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

The present study was aimed at replicating, in a sample of Brazilian subjects, findings generated mostly in developed countries on the relative prevalence of alcohol problems, associated psychiatric disorders, family history of alcoholism and other familial psychiatric disorders in alcoholics and controls. A group of Brazilian male alcoholics (n = 103) and controls (n = 63) at first admission to ambulatory or inpatient treatment were interviewed individually using sections of the Structured Clinical Interview for DSM-III-R. Information on demographic characteristics, alcohol-related problems, psychiatric problems and family history of alcoholism and depression were collected from all subjects. Alcoholics had a higher prevalence of a family history of alcoholism, a family history of depression and of a personal history of other psychiatric disorders when compared to controls. Comparisons between FHP and FHN alcoholics, although preliminary, showed few significant differences between these subgroups. Comparisons between FHP and FHN control showed a non-significant trend towards a higher prevalence of psychiatric problems and towards antisocial behaviours among those with a positive family history of alcoholism. The findings point to the importance of cross-cultural studies on genetic and environmental factors related to alcohol dependence.
Addiction 1995 Sep
PMID:Family history of alcoholism and psychiatric co-morbidity in Brazilian male alcoholics and controls. 758 Aug 18

This study used a stress and coping model to examine the process of entering treatment among 515 problem drinkers without prior formal treatment for alcohol abuse who were recruited at alcoholism information/referral (I&R) and detoxification centers. Over a 1-year follow-up period, 76% of the individuals in the sample entered some form of treatment, including Alcoholics Anonymous. People were more likely to enter treatment if they perceived their drinking problem as more severe, had more dependence symptoms, experienced more adverse consequences as a result of drinking, had more symptoms of depression, were more self-derogating, experienced more negative life events in the past year, and/or experienced more stressors in various life domains. Facilitative factors also related positively to treatment entry: people who had sought help from non-formal treatment sources before, who recalled being referred to treatment programs by an I&R center, and/or who received detoxification at a center that had treatment services available on-site, also were more likely to enter treatment. For people with greater resources in multiple life domains the positive effects of days intoxicated, dependence symptoms and stressors on help-seeking were intensified. Overall, the findings suggest that perceived severity of drinking problem plays a central role in the treatment entry process and mediates the effects of many other intrapersonal and environmental variables in generating an impetus or readiness to seek treatment.
Addiction 1995 Sep
PMID:Entering treatment for alcohol abuse: a stress and coping model. 758 Aug 20

Patients in the ICU who require intubation and mechanical ventilation benefit from adequate sedation and analgesia. Traditionally, this has been achieved using benzodiazepines and opioids. Alternatively, propofol is being administered for sedation of patients in the ICU with increasing frequency. Propofol has a number of properties that make it a potentially superior choice for sedation of intubated ICU patients. The rapid onset and offset of sedation with propofol, even after prolonged administration, allow for greater control over the level of sedation and more rapid weaning from mechanical ventilation. In addition, long-term administration of propofol does not appear to be associated with the development of tolerance, addiction, or withdrawal following discontinuation. Propofol suppresses cellular oxygen consumption and carbon dioxide production without increasing anaerobic metabolism. This may be beneficial in patients with severe hypoxemia, hypercarbia, or myocardial ischemia. Finally, the use of propofol may reduce or eliminate the need for other medications in these patients such as muscle relaxants, antihypertensives, lipid nutritional supplements, and analgesics, thereby simplifying their medication regimens and reducing the overall cost of their care while in the ICU. Propofol can be administered to critically ill patients for sedation with a high degree of safety and efficacy. Propofol causes systemic vasodilatation which may result in unwanted hypotension, especially in patients who are already hemodynamically compromised. Propofol also causes ventilatory depression, so its use should be restricted in the ICU to patients whose airway is protected by an endotracheal tube and whose ventilation is closely monitored. Finally, continuous administration of propofol may cause clinically significant hypertriglyceridemia in patients with disordered triglyceride metabolism, or in patients receiving excessive doses of propofol or parenteral lipid supplements. Although propofol is more expensive than equipotent doses of other sedative agents, the additional cost of using propofol for sedation of critically ill patients in the ICU may be more than offset by the savings accrued from faster times to extubation, shorter ICU stays, and the use of fewer medications to manage these patients. Further research needs to be done to determine the potential clinical and cost benefits of using propofol for sedation of patients in the ICU.
 ...
PMID:Propofol: a new drug for sedation in the intensive care unit. 763 54

Opioids are underused by physicians for the treatment of cancer pain. Reasons for this include excessive concern about opioid-induced respiratory depression, tolerance, and addiction, as well as the impact of controlled substances regulations. The negative impact of controlled substances regulations on patient care is not well understood. This paper reviews the historical basis and current structure of the regulatory system. Four potential ways in which controlled substances regulations and policies can affect medical care are discussed: (1) by placing restrictions on physician practice, (2) by affecting patient access to opioids, (3) by stigmatizing patients, and (4) indirectly through physicians' perceptions of regulations, resulting in modified medical practices. Physicians are urged to work with state regulatory agencies to identify regulatory impediments to appropriate patient care.
 ...
PMID:Doctors, opioids, and the law: the effect of controlled substances regulations on cancer pain management. 768 31

