Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three hundred and twenty-eight patients aged 45 years and over with major depression, dysthymic disorder or adjustment disorder with depressed mood (according to DSM-III) were asked about childhood loss experiences (death of one or both parents or at least 1 year's separation) and their current state of health. No statistically significant relationships were found between experiences of loss in childhood and type of depression, sex and age at first episode. However, there was an increased incidence of suicide attempts in patients with experiences of loss in childhood, both by separation and by death of parents. The increased suicidal tendency could mainly be attributed to loss of the father.
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PMID:Childhood experiences of loss and suicide attempts: significance in depressive states of major depressed and dysthymic or adjustment disordered patients. 179 Dec 61

Poisoning is a significant problem in the elderly. The majority of poisonings in older people are unintentional and may result from dementia and confusion, improper use of the product, improper storage or mistaken identities. Depression is also common in the elderly and suicide attempts are more likely to be successful in this age group. The elderly patient's recuperative abilities may be inadequate as a result of numerous factors including impaired hepatic or renal function as well as chronic disease processes. General management of poisoning in the elderly parallels management of younger adults, but it is especially important to ascertain underlying medical conditions and concurrent medications. In most poisonings, activated charcoal and cathartic are sufficient. Haemodialysis or haemoperfusion may be required at lower plasma drug concentrations in elderly patients. While the specific indications for antidotes are the same for all age groups, dosage alterations and precautions may need to be considered in the elderly. Drugs most often implicated in poisonings in the elderly include psychotherapeutic drugs, cardiovascular drugs, analgesics and anti-inflammatory drugs, oral hypoglycaemics and theophylline. Cardiovascular and neurological toxicities occur with overdoses of neuroleptic drugs and, more frequently and severely, with cyclic antidepressants. Patients with pre-existing cardiovascular disease are at particular risk of worsening ischaemic heart disease and congestive heart failure. Benzodiazepines only appear to produce significant toxicity during long term administration or in combination with other CNS depressants. Digoxin can cause both chronic and acute intoxication, most seriously cardiac toxicity including severe ventricular arrhythmias, second or third degree heart block or severe refractory hyperkalaemia. Immune Fab antibody is indicated for the management of digoxin toxicity, although patients dependent on the inotropic effect of digoxin may develop heart failure after digoxin Fab antibody administration. Nitrates can cause toxicity including headache, vomiting, hypotension and tachycardia from excessive sublingual, transdermal or intravenous doses. Conduction disturbances and hypotension occur with overdoses of antihypertensive drugs; these effects are mild with angiotensin converting enzyme (ACE) inhibitors, occasionally severe with beta-blockers and of significant concern with calcium channel antagonists. The elderly commonly use aspirin and other salicylates, are more likely to develop chronic intoxications to these agents, and are more susceptible to severe complications such as pulmonary oedema. Salicylate poisoning, recognition of which is often delayed, should be considered in elderly patients with neurological abnormalities or breathing difficulties, especially in the setting of acid-base abnormalities. The clinical effects of NSAID overdose are mild and usually involve the central nervous system and gastrointestinal tract.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Poisoning in the elderly. Epidemiological, clinical and management considerations. 179 7

Presented is a suicide attempt with an enormous amount of food in a young female affected with Anorexia mentalis of symptomatic alcoholism. Reacting to a conflict situation with her boyfriend, in a fit of anxiety and depression on a principal of a "short circuit reaction" she took an uncontrollably large amount of food. After an attempt of gastric lavage which was unsuccessful, a laparotomy and gastrotomy was carried out because of vital reasons. Eight kilograms of various types of undigested food and mushy contents were removed from the stomach. The surgical treatment lasted for 26 days, and treatment was resumed at the department for neuropsychiatry and the patient was released to go home as recovered after 84 days of treatment. The authors have presented this case as a very rare suicide attempt, because they have not found a description of a suicide attempt with food in domestic nor available world literature.
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PMID:[A case of attempted suicide with an enormous quantity of food]. 180 71

Tricyclic antidepressants (TCAs) taken in large quantities during suicide attempts have altered pharmacokinetics. Their absorption may be delayed by inhibition of gastric emptying and peristalsis. A significant enterohepatic recirculation delays final elimination of a large fraction of the drug. The enzymes responsible for TCA benzyl-hydroxylation can become saturated and thus reduce TCA elimination to zero-order kinetics. TCA unbound to plasma proteins may also increase because of an acidemia resulting from a respiratory depression after overdose. Other compounds are ingested in suicide attempts which greatly change TCA pharmacokinetics. Metabolism of ethanol generates an excess of reducing equivalents which inhibit TCA oxidative metabolism. Neuroleptics directly inhibit TCA hydroxylation. Fluoxetine significantly prolongs elimination and increases plasma levels of TCA. Toxic hepatic metabolites of acetaminophen would delay TCA elimination. The elderly have slower rates of drug elimination and are particularly susceptible to TCA antidepressants taken in overdose.
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PMID:Clinical pharmacokinetics of tricyclic antidepressant overdose. 181 1

