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

The relationships between symptoms and both prior suicide attempts and current suicidal thinking were examined in a sample of schizophrenics at 2 points in time. Fifty subjects meeting DSM-III criteria for schizophrenia were assessed within 1 week of admission, and 41 were reassessed at a 6-month follow-up. On admission, prior suicide attempts were significantly associated with current depression, female sex, lower education and more frequent hospitalization. The association with depression remained significant at follow-up. In addition, current suicidal thinking was associated with depression at both times but also with negative symptoms at time 1 and delusions and hallucinations at time 2. These findings confirm and strengthen prior reports of an association between depression and attempted suicide.
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PMID:Attempted suicide and depression in schizophrenia. 159 63

Recurrent brief depression is now recognised separately in the international classification of diseases (ICD 10). The disorder is characterised by short severe bouts of depression which recur frequently but erratically. In our series of patients the median duration of the depression is 3 days, with two thirds lasting between 2 and 4 days. The severity is often marked with a mean MADRS score of 30, and the episodes recurred 20 times a year. The disorder is easily separated from major depression which lasts 2 weeks or more, although, there is an unfortunate overlap group with major depression superimposed on the recurrent brief pattern. Those with "combined depression" have a higher suicide attempt rate. There should be little overlap with dysthymia since on average only 20% of the time is spent depressed, whereas dysthymia requires a minimum of 50%. However, in practice the qualification of the time spent depressed is imprecise in dysthymia so there is potential for misdiagnosis. There is little overlap with bipolar illness. In our series with follow up of up to 15 years, the conversion rate to bipolar illness is low at 3%. Almost all of these were found to have combined depression, which suggests that the rate for pure recurrent brief depression is very low. These data suggest that pure recurrent brief depression is a unipolar depressive illness.
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PMID:Brief unipolar depressions: is there a bipolar component? 160 Sep 3

The single most important risk factor for adolescent suicide is a previous attempt. It is unclear if physicians can identify adolescents who have attempted suicide. Our objectives were to determine the prevalence of previous attempts in an adolescent clinic population, if physicians identify attempters, and if attempters demonstrate persistent distress. Of 332 patients aged 12-19 years attending a medical clinic, 48 (14.5%) reported a previous attempt. The physician's visit note documented that only 8 (16.7%) of the 48 attempters were asked about suicidal behavior. Attempters were more likely than nonattempters (p less than 0.05) to be female; to come to clinic without a guardian; to give a chief complaint pertaining to sexually transmitted disease, obstetrics-gynecology, or mental health; and to report previous mental health care. Attempters had poorer mean scores (p less than 0.05) on validated subscales for family relationships, social competence, depression, unpopularity, somatic complaints, thought disorders, delinquency, aggression, and identity. We conclude that suicide attempts are common among adolescent clinic patients, that physicians may not recognize attempters, and that attempters remain distressed and in need of care. Physicians who see adolescents for routine medical problems must consider the potential for self-destructive behavior, regardless of the presenting complaint.
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PMID:Adolescent suicide attempters: do physicians recognize them? 161 Aug 44

This outcome study of children and adolescents with severe burns (ages 7 to 19 years) reports that unrecognized depression is common during their lifetimes. Thirty children who had severe burns (range, 5% to 95% body surface area) were assessed for depression at a mean of 9 years after burn injury. This article presents an analysis of depression items from the Diagnostic Interview for Children and Adolescents, which was used in face-to-face interviews to assess child psychiatric disorders with diagnostic criteria from the American Psychiatric Association's Diagnostic and Statistical Manual--Third Edition. At the time that the interviews took place, only one child had symptoms of major depression and only three children had symptoms of dysthymic disorder. However, eight children had a lifetime history of major depression; two of them had been abused by burning and two had been physically or sexually abused. Four had made suicide attempts: one suicide attempt was the cause of the burn injury and three attempts were made after burn injury. Thirteen children had had suicidal thoughts, and their parents were often unaware of this. Other types of affective disorders were prevalent. There was no statistically significant association between depression and burn size or disfigurement. Although burn-related factors were associated with some depressive episodes, other biologic and social risk factors were also very important. The authors conclude that referral for diagnostic services and psychotherapy, and for some, treatment with antidepressant medication, is often a necessary part of medical services for children with burns.
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PMID:Depression in children after recovery from severe burns. 161 79

Suicide behavior is a significant problem for many American Indian populations, often more so than in the general population, but little tribal-specific data available. In this study, baseline data on the correlates of suicide ideation and the social and psychological differences between suicide attempters and nonattempters were collected on a sample of 84 Zuni adolescents. Results show significant correlations between a measure of suicide ideation and past suicide attempt behavior, drug use, depression, hopelessness, stress, psychological symptomatology, social support, liking for school, and interpersonal communication. Significant differences between the 30% of the students who reported having previously attempted suicide and the nonattempters were also found on these measures. Areas for education and prevention efforts are suggested.
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PMID:Psychological and social indicators of suicide ideation and suicide attempts in Zuni adolescents. 161 2

