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 incidence of depression ranges between 3% and 98% in chronic alcoholism. This discrepancy has been attributed to the lack in univocal diagnostic criteria and to poor attention to the moment when the observation takes place. In patients with chronic alcoholism, accurate clinical examinations are required to make a diagnosis of depression; furthermore, the presence of continuous alcohol abuse, or the condition of initial of prolonged abstinence must be considered. Using these criteria the diagnosis of depression in chronic alcoholism will probably become more reliable and will be possible to carry out a more appropriate therapy.
 ...
PMID:[Diagnosis of depression in chronic alcoholism: methodological aspects]. 297 68

Ethanol, a highly lipid-soluble compound, appears to exert its effects through interactions with the cell membrane. Cell membrane alterations indirectly affect the functioning of membrane-associated proteins, which function as channels, carriers, enzymes and receptors. For example, studies suggest that ethanol exerts an effect upon the gamma-aminobutyric acid (GABA)-benzodiazepine-chloride ionophore receptor complex, thereby accounting for the biochemical and clinical similarities between ethanol, benzodiazepines and barbiturates. The patient with acute ethanol poisoning may present with symptoms ranging from slurred speech, ataxia and incoordination to coma, potentially resulting in respiratory depression and death. At blood alcohol concentrations of greater than 250 mg% (250 mg% = 250 mg/dl = 2.5 g/L = 0.250%), the patient is usually at risk of coma. Children and alcohol-naive adults may experience severe toxicity at blood alcohol concentrations less than 100 mg%, whereas alcoholics may demonstrate significant impairment only at concentrations greater than 300 mg%. Upon presentation of a patient suspected of acute ethanol poisoning, cardiovascular and respiratory stabilisation should be assured. Thiamine (vitamin B1) and then dextrose should be administered, and the blood alcohol concentration measured. Subsequent to stabilisation, alternative aetiologies for the signs and symptoms observed should be considered. There are presently no agents available for clinical use that will reverse the acute effects of ethanol. Treatment consists of supportive care and close observation until the blood alcohol concentration decreases to a non-toxic level. In the non-dependent adult, ethanol is metabolised at the rate of approximately 15 mg%/hour. Haemodialysis may be considered in cases of a severely ill child or comatose adult. Follow-up may include referral for counselling for alcohol abuse, suicide attempts, or parental neglect (in children). The ethanol withdrawal syndrome may be observed in the ethanol-dependent patient within 8 hours of the last drink, with blood alcohol concentrations in excess of 200 mg%. Symptoms consist of tremor, nausea and vomiting, increased blood pressure and heart rate, paroxysmal sweats, depression, and anxiety. Alterations in the GABA-benzodiazepine-chloride receptor complex, noradrenergic overactivity, and hypothalamic-pituitary-adrenal axis stimulation are suggested explanations for withdrawal symptomatology.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Acute ethanol poisoning and the ethanol withdrawal syndrome. 304 Dec 44

Of 22 patients investigated for sleep disorders, habitual snoring and/or daytime hypersomnolence, 12(10 men) had obstructive sleep apnea syndrome (OSAS). 3 OSAS were mild, 5 moderate and 4 severe. The leading symptoms were daytime hypersomnolence and habitual snoring. As risk factors we found retro-micrognathia in 2 patients, macroglossia secondary to acromegaly in 1, alcohol abuse in 7 and obesity in 6. Conservative measures improved the disorder subjectively in 6 patients. One patient had a relapse 6 months after uvulopalatopharyngoplasty. 4 patients were successfully treated by nasal CPAP. Other diagnoses were idiopathic alveolar hypoventilation (2), Cheyne-Stokes breathing secondary to low cardiac output (1), monosymptomatic narcolepsy (2), sleep disturbances secondary to depression (2), chronic benzodiazepine abuse (1) and chronic bronchitis without nocturnal hypoxemia (1). History, clinical observation and oxymetry make diagnosis possible in most cases of OSAS severe enough to require treatment. Polysomnography is time-consuming and should be reserved for selected cases.
 ...
PMID:[Sleep-apnea syndrome. Elucidation, therapy and course]. 305 35

When alcohol abuse occurs with depression, both the substance abuse and the mood disorder necessitate treatment. These conditions may have some similar manifestations, making differential diagnosis difficult. Depressed alcoholics report more previous treatment for substance abuse, withdrawal symptoms, and marital problems than those without depression. They also incur greater loneliness, unemployment, and social ineptness. Depressive symptoms found commonly in this group include work inhibition, guilt, self-disgust, dissatisfaction, and social disinterest. A history of depression among relatives favors a dual diagnosis of alcoholism and depression. Distinguishing those alcoholics with specific depressive illness enhances the therapeutic efficacy. Alcohol abusers need treatment, but those with concomitant depression persisting well beyond detoxification often require antidepressant medications. In long-term care, lithium may reduce alcohol-related rehospitalizations. A strong doctor-patient relationship with or without pharmacotherapy promotes continuation in a therapeutic regimen. Involvement in Alcoholics Anonymous and disulfiram maintenance therapy are other deterrents to drinking relapse.
 ...
PMID:Depression and alcoholism: clinical considerations in management. 305 16

