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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The studies of maxillofacial gunshot injuries mainly focused on evaluating the surgical interventions and physical outcomes of the procedures. In this study we aimed to analyze the pre- and post-injury psychiatric status of the patients with self-inflicted gunshot wounds to the face. This study is based on 12 subjects who attempted suicide resulting in extensive maxillofacial injuries using guns placed beneath their chins. The psychiatric evaluation was conducted by interview and using SCID-I, SCID-II, MMPI, Rosenberg Self-Esteem Scale and Suicide Probability Scale. Two subjects were healthy, 1 had bereavement, 6 had current and 5 had previous MDD (major depressive disorder), 2 had dysthymic disorder, 3 had alcohol abuse, 2 had drug abuse and 4 had antisocial personality disorder. The suicidal group was more socially introverted according to MMPI. According to Rosenberg self-esteem subscale, self esteem, the constancy of self respect and depressive mood subtests were statistically significant in the suicide group compared to the healthy controls (P < 0.01). Depressive spectrum disorders are the most common causes. It is obvious that untreated or undiagnosed depression may increase risk of committing suicide. The changes in the physical facial appearance after the suicide attempt caused impairment of self-esteem and the constancy of self-respect. Similar to other studies, none of our patients reattempted suicide and all tried to return to their pre-injury lifestyle and appeared to accommodate to the stigma of their physical deformities. Early diagnosis and treatment should be considered as a factor to reduce the risk for suicide attempt.
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PMID:Psychiatric analysis of suicide attempt subjects due to maxillofacial gunshot. 1711 7

To adapt the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations, a Spanish translation of the scale was interviewer-administered to 554 subjects aged 18-34 years (65.9% women) and the ratings so obtained were compared with the SCID-CV-based diagnoses of expert clinicians. The internal consistency of the scale was satisfactory (Cronbach's alpha=0.89). Four factors identified by exploratory factor analysis (Depressive/Somatic, Positive Affect, Retarded Activity and Interpersonal Relations) accounted for 55.9% of the variance. A score of 26 was identified as a suitable cut-off for screening purposes, affording a sensitivity of 0.906 and a specificity of 0.918.
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PMID:An adaptation of the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations. 1714 80

Cognitive deficits are increasingly considered as essential in schizophrenic disorders. Positive symptoms and cognitive deficits have been found to be independent, whereas negative symptoms show only weak correlations to cognitive impairment. However, the relationship to a third symptom dimension, disorganization, is yet unclear. In a sample of n = 151 schizophrenia inpatients (DSM-IV/SCID) we assessed cognitive impairment using a comprehensive neuropsychological test battery and symptoms of schizophrenia applying the Positive and Negative Syndrome Scale (PANSS). Factor analyses resulted in three neuropsychological (attention, memory, abstraction) and five symptom factor scores (negative, impulsiveness, positive, disorganization, depression). The disorganization factor did not correlate significantly with any of the neuropsychological factor scores. Even after controlling for different demographic and clinical variables partial correlation coefficients did not reach a significant level. Thus, we could not confirm the previously reported associations between disorganization and measures of cognitive impairment. Despite a considerable conceptual overlap between interview based symptom ratings and classic neuropsychological tests the empirical association is limited. Our results suggest that disorganization and cognitive impairment represent different symptom dimensions.
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PMID:Disorganization and cognitive impairment in schizophrenia: independent symptom dimensions? 1716 77

Elevated plasma homocysteine levels have been found in different psychiatric disorders, including major depression and eating disorders. The aim of the present study was to evaluate whether presence of depression or depressive symptoms is associated with elevated homocysteine levels in patients with eating disorders. Total plasma homocysteine levels were assessed in 44 females with anorexia nervosa (n = 21) or bulimia nervosa (n = 23). Comorbid major depressive disorder (MDD) was diagnosed according to DSM-IV criteria using a semi-structured interview (SCID-I). Furthermore, depressive symptoms were assessed using Beck's depression inventory (BDI). Presence of MDD was not associated with elevated homocysteine levels (t-test: T = 0.42; df = 42; P = 0.68). However, self-rated presence of clinically relevant depressive symptoms (BDI score18) was associated with elevated homocysteine (T = -2.8; df = 42; P = 0.008). Presence of depressive symptoms may explain elevated homocysteine levels previously reported in patients with eating disorders or vice versa. Longitudinal studies are needed to unravel this hen or egg problem.
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PMID:Depressive symptoms may explain elevated plasma levels of homocysteine in females with eating disorders. 1718 57

The Hospital Anxiety and Depression Scale (HADS) is a widely used screening instrument for depression in medically ill patients. The purpose of this study was to examine the optimal scoring scheme, unidimensionality and item fit of the depression subscale of the HADS (HADS-D) in stroke survivors. A research assistant administered the HADS-D to 100 Chinese patients with acute stroke who were consecutively admitted to a general hospital. A psychiatrist, who was blind to the HADS-D scores, administered the SCID-DSM-III-R to all 100 patients and made a DSM-IV diagnosis of depression, which served as the benchmark for judging the performance of the HADS-D in screening for depression. Rasch analysis has shown that the HADS-D was unidimensional; low endorsements for the higher coded alternative response categories were found in the sample. In clinical samples with a low frequency of depression, the scoring categories of the HADS-D may be reduced.
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PMID:Rasch analysis of the scoring scheme of the HADS Depression subscale in Chinese stroke patients. 1726 49

