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

Depression is a common reaction to the vicissitudes of life among elderly people. Aged persons are physiologically and psychologically less able to adapt, yet they are required to change their life styles because of retirement, lowered financial resources, death of family and friends, and illness. Although many mental health professionals are reluctant to treat geropsychiatric patients, the prognosis for depressed patients can be good. Drug therapy is usually the most effective, although psychotherapy and other behavioral therapies may be used adjunctively. Electroconvulsive therapy (ECT) may be indicated for severely depressed patients. The beginning dosage of medication should be lower than for younger patients, and elderly patients must be monitored carefully for side effects. Adverse reactions due to multiple drug interactions are also possible. When aged persons become severely depressed, they are at high risk of suicide; almost all suicide attempts by elderly people are successfl. Depression in later life is treatable, and the pessimism that often surrounds the prognosis for geropsychiatric patients is unwarranted.
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PMID:Depression in elderly patients. 112 12

Patients' reasons for their suicide attempts were categorized and related to levels of hopelessness and depression. The findings are discussed in the light of the psychotherapy of suicidal individuals.
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PMID:The use of suicidal motives in the psychotherapy of attempted suicides. 116 91

Comparison of a series of twenty-four wrist-cutters with a control group of self-poisoners showed a number of significant differences. The wrist-cutters were younger and their acts were regarded as being of low lethality; they are no more likely to have made previous suicide attempts; they complain less often of depression, and more frequently of 'emptiness' and tension as primary complaints. Sudden, unpredictable mood swings are common and there is a greater tendency for their physicians to diagnose personality disorders, often in pejorative terms. They frequently have substantial medical interests and paramedical occupations. A high proportion complain of dysorectic symptoms (anorexia or overeating or combinations of both), use drugs and/or alcohol in excess; show sexual disturbance and distress, and also promiscuity. They more frequently have a negative reaction to menarche and menstruation; have come from broken homes and have experienced parental deprivation. A proportion of the group exhibit difficulty in verbal communication, and absconding from hospital was more common in the group of cutters. Painless cutting after a period of depersonalization, followed by relaxation and repersonalization after bleeding, was the typical pattern.
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PMID:The phenomenology of self-mutilation in a general hospital setting. 119 28

Self-destructive behavior in the adolescent is a continuum that ranges from drug intoxications to gestures of low lethality to suicide attempts with high lethality of intent. Such behavior should be treated as a signal of long-term stress and strife. A "Psychological biopsy" is outlined for evaluation of the severity and type of perturbation. This focuses on 9 areas of inquiry: the circumstantial lethality of the event; prior self-destructive behavior; depression; hostility; stress; reaction of the parent or parent surrogate; loss of communication; lack of resources; and extremes of parental expectations and control. Adolescents under severe familial and socioeconomic stress, and with a history of acting-out behavior, often respond well to transfer to a more favorable home situation. In cases where there is no apparent familial perturbation, the physician should be alert to the possibility of severe psychiatric disorder. In either case, initial definition of the problem opens the way to a plan for management and support.
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PMID:Evaluation of suicide risk in adolescents. 120 61

To characterize siucidal behavior among hospitalized medical and surgical patients, all suicide attempts in the Peter Bent Brigham Hospital were surveyed for seven years. Seventeen attempts occurred, non of them fatal. Only four patients were seriously ill, two with neoplasia. All the attempts were impulsive and were associated with stress and disturbances of impulse control. Anger, not depression, was the effect most often seen before the attempts. In all cases the precipitating stress was loss of emotional support. However, patient vulnerability to suicide seemed to be the key determinant. Fifteen patients had mental disorders, including eight with personality disorders, three with schizophrenia, three with organic brain syndromes, and one with manic depressive psychosis. Seven were psychotic, and six had made prior suicide attempts. These findings suggest that the characteristics of impulsive suicide should be considered when a suicide prevention program is being developed for a general hospital.
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PMID:Suicide attempts by hospitalized medical and surgical patients. 124 68

A review of clinical experience with 163 patients with primary affective disorder indicates that patients with a history characterized by recurrent depression interspersed with periods of hypomania (bipolar II) may have clinical courses that are distinguishable from bipolar I (depression with histories of mania) or unipolar patients. A prior history of suicide attempt and suicide after discharge from the research unit were most frequent among bipolar II patients. The family histories of bipolar I and bipolar II patients revealed similarly increased morbid risks for bipolar illness, whereas no bipolar illness was found in the first-degree relatives of unipolar patients. The suggestion that patients classified as bipolar II be separately considered in future studies of affective disorder is discussed.
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PMID:Heritable factors in the severity of affective illness. 126 75