Substance abuse is associated diagnostically with existing depression, pathological mourning of the traumatic event itself, with the inevitable experience of object loss, and loss of love. Inability to form object representation insures primitive lack of object constancy, resulting in pre-oedipal longing and neediness and malignant affect. Ambivalence towards the sadistic love objective is recognized and allows for a healthier, more complete period of mourning (Freud, 1917). Indeed, depression is banished from family acknowledgement in the service of homeostatic denial. This only reinforces the identified patient's feeling of unreality, shame and guilt over verbalizing the depression and the frequent underlying traumatic history. The enormous role of socio-economic stress is pervasive, yet the focus here is on individuals with complex dynamic constellations which are often ignored in the face of external factors. Addiction as attempt to self-medicate depression and trauma remains the overarching theme.
 ...
PMID:Substance abuse: the role of depression and trauma--a case report. 777 11

This paper gives a comparison of the approach of the US courts and of the Solicitor's Disciplinary Tribunal in England to disciplinary proceedings concerning lawyers suffering from alcohol dependence and/or depression. A richer case law in the USA indicates a more sophisticated approach, higher standards as to evidence and better support systems for lawyers in recovery. Useful lessons could be learned from the American experience and the experience of doctors and dentists by English lawyers.
Addiction 1994 Oct
PMID:Alcohol and depression in English and American lawyer disciplinary proceedings. 780 84

Religious values in counseling and preferences for religious or secular counseling were investigated in two geographic areas. Over-all, 164 respondents distinguished religious from secular counseling and endorsed the importance of religious issues and the availability of counseling which can deal with religious issues. 51 preferred religious counseling. Small minorities expressed biases against religious or nonreligious counseling. Counseling preferences were based on the type of problem: religious counseling was preferred for marriage and family problems, and nonreligious counseling was preferred for mental illness and addiction, but religious and nonreligious counseling were equally chosen for depression. Frequency of church attendance was broadly related to preferences for religious and nonreligious counseling.
 ...
PMID:Preferences for religious or nonreligious counseling and psychotherapy. 780 29

Optimal pain control in the dying child often requires aggressive opioid therapy that exceeds recommended parameters and may hasten death caused by respiratory depression. For pediatric nurses caring for the dying child, the administration of potentially life-shortening analgesia gives rise to a number of ethical issues. Pediatric nurses often express concern that aggressive pain control is a form of euthanasia or fear the child will develop a drug dependence. Lack of clarity about the ethical obligations and professional responsibilities of nurses who administer potentially life-shortening analgesia may also contribute to the dilemmas surrounding such situations. If left unresolved, these issues can interfere with the nurse's ability to implement an appropriate pain regimen. To provide adequate pain control, pediatric nurses who care for dying children must accomplish the following: critically examine ethical issues and underlying principles; understand the phenomena of addiction, tolerance, and physical dependence; and identify the boundaries of acceptable nursing practice when administering potentially life-shortening analgesia to terminally ill children.
 ...
PMID:Pain management and potentially life-shortening analgesia in the terminally ill child: the ethical implications for pediatric nurses. 781 90

Many of the symptoms of nicotine withdrawal are similar to those of other drug withdrawal syndromes: anxiety, awakening during sleep, depression, difficulty concentrating, impatience, irritability/anger and restlessness. Slowing of the heart rate and weight gain are distinguishing features of tobacco withdrawal. Although nicotine withdrawal may not produce medical consequences, it lasts for several weeks and can be severe in some smokers. Like most other drug withdrawals, nicotine withdrawal is time-limited, occurs in non-humans, is influenced by instructions/expectancy and abates with replacement therapy and gradual reduction. Unlike some other drug withdrawal syndromes, protracted, neonatal or precipitated withdrawal does not occur. Whether nicotine withdrawal is associated with tolerance, acute physical dependence, greater duration and intensity of use, rapid reinstatement, symptom stages, cross-dependence with other nicotine ligands, reduction by non-pharmacological interventions and genetic influences is unclear. Whether nicotine withdrawal plays a major role in relapse to smoking has not been established but this is also true for other drug withdrawal syndromes.
Addiction 1994 Nov
PMID:Nicotine withdrawal versus other drug withdrawal syndromes: similarities and dissimilarities. 784 57

Whereas early formulations of addictive behaviour placed great emphasis upon withdrawal as a defining feature, current views focus more upon compulsive use as its central characteristic. However, the withdrawal syndrome continues to occupy an important place in the study of the addictions. It is interesting both in its own right and in relation to the development and maintenance of the compulsive use of drugs. Despite the attention devoted to withdrawal phenomena over many years, precise demarcation of the withdrawal symptoms associated with drugs of dependence has proved difficult to achieve. Withdrawal from all drugs of dependence appears to lead to mood disturbances although the extent to which these are due to the pharmacological actions of the drugs or to other physiological or psychological processes is unclear. Sleep disturbance is also common, although again direct links with the pharmacological actions of the withdrawn drug are yet to be established. Withdrawal from alcohol, benzodiazepines and opiates is often associated with somatic symptoms. In the former two cases, these can involve sweating, tremor and occasionally seizures. Perceptual disturbances have also been reported. In the case of opiates, flu-like symptoms are often reported, including muscle aches and gastric disturbances. In the case of nicotine, heightened irritability has been established as a direct pharmacological withdrawal effect. Characterization of stimulant withdrawal is still uncertain. There is little evidence of somatic symptoms but depression may occur as a result of a physiological rebound. There is also uncertainty over what role pharmacological withdrawal symptoms play in maintaining compulsive use.(ABSTRACT TRUNCATED AT 250 WORDS)
Addiction 1994 Nov
PMID:Overview: a comparison of withdrawal symptoms from different drug classes. 784 60


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>