Hypomania in a 28- to 30-year-old cohort is described. Data were taken from a prospective longitudinal cohort study from the general population of Zurich, Switzerland. An estimated 1-year prevalence rate of hypomania of 4% was found. Over a period of time hypomania was associated with major depression and dysthymia. We found equal proportions of suicide attempts and equal rates of treated family members among hypomanics and depressives. Furthermore, the previous history of treatment of mild bipolars (hypomania with depression) and unipolar depressives was comparable. The sum of life events, several SCL-90R scores and the scores of distress in relationships were already elevated in hypomanics 7 years before diagnosis of hypomania, indicating an increased activity level, a generalized increase in neuroticism, and a relatively unvarying behaviour pattern in social relationships.
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PMID:The Zurich Study. X. Hypomania in a 28- to 30-year-old cohort. 183 65

This article reports on the evidence for the validity of psychotic major depression as a distinct subtype based on cross-sectional and 1-year prospective data from the Epidemiologic Catchment Area study. Consistent with findings from previous clinical studies, only about 14% of major depressions were accompanied by psychotic features. Psychotic as compared with nonpsychotic depression had a more severe course, as reflected in increased risk of relapse, persistence over 1 year, suicide attempts, hospitalization, comorbidity, and financial dependency. These differences could not be explained by differences in demographic characteristics or by symptom severity, as assessed by symptom profile or number of symptoms. The boundary problem with schizophrenia and bipolar affective disorder that is seen in clinical studies was also found in this sample. To our knowledge, this is the first study to examine the validity of psychotic depression in a community sample; the findings are consistent with those from clinical samples. They support the clinical significance of psychotic depression and the continuation of its inclusion as a distinct subtype in DSM-IV.
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PMID:The validity of major depression with psychotic features based on a community study. 184 25

The prevalence of depressive symptoms, suicidal ideation and their relationship to perceived health problems and social relations were examined in a sample of 605 Swedish adolescents aged 13-18 years. Short-term stability of depressive symptoms and the turnover rate from a nondepressed to a depressed state were examined for subsamples of 36 depressed and 71 nondepressed subjects, respectively, who were retested after 4 to 6 weeks. Using Beck's criteria for clinical depression, 9% of the adolescents experienced moderate to severe depressive symptom levels. However, a more conservative estimate, 4%, was obtained when DSM-III criteria for major depressive disorder were applied. Approximately 3% of the adolescents had pronounced suicidal ideation and had made at least one previous suicide attempt. There was a tendency for boys to show more stable depressive symptoms and suicidal ideation than girls. Furthermore, a set of 5 psychosocial variables concerning the students' satisfaction with their school and leisure time, conflictual level at home and number of close friends predicted 31% of the variance of the subjects' total depressive symptom scores. Although a 32% decrease of depressive symptoms was noted for the depressed subsample of adolescents, 44% of these subjects continued to experience moderate to severe depression at follow-up.
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PMID:Short-term stability of depressive symptoms and suicide attempts in Swedish adolescents. 185 32

A clinical study of 25 male and 17 female schizophrenic suicides is presented. Jumping from a height was the most common method used. The 42 suicidal schizophrenics in Taiwan were compared with both 84 sex- and age-matched and 60 5-year illness course non-suicidal schizophrenic control groups. The suicidal schizophrenics were not significantly different from the non-suicidal counterparts of both control groups with regard to age, sex, ethnicity, religion, educational background, the presence of suicide cases in the family history, and the presence of insight, but were significantly different in characteristics of a history of previous suicide attempts, presence of psychotic symptoms during their final month, depression during their final month, a history of depression, a history of previous psychiatric hospitalizations, and the number of hospitalizations. We discuss the findings from this study and others in the literature in the context of the different clinical and socio-cultural backgrounds of these Taiwanese schizophrenic suicides.
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PMID:A clinical study of schizophrenic suicides. 42 cases in Taiwan. 185 76

This article reviews the risk of suicide in panic disorder beginning with early studies showing increased mortality, including suicide, among patients belonging to the broad category of neuroses. More recent follow-up studies of patients with anxiety disorders have found about 20% of deaths due to suicide, a proportion similar to that found in depressive disorders. Also, suicide attempts have been reported by similar proportions of subjects with panic disorder and major depression from the general population. Preliminary data indicate that more severely ill patients with coexisting depression and substance abuse are more likely to attempt or complete suicide. Thus, although limited, the data indicate that the risk of suicide in panic disorder is substantial. As a consequence, clinicians should alert themselves to this preventable outcome and approach treatment with added caution.
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PMID:Suicide and panic disorder: a review. 188 Mar 4

Psychiatric disorders, psychosocial dysfunction, family pathology, and environmental stressors are thought to be risk factors for adolescent suicide attempts. Variables from each of these categories were examined, by means of a structured interview and questionnaires, to determine whether a group of 21 adolescent suicide attempters could be differentiated from a group of 34 normal control subjects and a group of 15 at-risk adolescents (teenagers with known risk factors but without recent suicide attempt). The attempters differed significantly from control subjects on a large number of variables, particularly in the areas of substance abuse, depression, self-image, interpersonal relationships, communication patterns, family support, and problem behaviors. Only three items--the Beck Hopelessness Scale score, the SCL-90-R Positive Symptom Distress Index, and a history of suicidal ideation--differentiated the attempters from the at-risk adolescents. A discriminant analysis revealed that hopelessness and suicidal ideation were able to identify 93% of the suicide attempters.
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PMID:Can adolescent suicide attempters be distinguished from at-risk adolescents? 188 47


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