The existence of depression in young individuals has often been denied or at least underestimated particularly during adolescence, to the benefit of such other concepts as morosity, inherent in this period of life, and from which depression should be differentiated. Recent epidemiological investigations in the general population have revealed an approximate 2% and 10% prevalence of depression in the child and the adolescent, respectively. This considerable increase in morbidity is associated with a modification of the sex ratio: more boys are affected before puberty, more girls after puberty. In the present work we shall first deal with the semiology and comorbidity of depression as related with the developmental changes occurring in the child and the adolescent. Thus, several studies have shown that the DSM III criteria for affective disorders are consistently applicable to pre-puberty children and adolescents as well. However, depression in the pre-puberty children may be more ostentatious, manifesting itself by psychomotor agitation, somatic complaints and anxiety comorbidity of the type: Separation Anxiety Disorder and phobias. Depressed adolescents may exhibit more anhedonia, more depressive cognition, hypersomnia, weight variations, more alcohol or drug abuse and suicide attempts, and, in one third of them, greater coexistence of anxiety disorders or behavioural disorders. The course of depression at this age is now known, owing to catamnestic studies that proved methodologically satisfactory (we personally managed the follow-up of 75 depressed adolescents over an average 45 months). Depression in the child and the adolescent is not a benign affection, it is a long-lived, recurrent and disabling illness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Time and depression in children and adolescents]. 130 45

In this longitudinal study of 9,904 clients who were treated at methadone, outpatient drug-free (OPDF), and residential treatment facilities, at intake more than half of all clients reported symptoms of depression or suicide. Females and multiple nonnarcotics users were at highest risk for suicide attempts. Despite a dramatic drop in the level of symptomatology by 4 weeks in treatment, many clients remained suicidal throughout the study period. Suicidal tendencies at both intake and 4 weeks were strongly related to suicidal tendencies at 12 months post-treatment; even more strongly related was the return to weekly or more frequent use of narcotics or nonnarcotics for residential and OPDF clients.
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PMID:Effects of drug misuse treatment on symptoms of depression and suicide. 132 75

Prevention or reduction of suicide remains a serious challenge for the medical community. Psychotherapeutic and psychosocial interventions have not been shown to reduce the incidence of suicide attempts and analytic psychotherapy has been shown to increase suicidal behavior. The efficacy of pharmacotherapy in reducing suicide attempts in patients with a history of repeated suicidal behavior has been shown with low doses of the neuroleptic agent flupenthixol compared with placebo. Supporting findings have been reported with trifluoperazine. There is evidence to suggest that some antidepressants may not be neutral in their effect on suicidal behavior. Maprotiline, for example, was associated with an increase in suicide attempts compared with placebo in a large long-term treatment study despite its significant efficacy in preventing relapse of depression. Differential lethality indices taken from large community studies support the notion that noradrenergic drugs such as maprotiline, desipramine, and nortriptyline are associated with a higher than expected incidence of death from overdose, and the suicide-provoking potential may relate to some noradrenergic property. The studies of serotonergic antidepressants do not suggest that they are suicide-provoking agents; rather they appear to be neutral or protective. Prospective prophylactic studies are needed to test the ability of potential treatments for the reduction of suicidal behavior.
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PMID:Pharmacotherapy in the prevention of suicidal behavior. 846 51

Platelet or whole blood serotonin content did not differ significantly in patients with major depression compared to healthy controls, but within the patient group, platelet serotonin levels correlated negatively with severity of depression (r = -0.49, p = 0.007). Levels were 39% lower in patients who had made a suicide attempt compared to nonattempter patients (47.2 +/- 27.3 versus 77.6 +/- 41.7 ng/10(8) platelets, p = 0.04). Conversely, comorbid borderline personality disorder (85.3 +/- 41.5 ng/10(8) platelets) was associated with 31% greater platelet serotonin content than nonborderline patients (58.9 +/- 31.1 ng/10(8) platelets) and 27% greater than healthy controls (62.4 +/- 19.8 ng/10(8) platelets). A pronounced seasonal variation in whole blood and platelet serotonin content was found in both patients and controls, largely due to lower levels in summer. Excluding cases tested in the summer abolished the statistically significant differences in patients with and without comorbid borderline personality disorder (BPD). Nevertheless, BPD attempters had lower serotonin levels than BPD nonattempters but higher serotonin levels than non-BPD attempters. Current hostility and a life-time history of aggression were positively correlated with platelet serotonin content (r = 0.44, p = 0.04 and r = 0.41, p = 0.06). This study provides evidence for an association between lower platelet serotonin content and depression and suicidal behavior, and association of higher platelet serotonin content and comorbid borderline personality disorder and behavior traits such as aggressivity.
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PMID:Platelet and whole blood serotonin content in depressed inpatients: correlations with acute and life-time psychopathology. 142 Jun 42


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