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

Seventy-three children and adolescents in end-stage renal failure (ESRF) undergoing haemodialysis (n = 32), continuous ambulatory peritoneal dialysis (CAPD) (n = 28) or with a functioning transplant (n = 13), were assessed, with their parents, on adjustment to dialysis and psychological functioning. Quantitative assessment techniques were used; the three treatment groups were compared using the Mann-Whitney U test. Findings showed a number of advantages of transplantation over dialysis, and of CAPD over haemodialysis. Children with transplants suffered less functional impairment (P = 0.007), less social impairment (P = 0.001) and fewer practical difficulties associated with treatment (P = 0.000) than children undergoing dialysis. Parents of children with transplants also reported fewer practical difficulties than parents of children on dialysis (P = 0.002). Dialysis and transplant groups did not differ on children's or parents' reports of psychological stress associated with treatment, parents' reports of marital strain, children's and parents' levels of anxiety and depression or children's behavioural disturbance. Compared with children undergoing hospital haemodialysis, those using CAPD suffered less social impairment (P = 0.004), reported better adjustment to dialysis (P = 0.031) and fewer practical problems associated with treatment (P = 0.005), had lower depression scores (P = 0.054), and showed less behavioural disturbance (P = 0.013). Parents of children undergoing either CAPD or hospital haemodialysis reported similar practical difficulties, psychological stress or marital strain associated with treatment, but mean depression and anxiety scores were lower in the parents of children undergoing CAPD (P = 0.042 and P = 0.054).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Psychosocial adjustment to end-stage renal failure: comparing haemodialysis, continuous ambulatory peritoneal dialysis and transplantation. 149 11

Demographic, psychiatric, social, cognitive, and life stress variables were used to determine the etiology of depression in childbearing (CB; n = 182) and nonchildbearing (NCB; n = 179) women. Hormonal variables in postpartum depression were also evaluated. In the CB group predictors of depression diagnosis were previous depression, depression during pregnancy, and a Vulnerability (V) x Life Stress (LS) interaction; predictors of depressive symptomatology were previous depression, depressive symptoms during pregnancy, life events, and V x LS. Only estradiol was associated with postpartum depression diagnosis. In the NCB group V X LS was the only predictor of depression diagnosis; depressive symptoms during pregnancy and life events were predictors of depressive symptomatology. Previous findings about depression vulnerability were replicated. The significant V x LS interactions support the vulnerability-stress model of postpartum depression.
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PMID:Controlled prospective study of postpartum mood disorders: psychological, environmental, and hormonal variables. 200 73

The psychophysiological responses to two mental stress tests (mental arithmetic and an interactive concentration task) were assessed in 168 unmedicated, male, postinfarction patients 36-69 years old. Patients also completed a standard battery of psychological tests. Psychophysiological responses were generally unrelated to age and education. Comparison of patients scoring high (more than 75%) and low (less than 25%) relative to the normal population on psychological measures indicated that heart rate and blood pressure responses to mental stress tests were significantly greater in those reporting low than in those reporting high neuroticism. The study population was subsequently divided into high, medium, and low cardiovascular responders on the basis of rate-pressure product reactions to the two stress tests. The three cardiovascular response groups did not differ in age, interval between myocardial infarction and stress testing, ejection fraction, incidence of exercise-induced ischemia, or ischemic signs during Holter monitoring. However, the high cardiovascular responders were more likely to manifest possible or definite electrocardiographic signs of ischemia or significant arrhythmia during mental stress testing than were the medium or low cardiovascular responders (50% versus 19.6% and 7%, respectively). High cardiovascular responders also reported lower levels of trait anxiety, neuroticism, psychophysiological symptoms, and depression.
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PMID:Psychophysiological stress testing in postinfarction patients. Psychological correlates of cardiovascular arousal and abnormal cardiac responses. 200 27

