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

At least one psychiatric diagnosis was made for 205 of 220 children whose psychiatric evaluation had been requested by the medical service. Only 78 of 242 psychiatric diagnoses given the 205 patients were reflected correctly in the medical discharge diagnoses. In addition, seven of fifteen patients considered to be "normal" by the consulting psychiatrist had a psychiatric or mixed medical-psychiatric diagnoses included in the discharge diagnoses. Psychophysiological disorders, psychoses and special symptom diagnoses were likely to be correctly reflected in the discharge diagnoses, while depression and adjustment reaction were not. Possible reasons why the psychiatrist's diagnostic opinion is not correctly reflected in the discharge diagnosis in over one-half of the referrals are discussed. Pediatricians may be reluctant to label their patients "neurotic" for life, or may consider the problem transient-that is, only a "passing phase". But these theories are discounted by the fact that seven patients considered to be emotionally normal when assessed by the psychiatrist were discharged with a psychiatric or mixed medical-psychiatric diagnosis.
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PMID:Pediatric referrals to psychiatry: III. Is the psychiatrist's opinion heard? 64 73

Symptoms of depression in the majority of patients immediately following acute myocardial infarctions (AMI) resolve rapidly; they are an adjustment reaction. However, in a group of 552 male patients there were 80 (14.5%) patients with persistent major depressive symptoms during a finite period after AMI. Infarction size was assessed by maximum creatine kinase levels, the QRS-complex and the occurrence of late potentials. These measures did not correlate with the degree of depressed moods in these groups. An arrhythmic event in the early hospitalization phase, a recurrent infarction, dyspnoea, and persistent angina pectoris before the AMI were significantly related to more profound degrees of depression. Patients who reported serious life-events in the last 2 yr before AMI, or who suffered from exhaustion and fatigue in the prehospital phase were subject to significantly higher levels of depression. A prodromal phase prior to hospitalization free of bodily symptoms and the use of denial were related to low levels of depression. The logistic regression model incorporating all univariate significant variables revealed that symptoms of exhaustion and fatigue prior to AMI had the strongest independent correlation with post AMI depression.
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PMID:Factors which provoke post-infarction depression: results from the post-infarction late potential study (PILP). 143 62

Diagnostic profiles of 400 adolescent and 1159 adult Navajo Indians consecutively admitted to a psychiatric unit between 1980 and 1989 are presented in this paper. The major discharge diagnoses for adolescents were as follows: adjustment reaction, mixed, and depression, not otherwise specified (NOS), with females accounting for two-thirds of either diagnosis; schizophrenia, with males accounting for 68% of all diagnoses, and personality disorder, NOS, with no gender differences. The four major discharge diagnoses for adults were schizophrenia and depression, NOS, in which there were no gender differences; alcohol withdrawal, syndrome, in which males accounted for 76% of those discharged; and adjustment reaction, mixed, in which females constituted 60% of those discharged. Over the 10-year period, there was a decrease in adult and an increase in adolescent admissions. During the last 2 years (1988 and 1989) adolescents accounted for almost 30% of all admissions compared with 14% during the first 2 years (1981 and 1982).
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PMID:Psychiatric diagnostic profiles in hospitalized adolescent and adult Navajo Indians. 143 95

Depressed mood and the psychiatric diagnosis of major depressive episode (MDE) are common findings in patients with chronic fatigue syndrome (CFS). The relationship between depression and CFS is unclear and may be explained by one of four models: (1) CFS is an atypical manifestation of MDE; (2) depression is the result of CFS as either an organic mood syndrome or an adjustment reaction; (3) CFS and MDE are covariates; and (4) the diagnosis of MDE is artifactual. The evidence for these models is discussed. The potentially confounding effect of depression on tests of immune function and neuropsychological testing is described. The implications of these different models for the design of studies of CFS are examined.
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PMID:Chronic fatigue syndrome and depression: cause, effect, or covariate. 202 Aug 5

Parent, teacher, and child reports were used to identify situational and personal factors associated with school refusal in 114 3- to 13-year-old Venezuelan children. The sample consisted of 57 school refusers and 57 nonrefusers matched on age, school, and sex. As compared with nonrefusers, the refusers had changed schools more often, were rated as more dependent, had more school-related fears, and were perceived by their parents as more difficult to manage. Stepwise multiple regression analyses revealed that school refusal status could be predicted by both situational and personality variables including the child's fear level, dependency, depression, frequency of school changes, history of refusal in the family, and other variables. Refusal onset frequently coincided with situational stress (e.g., the beginning of the school year, a new school or teacher, or trouble with a teacher or peers). Categories of refusal resembled those of other studies and included adjustment reaction, school phobia, and emotional disturbance. In the future, these risk factors can be used to identify and treat potential school refusers.
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PMID:Characteristics of Venezuelan school refusers. Toward the development of a high-risk profile. 359 67