Pregnant women (N=253) were recruited during their second trimester of pregnancy (M=22.3 weeks gestation) and assigned to depressed (N=83) and non-depressed groups based on a SCID diagnosis of depression. They were then given self-report measures on sleep disturbance, depression, anxiety and anger, and their urine was assayed for norepinephrine and cortisol. These measures were repeated during their third trimester (M=32.4 weeks). Their newborns were then observed during sleep. During both the second and third trimesters, the depressed women had more sleep disturbances and higher depression, anxiety and anger scores. They also had higher norepinephrine and cortisol levels. The newborns of the depressed mothers also had more sleep disturbances including less time in deep sleep and more time in indeterminate (disorganized) sleep, and they were more active and cried/fussed more.
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PMID:Sleep disturbances in depressed pregnant women and their newborns. 1729 85

This paper is the final one in our series examining the DSM-IV diagnostic criteria for major depressive disorder. The data collected were part of the Rhode Island Methods to Improve Diagnostic Assessment and Services project, a unique integration of a research assessment protocol into a community-based clinical practice. We were able to examine a number of psychometric and conceptual issues in the diagnosis of depression because we modified the diagnostic interview to inquire about all diagnostic criteria, as well as additional associated features, of all patients. The results reported in the papers published earlier in the series suggested that some changes in the diagnostic criteria might be warranted. However, before changes are made to the diagnostic nomenclature, the results of any single study should be replicated. The cost of conducting this type of research is high, thereby reducing the likelihood of replication. As part of the Methods to Improve Diagnostic Assessment and Services project, we developed the Diagnostic Inventory for Depression (DID), a self-report scale that was specifically designed to assess the DSM-IV diagnostic criteria for major depressive disorder; thus, this scale could potentially be used to study many of the same questions examined in the present series, though at a fraction of the cost. In the present report, we used the DID to examine questions that were addressed in three of the prior reports in this series. The results of the present analysis based on the DID replicated the previously reported findings based on the SCID. This suggests that a self-report measure such as the DID could be used in other settings to examine the issues studied in the present series of papers, thereby facilitating the compilation of a more substantial literature upon which decisions regarding criteria modification could be based.
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PMID:Diagnosing major depressive disorder XII: can a self-report depression questionnaire be used to examine questions about the DSM-IV diagnostic criteria? 1729 4

The Patient Health Questionnaire-9 (PHQ-9; R. L. Spitzer, K. Kroenke, J. B. W. Williams, & The Patient Health Questionnaire Primary Care Study Group, 1999), modified to ask about the worst period of depression lifetime, was validated against lifetime mood disorder diagnoses established by the Structured Clinical Interview for DSM-IV (SCID; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 2001) in 526 participants. PHQ-9 dichotomous scores corresponded highly with major depressive episode (MDE) Criterion A, MDE, and major depressive disorder (MDD), odds ratios >or= 9.5, and area under the receiver operating characteristic curve (AUC) >or= 0.84. The continuous scale score was higher in participants who did (M=17.14, SD=7.36) than in those who did not (M=6.05, SD=6.29) meet MDE Criterion A, t(524)=18.09, p<.001; was correlated with number of MDE Criterion A symptoms, r(525)=.67, p<.001; and detected MDE Criterion A (AUC=0.88). The PHQ-9 as a lifetime measure may be used to complement or replace more costly interview assessments.
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PMID:The PHQ-9 as a brief assessment of lifetime major depression. 1756 7

The objectives of this study were 1) to determine the prevalence of suicidal ideation (SI) in pregnant women with a history of neuropsychiatric illness, 2) to assess the relative sensitivity of commonly used depression rating scales for detecting SI, and 3) to examine the sociodemographic and clinical predictors of SI in pregnant women. Demographic data, Beck Depression Inventory [BDI] and Hamilton Rating Scale for Depression [HRSD] questionnaires, and SCID interviews were obtained from 383 pregnant women presenting to the Emory Women's Mental Health Program or the Emory Women's Epilepsy Program. Among those who completed both scales, 29.2% endorsed SI on the BDI and 16.9% on the HRSD, with 33.0% endorsing SI on at least one of the rating scales and 13.1% on both rating scales. The rate of SI endorsement on the BDI was 73.3% higher than the HRSD. Multivariate logistic regression demonstrated that SI in pregnant women was associated with unplanned pregnancy (OR = 2.97), current major depression (OR = 4.12), and comorbid anxiety disorder (OR = 4.17). Further studies are warranted to identify additional predictors of perinatal suicidality and to clarify the nature of the association between such factors and the presence of SI in pregnant women.
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PMID:Suicidal ideation in pregnancy: assessment and clinical implications. 1772 40

The aim of this study was to determine the relationship between nocturnal panic attacks and comorbidities, clinical variables and panic attack symptoms. One hundred and six consecutive patients with DSM-IV panic disorder were enrolled in the study. The patients were divided into two groups depending on the presence of nocturnal panic attacks. Comorbidities were diagnosed with the help of SCID-I and SCID-II. The groups were compared using the Beck Depression Inventory, State-Trait Anxiety Inventory and Symptom Checklist. Nocturnal panic attacks were not related to comorbidities or age at the onset of the disease. The scores from the Beck Depression Inventory, general scores from the Symptom Checklist, somatization, obsession-compulsion, interpersonal sensitivity and anger-hostility sub-scale scores were higher in the nocturnal panic attack group. Patients with nocturnal panic attacks experience more frequent respiratory symptoms, suggesting that nocturnal panic attacks may be related to respiratory symptoms. Our findings demonstrate that patients with nocturnal panic attacks have more respiratory symptoms of panic, depressive and other psychiatric symptoms than the no nocturnal panic group.
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PMID:Panic disorder with nocturnal panic attacks: symptoms and comorbidities. 1793 81


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