Psychiatrists at Emory University Hospital in Atlanta, Georgia examined a 37-year old divorced woman suffering from refractory depression. She reported her 1st bout of depression to be at 9-10 years old (onset of menses). She tried to kill herself at ages 11 and 17. The only time she remembered not being depressed was when she was using oral contraceptives (OCs). She 1st took them for oligomenorrhea at age 14. She suffered from oligomenorrhea off and on ever since then. The next time she took OCs was in her early 20s while she was married. She stopped taking them after she had her son. An outpatient psychiatrist had been treating her for the last 10 years. 3 years before this visit to Emory, psychotic depression and a suicide attempt sent her to a hospital. 5 years before coming to Emory, she gained 40 lbs and developed hirsutism, acne, and a low-pitched voice. 8 months before coming to Emory, a physician diagnosed acanthosis nigricans which is dark hyperpigmentation of the epidermis in body fold areas. 6 months prior to coming to Emory, an endocrinologist evaluated her for oligomenorrhea, obesity, and hirsutism and prescribed 0.25 mg dexamethasone/day to inhibit androgen production, regulate menses, and reduce facial hair. 3 months before admission, she experience severe depression. Her psychiatrist treated her with bupropion, amitriptyline, buspirone, and lithium and continued the same dexamethasone treatment. At Emory, her glucose tolerance tests were abnormal and her insulin levels were elevated. Emory psychiatrist stopped all psychotropic medications and dexamethasone. They and some endocrinologists diagnosed HAIR-AN syndrome (hyperandrogenism, insulin resistance, and acanthosis nigricans). They prescribed OCs and within several weeks her mood improved. 2 months later she was fine and had lost 25 lbs. The primary disturbances of HAIR-AN syndrome are insulin resistance and hyperandrogenism. These 2 disturbances together cause acanthosis nigricans.
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PMID:Organic mood disorder associated with the HAIR-AN syndrome. 855 59

The friends and acquaintances (N = 58) of 10 adolescent suicide victims were interviewed 6 months after the death of the victims, and the rates of psychiatric disorders that had onset after the death were compared with the 6-month incidence of psychopathology in 58 demographically and psychiatrically matched unexposed controls. The exposed group showed higher rates of any new onset major depressive disorder, but the rate of incident suicide attempts was the same in both groups. The median onset of incident depression among the exposed group was within the first month after exposure, and the majority of those exposed youth with incident depression were still depressed at interview 6 months after the death. Adolescent friends and acquaintances of suicide victims experience considerable psychiatric morbidity subsequent to exposure to suicide, most consistent with pathological grief.
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PMID:Psychiatric effects of exposure to suicide among the friends and acquaintances of adolescent suicide victims. 164 25

This study examines the level of psychopathology in 53 African-American females who attempted suicide by ingestion. Parents completed a measure of adolescent psychopathology, and the youths completed measures of depression and psychopathology. Overall, the results suggested that these youths were not experiencing significant emotional distress. However, after classifying the youths into four groups by their self-reported level of depression, the incidence of parent- and youth-reported psychopathology varied. More significant levels of depression corresponded to significant internalizing difficulties, as reported by the adolescent, and myriad psychopathological difficulties, as reported by the parents. These results are discussed from a clinical perspective with a developmentally and culturally sensitive focus. Disposition decisions must consider the level of psychopathology reported by child and parent, the family's willingness to participate in outpatient treatment, and the degree to which the adolescent and her family acknowledge the significance of the suicide attempt.
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PMID:Psychopathology in urban female minority adolescents with suicide attempts. 164 29

This is a case report of a spontaneous remission of depression after an attempted suicide by hanging. The patient suffered from cardiopulmonary arrest and anoxic encephalopathy, but recovered without apparent neurologic sequelae. The authors review the literature and explore the possible effects of hypoxia and hypercapnea on the locus ceruleus and the limbic system which could contribute to the patient's remission of symptoms. Also discussed are the psychosocial factors affecting patients' moods after a suicide attempt.
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PMID:Spontaneous remission of depression after attempted suicide by hanging: a case report and literature review. 177 91

Sexual assault of women in the United States may have a prevalence rate of 25% or more. Moreover, the majority of survivors of sexual assault know their assailants. Consequences of assault may be severe and long-term, including fear and anxiety, depression, suicide attempts, difficulties with daily functioning and interpersonal relationships, sexual dysfunction, and a whole range of somatic complaints. Recent evidence implicates societal factors, such as acceptance of rape myths, rigid sex role stereotyping beliefs, and acceptance of violence as a legitimate means for obtaining compliance in interpersonal relationships, in the etiology of sexual violence against women. I present a model for primary, secondary, and tertiary prevention of rape. Primary prevention represents a program of anticipatory guidance in a developmental framework. Secondary prevention entails identification of and early intervention in dysfunctional families. Tertiary prevention consists of the appropriate treatment of the survivor of sexual assault to prevent or minimize subsequent physical and psychological problems. This preventive framework may be incorporated into the practice of clinical preventive medicine and primary care.
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PMID:Sexual violence against women: prevalence, consequences, societal factors, and prevention. 179 44


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