Patients with hypertension in the clinic but not during daily activities ("white coat" hypertension) may be at lower risk of hypertensive morbidity and mortality than patients with hypertension in both settings ("persistent" hypertension). We hypothesized that the white coat phenomenon was due to greater blood pressure reactivity to the stress of a clinic visit and that, as a consequence, white coat hypertensive patients would display greater blood pressure reactivity to exercise and mental stress, as well as increased emotional reactivity and higher levels of anger, anxiety, or depression. We studied 89 patients with essential hypertension between 29 and 59 years old with ambulatory blood pressure monitoring, treadmill exercise testing with oxygen consumption measurement, mental stress testing (including mental arithmetic, public speaking, and video game tasks), and psychological testing (State-Trait Anxiety Scale, Cook-Medley Hostility Scale, Center for Epidemiologic Studies Depression Scale, emotional reactivity scale). We defined white coat hypertension as a mean ambulatory systolic blood pressure of 135 mm Hg or less and diastolic 85 mm Hg or less and persistent hypertension as a mean ambulatory systolic blood pressure of 140 mm Hg or more or diastolic 90 mm Hg or more. Forty-nine patients were classified as persistent hypertensives and 20 as white coat hypertensives. No significant differences were seen in demographic or clinical characteristics, fitness level, blood pressure response to exercise or mental stress, or psychological characteristics, except that white coat hypertensive patients had lower systolic blood pressures in the clinic and during exercise and greater variability of clinic diastolic blood pressures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Physiological, psychological, and behavioral factors and white coat hypertension. 237 47

Psychological stress has been demonstrated to induce myocardial ischemia. To determine whether stressful events before a coronary artery bypass grafting procedure precipitate myocardial ischemia, silent or symptomatic, and whether this can have an effect on the prognosis, 26 patients were evaluated before a bypass operation with continuous Holter monitor recording. Specific events monitored were signing surgical consent, receiving preoperative medications, shaving and preparing, and transfer to the operating room. A positive Holter result was defined as an ST segment depression of 1 mm or more lasting one minute or longer. Six patients (23%) were found to have one or more episodes of substantial ST segment depression, with a total of ten episodes lasting 208 minutes recorded. All episodes were silent and not associated with an increase in mean heart rate. The majority of episodes occurred randomly, although three episodes did occur between 5 and 6 AM at the time of transport to the operating room. This appeared to be related more to the circadian rhythm than to the stress of transport. No perioperative or postoperative myocardial infarctions occurred, and all patients were alive at 30 days. In conclusion, silent myocardial ischemia present in the immediate preoperative period does not appear to be related to specific preoperative events. Frequency of early morning ischemia may warrant changes in the medication schedule to provide additional protection during these hours.
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PMID:Anticipation of bypass surgery: can it induce silent myocardial ischemia? 278 70

Several psychological outcomes that accompany acute and chronic exercise have medical significance. Transient reductions in somatic tension and subjective anxiety appear most reliable. Symptom abatement in moderate depression can occur with chronic exercise in a manner comparable to psychotherapy and may offer a better prognosis in some instances. Other cognitive, behavioral, and perceptual events associated with exercise may assist in managing mental health, and exercise has been successfully used as a therapeutic adjunct in a variety of psychiatric disorders. Regular exercise may also complement treatments designed to manage aspects of coronary-prone behavior and psychoendocrine responsivity to mental stress. The lack of strict experimental control or effective placebo contrasts in most exercise studies precludes a convincing argument that exercise causes the psychological outcomes observed. Rather, expectancy of benefits, generalized treatment or attention effects, social reinforcement, and past history or selection bias represent likely alternatives. These competing explanations do not discount, however, that many individuals benefit in a clinically significant way. Exercise offers a low-cost alternative or adjunct with side effects that appear largely health-related. Although the effective psychological dosage or modality has not been quantified, current physiologic guidelines of the American College of Sports Medicine (large muscle rhythmic activity, for 20 to 60 minutes, 3 to 5 days per week at 60 to 80 per cent age-adjusted maximal heart rate), or a weekly caloric cost of 2000 kcal, should be effective with little medical risk. However, no evidence confirms that an increase in metabolic or psychoendocrine tolerance to exercise is necessary or sufficient for psychological outcomes to occur. Although biologic adaptations are known to follow exercise training and subside with diminished activity, there is currently no objective evidence that habitual exercise leads to dependence. If exercise has use in managing subjective or somatic symptoms, these may return during periods of exercise abstinence. Moreover, despite popular hypotheses concerning endorphins and biogenic amines, no direct relationships have yet been shown between exercise-induced mood swings and peripheral biochemical events. A proportion of habitual runners have reported acute episodes of euphoria-like states during or following exercise, but this remains a subjective and unpredictable event that may be related to psychophysiologic relaxation or acute changes in self-esteem.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Medical psychology in exercise and sport. 285 2