The article reports upon the characteristics of 300 abortion applicants in Arkansas manifesting significant stress from unwanted pregnancy between May 1, 1970 and June 30, 1971. The sample is limited by the fact that all of these women had been willing to seek medical aid. Patients ranged from ages 13-47, 131 of them ages 17-21. 35% had had some college education; another 29% were high school graduates. 50.6%, 20.6%, and 27.3% were single, divorced, and married, respectively. 59.6% of the patients were primiparas. 18.3%, 9.6%, and 12.3% were classified as being neurotic, having psychophysiologic tendencies (gastrointestinal problems, obesity, chronic headaches), and having sociopathic features (passive-aggressive, frankly rebellious, delinquent, antisocial, alcoholic), respectively. 12 women had noticeable schizoid features; 4 women had mildly active schizophrenia. Fathers of the women were usually blue-collar workers (55.3%) or white-collar workers (24.6%). The most frequent ordinal sibling position among the women was oldest child (38%). Parental instability (1 or both parents lost through death, divorce, father usually away working, chronic alcoholism, etc.) was reported by 39.6% of the patients. Patients' attitudes toward the unwanted pregnancy included dislike of inexpediency of the situation (82.6%), self-depreciation (55.6%), and aversion (28.6%). Precipitated psychiatric disorders were for the greatest part mild. Manifesting symptoms included depression (66.7%), anxiety (21%), and mixed anxiety and depression (12.2%). Suicidal threats and gestures were made by 22 and 8 patients, respectively. In summary, the study reveals a group of predominantly Caucasian women from unstable, middle-class urban families who were going through an adjustment reaction to adolescence or adult life.
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PMID:Abortion applicants in Arkansas. 426 12

Inpatient and outpatient, emotionally disturbed, borderline to severely mentally retarded adults (N = 110) were assessed to evaluate the relationship of medication to psychiatric diagnosis and symptomatology. Patients were assessed on the Psychiatric Instrument for Mentally Retarded Adults, the Beck Depression Inventory, the Zung Self-Rating Depression Scale, the Hamilton Rating Scale for Depression, and the Social Performance Survey Schedule--a measure of social adaptation. All these instruments had been modified for use with mentally retarded persons. Comparisons were made evaluating patients receiving major tranquilizers, anticonvulsant and antianxiety drugs, by diagnostic category. Furthermore, an assessment was made of inpatients versus outpatients, based on amount of medication prescribed. It was found that considerable variation in the numbers of drugs and the amount of drug used occurred, based on the type of psychiatric condition, particularly those on informant data on schizophrenia, affective disorder, and adjustment reaction disorder. Implications of these and related results for psychotropic drug use with mentally retarded emotionally disturbed persons are discussed.
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PMID:Diagnosis and drug use in mentally retarded, emotionally disturbed adults. 615 23

All patients referred for a psychiatric consultation from the adult wards of a General Hospital over a 10-month period were examined. The referral rate was 1.4%. Twice as many female patients were referred as male patients. Parasuicide accounted for 68% of referrals. The most common psychiatric diagnoses were adjustment reaction (41%), depression (23%), alcohol dependence (5%) and schizophrenia (5%). In 30% of referrals, no psychiatric treatment was necessary; 26% were transferred to the psychiatric unit and 17% were discharged to the out-patients' psychiatric clinic. Explanations are offered for the "hidden" psychiatric morbidity in General Hospitals and the high percentage of referrals who did not need psychiatric follow-up. Suggestions are made for a better liaison between physicians and psychiatrists.
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PMID:The pattern of in-patient psychiatric referrals in a general hospital. 816 Apr 58

DSM-IV is provisionally including a category of mixed anxiety and depression for several reasons. First, it will be included in ICD-10, and therefore used worldwide. The ICD-10 category and the mixed anxiety and depression category now being included in the appendix of DSM-IV are subsyndromal in that they include patients with both anxious and depressive symptoms that fail to meet criteria for an established anxiety or depression diagnosis. Primary-care physicians regularly report a high incidence of patients whose symptoms fit this subsyndromal definition of mixed anxiety and depression. Such patients are not easily classifiable using DSM-III or DSM-III-R criteria, yet they often manifest sufficient distress and/or disability to require treatment. Those who oppose establishing the diagnosis of mixed anxiety and depression make the following points: (1) patients considered eligible for this diagnosis will actually meet criteria for a current DSM disorder; (2) mixed anxiety and depression will become a "wastebasket" category for a heterogeneous group of patients; (3) if any new subsyndromal diagnosis is needed, minor depression should suffice; and (4) mixed anxiety and depression will overlap extensively with adjustment reaction.
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PMID:Mixed anxiety and depression: should it be included in DSM-IV? 850 57

This paper presents the data of 90 patients admitted consecutively for crisis intervention in the psychiatric ward of the National University Hospital, Singapore. There were 48 men and 42 women; their mean age was 31.4 years (SD +/- 12.9). More women (73%) had relationship problems than men but more men (52%) had work related problems-the difference is significant (p < 0.01). The commonest diagnoses were depression (45%) and adjustment reaction (24%). The mean duration of hospitalisation was 4.3 days (SD +/- 2.3). The majority of patients (63%) were managed by supportive psychotherapy and the remaining 37% by supportive psychotherapy and medication. On follow up after one month, 20% of the sample were well, 62% improved and 18% were not better. About 85% of the sample could be contacted after 3 months, and of these, 51% were well, 39% improved but 10% were still not better. The efficacy of crisis intervention is briefly discussed.
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PMID:Crisis intervention in a general hospital. 894 57


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