months are available for proportions of each diagnostic group. Survival curves suggest similar outcomes in psychotic depression and nonpsychotic depression, whereas outcomes in schizoaffective depression remain disparate. These trends together with family history studies suggest that a small proportion of patients with schizoaffective disorder, depressed type, will have a long-term course consistent with schizophrenia. Moreover, these data show that outcome studies of schizoaffective disorder must control for follow-up length and the effects of psychosis per se.
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PMID:Outcome in schizoaffective, psychotic, and nonpsychotic depression. Course during a six- to 24-month follow-up. 674 79

The authors measured the middle ear muscle activity during REM sleep of normal subjects (N = 13) and patients with schizophrenia (N = 11), schizoaffective disorder (N = 8), or major depressive disorder (N = 10). The rates of middle ear muscle activity for 5 schizophrenic patients were higher than the highest rates of the other groups. The patients with major depressive disorder had normal rates, and the rates of those with schizoaffective disorder were below normal. Within the schizophrenic patients, high middle ear muscle activity could not be directly attributed to background sleep disturbances, age, anxiety, depression, or diagnostic subtype.
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PMID:Middle ear muscle activity during REM sleep in schizophrenic, schizoaffective and depressed patients. 713 99

The authors measured gamma-aminobutyric acid (GABA) levels in the lumbar CSF of patients with depression, with psychosis, or undergoing evaluation for a neurologic disorder. GABA levels in the CSF from depressed patients were significantly decreased compared with neurologic control patients. CSF GABA levels in psychotic patients were not different from those in neurologic patients, although the data suggested a decrease in CSF GABA levels in patients with schizoaffective disorder.
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PMID:GABA levels in CSF of patients with psychiatric disorders. 735 67

A case report of a patient with schizophrenic and affective symptoms in remarkable correlations (r = .94) is presented to highlight difficulties in documenting the diagnosis of schizoaffective disorder. Proposed solutions include the frequent use of appropriate rating scales, recognizing that postpsychotic depression is common and may mimic primary affective disorders, and employing statistical methods applicable to the individual case.
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PMID:Covariance of affective and schizophrenic symptoms in schizoaffective psychosis. 741 Nov 30

Mood disorders in schizophrenia are common and are associated with a poor outcome, an increased risk of relapse and a high rate of suicide. Consequently, treatment strategies need to take mood disorders into account. In depressed and actively psychotic schizophrenic and schizoaffective patients, treatment with neuroleptic plus antidepressant may be less effective than neuroleptic alone. However, patients with post-psychotic depression on maintenance neuroleptics respond well to tricyclic antidepressants. Mood disorders can be caused by neuroleptics and if so will often improve if the dose is reduced or if the drug is changed. Anticholinergics may also help. In schizoaffective disorder, lithium is usually beneficial, especially for patients with classical affective disorder. Carbamazepine may be more effective in patients with schizoaffective and schizophreniform disorders. At doses comparable with those effective in schizophrenia, clozapine may be as good or better than conventional neuroleptics in schizophrenic patients with psychotic mood disorder or schizoaffective disorder. In patients with high BPRS anxiety/depression scores, risperidone (8 mg/day) was more effective than haloperidol (10 mg/day). Risperidone at a mean dose of 8.6 mg/day was also more effective than haloperidol (mean dose 9.2 mg/day) or levomepromazine (methotrimeprazine -- mean dose 125 mg/day) on the Psychotic Anxiety Scale. Mood-related symptoms are therefore amenable to treatment. Risperidone and clozapine appear to be good candidates for the long-term treatment of mood disorders in schizophrenia, although long-term, double-blind, controlled studies are needed to confirm this.
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PMID:Long-term treatment of mood disorders in schizophrenia. 754 99

Weekly assessments of depression, anxiety, and positive and negative symptoms were performed on 80 subjects with schizophrenia or schizoaffective disorder. Using procedures previously reported in another study, the frequency of significant correlations between the sum of anxiety and depression ratings and positive symptoms was compared with the frequency of significant correlations between the sum of anxiety and depression ratings and negative symptoms. Results confirm that dysphoria in schizophrenia tends to be more frequently associated with positive versus negative symptoms, regardless of diagnostic subtype or symptom type. This provides further evidence of the independence of negative symptoms from dysphoria and suggests that the level of positive symptoms and level of dysphoria may mutually influence one another.
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PMID:The frequency of associations between positive and negative symptoms and dysphoria in schizophrenia. 775 96