The finding of a diminished TSH response to exogenously administered TRH in a significant proportion of depressed patients has now been established as one of the most reproducible findings in biological psychiatry. More than 50 reports, in which more than 1000 patients have been studied, reveal that the TSH response is blunted in approximately 25% of patients with major depression. TSH blunting is clearly not specific for depression, because it also has been observed in mania, alcoholism, and borderline personality disorder. It is doubtful that TSH blunting represents a non-specific response to mental stress: it was found only rarely in schizophrenic patients, and the TSH response to in vivo flooding therapy in phobic patients was normal. In both depression and alcoholism, TSH blunting has been reported to be sometimes a state marker and sometimes a trait marker, i.e. the fault was found to persist into remission in more than half the patients. In both conditions, TSH blunting was unrelated to the patients' age, body weight, height, body surface, thyroid status, and serum cortisol concentrations. It also is unlikely that TSH blunting was due to increased dopaminergic inhibition of thyrotroph cells: serum prolactin concentrations in TSH blunters were found to be normal, and pretreatment with haloperidol had no effect on either basal TSH levels or TSH blunting. In depression, TSH blunting was not associated with previous drug intake, dexamethasone suppression test abnormalities, or variables of biogenic amine metabolism, nor did it usefully segregate between primary and secondary depression or between unipolar and bipolar subgroups. Preliminary evidence suggests that TSH blunting in depression may be related to duration of illness, history of violent suicide attempts, and a reduced 24 h TSH secretion. In alcoholism, TSH blunting was unrelated to family or personal history of depression and duration of abstinence. With reference to clinical utility, TSH blunting may aid in assessing the response to antidepressant treatment, predicting outcome to such treatment, assessing the risk for violent suicide attempts, and describing relationships between different psychiatric populations (e.g. depression and alcoholism).
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PMID:The TRH-induced TSH response in psychiatric patients: a possible neuroendocrine marker. 286 65

Students who reported experiencing a high number of stressful life events were randomly assigned to: (a) an aerobic training condition, (b) a relaxation training condition, or (c) a no treatment control condition. Immediately before and after the 11 week training/control period, subjects' aerobic fitness and cardiovascular responses to acute psychological stress were assessed. Results indicated that: (1) subjects in the aerobic training condition showed significantly greater improvements in aerobic fitness than subjects in the other conditions, and (2) the subjects in the aerobic training condition showed significantly greater reductions in heart rate during all phases of the stress than subjects in the other conditions. Post-training differences between aerobic and control conditions during the moderate psychological stress were as great as 17 b.p.m. These results provide evidence for the utility of aerobic training for reducing cardiovascular activity during psychological stress, and they are consistent with earlier findings linking fitness to less illness following stress, reductions in depression and enhanced recovery in cardiac patients.
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PMID:Effects of aerobic exercise training and relaxation training on cardiovascular activity during psychological stress. 307 14

In a survey of risk factors for coronary heart disease 14 102 middle aged men and women answered a questionnaire on lifestyle, diet, and health, including symptoms of functional abdominal disorders. The overall prevalence of reports of one or both of the abdominal symptoms of "bloating and rumbling" or "cramping abdominal pain" was 28% in men and 35% in women. Only a weak negative association between age and prevalence of reported pain was found in both sexes. Women reported abdominal symptoms, especially cramping abdominal pain, significantly more commonly than men. In a multiple regression analysis abdominal symptoms were much more strongly associated with symptoms of mental stress such as depression, sleeping difficulties, problems of coping, and the use of analgesics than with lifestyle, dietary, and social variables together. The association was stronger in subjects reporting both symptoms. This strong and consistent association between functional abdominal disorders and psychological and social problems suggests that action other than prescribing drugs, diets, or radiography is required.
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PMID:Associations between symptoms of irritable colon and psychological and social conditions and lifestyle. 308 51

The identification of a genetic marker linked to Huntington's chorea may soon lead to a generally available presymptomatic test that has a high degree of accuracy. Bird outlines the likely consequences of such genetic screening for potentially affected persons and their families. The desire to know whether one has inherited a fatal defect, versus the psychological stress if such a defect is found, are factors to consider. Foreknowledge of disease may lead to better decision making about life-style or reproduction, but depression or suicide may also result. Counseling should be available to those at risk and to their families; whether to be tested should be an individual decision. Confidentiality of all test results must be maintained.
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PMID:Presymptomatic testing for Huntington's disease. 315 56


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