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

To test the hypothesis that the antidepressant effects of total sleep deprivation (TSD) are linked to the serotonergic and/or noradrenergic system the authors carried out a double-blind study (fluvoxamine versus maprotiline) in 42 inpatients with endogenous depression (ICD). Patients were randomized to a four-week treatment with either fluvoxamine (100-300 mg/day) or maprotiline (100-300 mg/day). In addition, patients underwent a TSD procedure before and after one week of antidepressant medication. There was a statistically significant reduction of depression ratings (HDRS) in both the fluvoxamine and maprotiline group. The day-1 response to TSD before antidepressive medication was not associated with a clear relationship to the outcome after four weeks of treatment with either fluvoxamine or maprotiline. On the other hand, the day-2 response to TSD was significantly correlated with a good outcome to subchronic treatment with maprotiline. Furthermore, the results of the authors' data suggest that a favorable short-term outcome of TSD may be connected to antidepressants enhancing the serotonergic neurotransmission. The global comparison between fluvoxamine and maprotiline revealed that the group of patients treated with fluvoxamine had a significantly higher efficiency index (CGI) than the maprotiline group; fluvoxamine was rated to be tolerated excellently in 70% of the patients whereas this percentage was only 43% in the maprotiline group. There was also significantly more vertigo and dry mouth in the maprotiline group whereas the fluvoxamine group was rated to have significantly more sleep disturbances during the trial.
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PMID:Response to total sleep deprivation before and during treatment with fluvoxamine or maprotiline in patients with major depression--results of a double-blind study. 211 80

Temporomandibular joint (TMJ) disorders have been collectively grouped as myofascial pain-dysfunction syndrome (MPDS) or temporomandibular joint dysfunction syndrome (TMJDS). In the past, these terms have been used synonomously to describe a set of clinical signs and symptoms that include pain in the TMJ and muscles of mastication, limited or deviant opening of the mandible, and/or joint sounds. The present study segregated two major subgroups subsumed within this diagnostic classification and assigned them to a myogenic facial pain (MFP) group and a TMJ internal derangement (TMJID) group. Previous studies may have included both of these disorders as MPDS/TMJDS. While some signs and symptoms are similar, the primary differentiation is based on meniscus displacement present with TMJID patients and pain distribution patterns between the two groups. While MFP/TMJID patients comprise the majority of the facial pain population, a third major group of patients is encountered, being classified under the diagnostic appellation of atypical facial pain (AFP). Patients with AFP usually complain of vague and wandering pain in the maxilla or mandible; however, no identifiable source of infection or organic disease can be uncovered. One hundred fifty patients seeking consultation and care for facial pain met the criteria for inclusion into one of three clinical groups. The groups were compared for age, sex, duration of symptoms, bruxism and/or clenching habits, and disturbed sleep patterns. Differences in surface electromyographic levels from the facial and cervical muscles were also examined. Minnesota Multiphasic Personality Inventory (MMPI) scores from 95 subjects were compared with self-report measures of depression and anxiety. It was concluded that subcategorization of myofascial pain dysfunction patients into a MFP and TMJID group is justified on the basis of psychometric differences, clenching habits, masseter EMG levels, and male:female ratio. Furthermore, psychopathological factors are more significant among MFP and AFP subjects than TMJID patients.
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PMID:Comparison of clinical characteristics in myogenic, TMJ internal derangement and atypical facial pain patients. 213 94

Psychotropic effects have been imputed to oral contraceptives (OCs); however, studies with large populations found no depressive episodes caused by OCs. Affective disorders of women such as premenstrual syndrome and postpartum and menopausal depression are well-known. The estrogen and progesterone levels are high during pregnancy, when the risk of emotional disease declines. A study on Marvelon (containing .15 mg of desogestrel and .03 mg of ethinyl estradiol) involving 27,000 women found a history of depression in 3%, but in 90% the symptoms disappeared after OC use. Other studies corroborated the finding that OCs exerted a stabilizing effect on emotional disorders. The overwhelming majority of women without psychiatric anamnesis did not suffer any mood fluctuations under OC use. In a study, 4327 women were interviewed at 3 and 6 months of OC use, and in 45.7% their sense of well-being improved, 30.3% were in a good frame of mind, and 21.2% had a slight deterioration of their sense of well-being. Neurotic and introverted persons tended to attribute affective disorders, weakness of concentration, sleep disturbances, and the avoidance of sex to OCs. With such individuals, OC indication requires particularly strict adherence to rules. The ability of Ocs to improve acne was analyzed when 1785 questionnaires were examined from 1958 women who had used Marvelon. 60% reported improvement of their acne, and 50% of the more severe cases improved. Dysmenorrhea and menstrual cycle disorders improved similarly. Body weight increase in insignificant with modern OCs. OCs exert a positive psychotropic effect through their ability to influence these conditions.
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PMID:[Does the pill have a psychotropic effect?]. 215 6