Major types of coping responses are described and the problems with the measurement of coping behavior are discussed. The Coping Response Inventory is introduced. Family and work resources provide a social context for coping: An integrating framework is described. First results of the association between coping responses and the process of remission and relapse in depression and alcohol abuse are presented.
 ...
PMID:[Coping: concepts and measuring procedures]. 306 7

The number of elderly women is growing in absolute numbers and in proportion to the U. S. population. Current epidemiologic research indicates that the most frequent psychiatric disorders among older women are phobias, severe cognitive impairment, dysthymia, and major depressive episode without grief. The rates of all of these disorders, except for cognitive impairment, are lower for older than for younger women. The rates of psychiatric disorders in older women are higher than in older men, except for alcohol abuse-dependence, which is higher in men. Depression is a common psychiatric problem in older women. The differential diagnosis includes other medical disorders, drug effects, normal grief, and early dementia. Older depressed women may present with physical complaints rather than complaints of depression, and thus be misdiagnosed. Treatment consists of psychotherapy, antidepressant medication, and activities to improve self-esteem. Dementia affects 4 percent of elderly women over age 65, and 20 percent of those over age 85. The most common cause is Alzheimer's disease. Current research is focusing on abnormalities in the cholinergic system in the brain. A careful psychiatric evaluation may identify medical conditions, including depression, which can be treated and can lead to improvements in the patient's functioning.
 ...
PMID:Mental health and older women. 312 Feb 18

The frequencies of 15 self-reported symptoms of cocaine withdrawal were compared in 75 subjects to the symptoms listed as criteria by DSM-III and DSM-III-R for either amphetamine or cocaine withdrawal. Three of the four most frequently reported symptoms, depression (75%), sleep disturbance (71%), and fatigue (69%), corresponded to DSM-III and DSM-III-R criteria. The only other DSM-III symptom, increased dreaming (33%), was infrequently reported, lending support to its deletion by DSM-III-R. Physical withdrawal symptoms, which are generally unappreciated in cocaine withdrawal, were reported by 64% of the sample. Neither the DSM-III criteria nor the new DSM-III-R criteria include other frequent symptoms which might contribute to relapse and impaired functioning, such as craving (69%), apathy/amotivation (67%), and restlessness (64%). Thus, these criteria may be too narrowly defined for treatment purposes.
Am J Drug Alcohol Abuse 1988
PMID:A comparison of self-reported symptoms and DSM-III-R criteria for cocaine withdrawal. 318 56

During a 2.5-yr follow-up of 263 opioid addicts, suicidality was examined as a predictor of outcome and as an outcome to be predicted among initially nonsuicidal addicts. Suicidality predicted poor medical, psychosocial, and substance abuse outcomes, but fewer legal problems during follow-up. Among the 218 initially nonsuicidal opioid addicts, subsequent suicidality was not associated with a history of drug overdoses, and psychosocial factors predictive of future suicidality differed from factors associated with a history of overdoses. Factors associated with overdoses included alcoholism, poor social adjustment, and legal problems, while depression, neuroticism, and family problems predicted suicidality during the subsequent 2.5 yr.
Am J Drug Alcohol Abuse 1988
PMID:Suicidality among opioid addicts: 2.5 year follow-up. 318 57

The MMPI and MCMI were administered to 163 former opiate addicts who were being maintained in a methadone program affiliated with an urban hospital. Highest group mean MMPI scores were found for Psychopathic Deviate, Depression, Hypomania, and Hysteria. For the MCMI, highest group mean clinical syndrome scores were found for Drug Abuse, Alcohol Abuse, Anxiety, and Dysthymia; highest personality disorder scores were found for Antisocial, Narcissistic, Histrionic, and Paranoid. The MCMI Drug Abuse Scale identified only 49% of subjects as having a recurrent or recent history of drug abuse. Frequency and factor analyses documented the heterogeneity of the population with respect to clinical syndromes, as well as the prevalence of personality disorders (86% had elevations on MCMI Personality Scales). Factor and correlational analyses did not provide strong evidence of similar factor structure or convergent validity of the MMPI and MCMI with this population.
Am J Drug Alcohol Abuse 1988
PMID:Psychopathology of opiate addiction: comparative data from the MMPI and MCMI. 321 33

One hundred and fourteen patients with a diagnosis of "treatment resistant depression" (TRD) were assessed and treated at a Mood Disorders Clinic. Diagnostically, 52 (45.6%) subjects met criteria for bipolar disorder, 49 (42.9%) for recurrent depression, and 13 (11.4%) patients did not fulfill diagnostic criteria for affective disorder which explained their treatment resistance. With appropriate, individualized treatment, 59 of 98 (60.2%) patients had complete symptom remission based on clinical and psychometric ratings (initial Ham-D 26.7, final Ham-D 5.9). Eighteen of 98 patients had partial remission (final Ham-D 15.9) with vigorous pharmacological interventions, and 8 subjects exhibited "absolute" TRD (final Ham-D 23.4). The results suggest the value of specialized mood disorder services. The partial and absolute TRD's were more likely to be older, received more Axis II diagnoses, and had previous histories of drug or alcohol abuse.
 ...
PMID:Treatment resistant depression: a clinical perspective. 276 99


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