Kraepelin proposed that schizophrenia and manic-depression were distinct and separable disorders. This hypothesis has been challenged recently by proponents of the "unitary psychosis" theory which posits a continuum from unipolar to bipolar disorder, continuing through schizoaffective and schizophrenic illness. In reviewing symptom cluster data and family studies, the author suggests that there is no compelling evidence to indicate a common pathophysiology for schizophrenia and bipolar disorder. More problematic is a diagnosis of schizoaffective disorder which does not appear to be a stable clinical entity. This would suggest that schizoaffective disorder is not a true clinical syndrome but rather a phenotypic variation.
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PMID:Schizophrenia and manic-depression: separate illnesses or a continuum? 787 66

The authors' specific aim was to assess hypocholesterolemia in 203 patients hospitalized because of affective disorders (depression, bipolar disorder, and schizoaffective disorder) compared with 1,595 self-referred subjects in an urban supermarket screening and with 11,864 subjects in the National Health and Nutrition Examination Survey II, a national probability sample. Low plasma cholesterol concentrations (< 160 mg/dL) were much more common in patients with affective disorders (20%) than in urban supermarket screenees (4%, P < or = 0.001) or in the National Health and Nutrition Examination Survey II subjects (10%, P < or = 0.001). When paired with supermarket screenees by age and sex, patients with affective disorders had much lower plasma total cholesterol (P < or = 0.0002), low-density lipoprotein cholesterol (P < or = 0.001), and high-density lipoprotein cholesterol (P < or = 0.0001), and higher triglyceride concentrations (P < or = 0.03). Neither the severity of the affective disorders nor severity-age interactions were associated with plasma cholesterol concentrations (P > 0.1); age and plasma cholesterol were positively associated (P = 0.01). None of the psychoactive drugs had a significant independent association with the patients' low-density lipoprotein cholesterol. Plasma cholesterol in patients hospitalized with affective disorders is shifted markedly downward toward hypocholesterolemic concentrations (< 160 mg/dL). There is no evidence that low plasma cholesterol could cause or worsen affective disorders.
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PMID:Hypocholesterolemia and affective disorders. 794 80

(1) Results from a study investigating psychosocial and neuroendocrine influences on post-partum psychosis are presented. Subjects were 43 pregnant women with histories of affective disorder (bipolar or schizoaffective disorder, n = 26; major depressive disorder, n = 17), together with 45 pregnant women without any psychiatric history. (2) At 36 weeks antenatal assessments were carried out of the women's psychiatric histories, current psychiatric state and also the occurrence of life events in the preceding year. They were then monitored for 6 months after delivery during which time psychiatric state and any further life events were recorded. Illness was defined according to Research Diagnostic Criteria (RDC); 22 high risk women and 3 control women were categorised as RDC 'cases' during the post-partum follow-up period. Fifteen of the bipolar/schizoaffective women (8 of whom subsequently became ill within 3 months of delivery) and 15 controls (all of whom remained well) also participated in a neuroendocrine test at 4 days post-partum when their growth hormone response to a challenge dose of the dopamine agonist, apomorphine, was measured. (3) The results showed that women with histories of depression and control women who became ill after delivery were three times more likely to have had a life event in the year preceding onset of illness than women from these subgroups who remained well. In contrast, for women with histories of bipolar or schizoaffective disorder, life events appeared to be unimportant. Instead bipolar/schizoaffective women who became ill showed an enhanced growth hormone response to the apomorphine challenge test compared to those who remained well and controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neuroendocrine and psychosocial mechanisms in post-partum psychosis. 836 72

In a review of psychiatric problems of the Vietnamese population in particular experiences with refugees to the USA are mentioned where with regard to the great influx it was necessary to resolve rapidly in particular problems of the mental health. The group is formed by 20 Vietnamese subjects (11 men and 9 women) who were hospitalized in 1979-1988 at the Prague Psychiatric Clinic, Charles University and who had various jobs in Prague. In six men psychosis was diagnosed (3x schizophrenia or schizoaffective psychosis, 2x depressive phase and 1x manic phase of manic depressive psychosis). In women the psychopathological symptoms were evaluated as neurotic, in 6 of them there were attempts of suicide, while in men suicidal behaviour was recorded only once. Regardless of sex, the suicidal attempts were made with great determination. Aggressive behaviour focused on the environment was found in three men. The authors describe cases of somatizing depression and hysterical manifestations. In the development of symptoms participated psychogenic factors such as separation from the home country, partnership conflicts, incl. unwanted pregnancy and unsatisfactory work. Some psychopathological symptoms reminded of experience with the so-called Gastarbeitersyndrom.
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PMID:[Psychiatric disorders in the Vietnamese]. 850 66


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