Sleep deficits are commonly found in geriatric depressed patients, particularly shortened rapid eye movements (REM) latency, disturbed sleep continuity, and decreased slow wave sleep (SWS). Here we report the sleep patterns of community volunteers responding to ads about memory loss and depression. The two groups, 24 geriatric-onset major depressive disorder (MDD) subjects with a minimal history of seeking treatment for depression and 24 gender- and age-matched control subjects, significantly differed from each other on only one measure of sleep--sleep latency; the MDD group showed a modest but significant shortening of latency to fall asleep. All other sleep/wake measures, including REM latency, temporal distribution of REM sleep across the night, SWS, and measures of nighttime wakefulness did not differ between groups. This lack of significant sleep disturbance suggests that the sleep deficits reported in many studies of major depression may be related to factors underlying treatment-seeking behaviors, physical health status, severity of the depression, or heterogeneity within the MDD population with some types seeking treatment and others not seeking it, rather than depressive state per se. The data indicate that community-dwelling healthy elderly individuals who have a diagnosed major depression but who have not actively sought health care do not necessarily manifest the sleep disturbances thought to be characteristic of major depressive illness.
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PMID:Sleep is undisturbed in elderly, depressed individuals who have not sought health care. 217 92

Trazodone (150 mg to 400 mg) was administered to six depressed patients with significant sleep disturbances in an 8-week single-blind study design. Patients were evaluated psychologically by means of the Hamilton Rating Scales for Anxiety and Depression. Polysomnographic monitoring in the sleep laboratory was conducted at each of the time points corresponding to the psychiatric evaluations. Five of the six subjects completed treatment. Patients showed a significant improvement in symptoms of depression and in their polysomnographic-determined sleep architecture. There was a 44% improvement in persistent sleep latency, decreasing from a mean +/- SD of 51.0 +/- 59.3 minutes at baseline to 28.5 +/- 24.2 minutes after 5 weeks of active treatment. Total sleep time improved 14% from 387.1 +/- 59.2 minutes at baseline to 441.3 +/- 23.7 minutes after 5 weeks. Stage IV sleep more than doubled with an increase of 153% from 1.9 +/- 3.0% at baseline to a more normal 4.8 +/- 5.5%. There was no change in percentage of rapid eye movement (REM); however, REM latency increased 28% from a mean of 74.6 +/- 35.9 minutes at baseline to a mean of 95.6 +/- 28.8 minutes. Sleep efficiency improved from 80.6 +/- 12.3%, considered clinically significant insomnia, to 91.9 +/- 4.9%, which is well within normal sleep patterns.
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PMID:Sleep laboratory evaluation of the effects and efficacy of trazodone in depressed insomniac patients. 221 59

Neurobehavioural symptoms and performance tests were evaluated in a group of 78 workers exposed to mixed organic solvents (printers, paint sprayers and paint production workers) and a referent group of 145 unexposed subjects (nonproduction factory workers and volunteer postal workers). Both groups were administered a structured symptoms questionnaire and eight neurobehavioural tests for psycho-motor function, visual and auditory memory. An excess of symptoms of fatigue, irritability, depression, poor memory, sleep disturbances and symptoms suggestive of autonomic dysfunction was found in the exposed group. Neurobehavioural test performance was generally worse, and performance on tests of psycho-motor function (choice reaction test and digit symbol) and auditory memory (digit span and associate learning) was significantly poorer in the exposed group. The findings support the view that apparently healthy and actively employed workers exposed to mixed solvents show neurobehavioural deficits.
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PMID:Neurobehavioural effects of industrial mixed solvent exposure in Chinese printing and paint workers. 225 12

To provide a better understanding of the etiology of subjective sleep complaints in HIV-infected individuals, a study to evaluate sleep/wake disturbances in 10 healthy HIV-infected male volunteers was performed. All subjects were HIV-infected but had no history of AIDS-related infections, and considered clinically asymptomatic. Interviews and sleep questionnaires revealed sleep complaints in nine subjects. Five healthy HIV-seronegative male subjects, with no history of sleep complaints, were also evaluated. Sleep architecture analyses detected that, in comparison to published normative data and to negative controls, there was a significant increase in the total percentage of slow wave sleep (SWS) and an increase in the percentage of SWS in the later sleep cycles. When compared with normative data, an increase in stage 1 shifts, rapid eye movement (REM) periods, and arousals were also observed in the HIV-infected group. Significant decreases in sleep latency, total percentage stage 2 sleep, and average REM durations were also observed in the HIV-infected group compared with normative data. These sleep architecture abnormalities could not be attributed to known sole primary sleep disorders, first night effect, medications, anxiety or depression. This study indicates that sleep disturbances occur early in the course of HIV infection and suggests that the observed alterations of sleep physiology may be a consequence of central nervous system involvement and/or immune defense mobilization in the early phases of HIV infection.
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PMID:Sleep disturbances in HIV-infected homosexual men. 226 Nov 33

The lymphocyte stimulation responses to the mitogens phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed (PWM) were investigated in 30 hospitalized depressed women undergoing a dexamethasone suppression test (DST). Patients were classified according to DSM-III as having major depression with melancholia, without melancholia, and minor depression. The Hamilton Depression Rating Scale (HDRS) and the State-Trait Anxiety Inventory (STAI) were measured. Patients with major depression showed significantly decreased lymphocyte stimulation induced by PHA, Con A, and PWM as compared to those with minor depression. These differences could not be attributed to age, body weight, weight loss, total number of leukocytes, menopausal status, sleep disturbances, concomitant use of low-dosage benzodiazepines or length of drug-free period before testing. The group mean differences in lymphocyte stimulation counts were not affected by the severity of illness or the severity of state and trait anxiety. There were no significant differences in the lymphocyte responses to PHA, Con A, and PWM between DST non-suppressors and DST suppressors. No significant correlations were established between baseline and post dexamethasone cortisol values and the lymphocyte stimulation counts.
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PMID:Impaired mitogen-induced lymphocyte responses and the hypothalamic-pituitary-adrenal axis in depressive disorders. 252 50

In order to examine the course of normal postpartum adjustment compared to the symptomatology of postpartum depression, 25 postpartum women who met Research Diagnostic Criteria for either major or minor depression were compared to 24 non-depressed postpartum women. The Schedule for Affective Disorders and Schizophrenia (SADS) and the Beck Depression Inventory (BDI) were administered to all subjects. Results suggest that sleep disturbances and loss of sexual interest are common concomitants of normal postpartum adjustment. A discriminant function analysis indicated that the cognitive-affective symptoms of loss of energy, guilt, difficulties in concentration, and loss of interest in usual activities discriminated between depressed and non-depressed women most efficiently. Finally, there was a lack of concordance between the BDI and the SADS interviews, which suggests that the BDI may not be an appropriate instrument for diagnosing depression in a postpartum sample.
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PMID:Postpartum depression and postpartum adaptation: overlapping constructs? 252 93

The authors report on 404 Southeast Asian refugees seen at a community clinic. Approximately three-quarters of these patients met DSM-III criteria for major depressive episode, and 14% had posttraumatic stress disorder. Complaints of pain and sleep disturbances were the predominant presenting symptoms. Most of the men were married, but more than 40% of the women were widowed. Between 15% and 30% of the patients reported specific traumatic experiences either in their homeland or during their escape. Widowhood and such traumatic experiences were positively correlated with more symptoms of depression and anxiety.
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PMID:Depression and posttraumatic stress disorder in Southeast Asian refugees. 258 53


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