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)

Symptoms compatible with a diagnosis of anxiety disorder frequently complicate the course of affective illness. Patients with depression may have panic attacks, phobias, severe social anxiety, obsessions, compulsions, and generalized anxiety. If the affective disorder is the primary condition, its treatment should be sufficient in most instances to relieve the concomitant anxiety symptoms. Thus, judicious choice of antidepressant therapy for treatment of major and atypical depression will usually resolve associated panic attacks, generalized anxiety, phobias, and compulsions. It must be recalled, however, that antidepressant therapy usually takes between 4 and 6 weeks to have full clinical effect; in the interim, anxiety symptoms may be the most troubling and disabling aspect of the illness. Therefore, using antianxiety agents in treating depressed patients who also have anxiety symptoms is often recommended while waiting for the antidepressant to work. Benzodiazepines are extremely useful for short-term treatment of most anxiety symptoms in depressed patients. The dose should be kept to the lowest possible to relieve symptoms, and the medication should be tapered and then discontinued once the underlying affective disturbance is relieved. Buspirone is also very effective in treating generalized anxiety disorder and may be used in conjunction with antidepressants of most classes. A wide range of behavioral and cognitive techniques may also help relieve anxiety symptoms in the depressed patient.
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PMID:Treatment of anxiety disorder in patients with mood disorders. 221 75

In an initial study with 120 patients with reactive mood and associated atypical symptoms, phenelzine sulfate was superior to imipramine hydrochloride and placebo. Since their response to phenelzine appears to be unique, this suggests that atypical depression may be a distinct subgroup of unipolar depressive illness. Unexpectedly, the benefit of antidepressants was limited to patients who also had spontaneous panic attacks. To help establish the validity of this syndrome, a new sample of 90 atypical depressives was studied. The clinical and demographic characteristics of the original and replication sample were virtually identical at baseline. In addition, the treatment response with either placebo, imipramine, or phenelzine was also indistinguishable in the two patient groups. The outcome in the replication study supports the hypothesis that this may be a distinct unipolar depressive subgroup. In the replication sample, a history of panic attacks did not appear to be a relevant predictor. We discuss the explanations for this discrepancy in the two patient samples.
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PMID:Atypical depression, panic attacks, and response to imipramine and phenelzine. A replication. 222 32

The relationship between substance abuse and panic-related anxiety can be divided into two broad areas: the incidence of anxiety disorders in substance abuse patients and the incidence of substance abuse in patients with panic-related anxiety disorders. Studies indicate that approx. 10-40% of alcoholics have a panic-related anxiety disorder, and about 10-20% of anxiety disorder patients abuse alcohol or other drugs. The majority of patients with both an anxiety and alcohol disorder report that anxiety problems preceded alcohol problems. In some cases substance abuse (e.g. cocaine) triggers the onset of panic attacks. Most patients believe that self-medication is efficacious despite the fact that they appear to have a more serious clinical condition (e.g. higher rates of depression). Directions for future research are outlined, including the proposal for a study to examine the effects of an anxiety intervention procedure for anxious alcoholics to reduce relapse rates.
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PMID:Substance abuse and panic-related anxiety: a critical review. 225 96

The problem of multiple diagnoses in the same patient is a very real one in psychiatry. Theoretical causes of disease associations are reviewed and illustrated with examples from a variety of psychiatric conditions. These include Huntington's disease and depression, mitroprolapse and panic attacks, anxiety disorder and depression, and others.
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PMID:The application of genetic methods to the study of disease associations in psychiatry. 228 Oct 7

Studies of familial transmission, twin concordance, epidemiologic patterns, and diagnostic stability on follow-up all support the fundamental separation of affective and anxiety disorders. The importance of subdividing cosyndromal conditions by the presumed primary illness follows logically from these data, and convention suggests the use of temporal sequencing to do this; however, evidence that this approach is successful is modest. At a practical level, panic attacks seem to indicate a depression of greater severity and poorer overall prognosis. Moreover, obsessions and compulsions that develop within depressive episodes tend to differ in their themes from those that develop autonomously, and depression may precipitate only certain types of phobias. Finally, panic attacks may predict better responses to MAOIs and poorer responses to conventional tricyclic antidepressants. All of these conclusions are based on a relatively small amount of literature. Interest in this topic has grown rapidly in the past decade, and subsequent reviews will draw different, or at least additional conclusions.
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PMID:Anxiety secondary to depression. 228 Oct 13

A total of 383 cases of incident panic attack were identified among 12,823 participants in the Epidemiologic Catchment Area Program over various 12-month periods in 1980-1983. These cases not phobia-stimulated were compared with 766 controls. Risk factors were examined for the onset of panic attacks, with attacks categorized as panic disorder, severe and unexplained panic attacks, or other panic attacks. Risk factors were also examined for the onset of attacks in which cardiovascular symptoms were experienced and those in which psychologic symptoms were experienced. Females were at greater risk than males for each category of attacks (relative odds ranged from 1.36 to 2.25). Persons aged 65 years or older were at lower risk than younger persons (relative odds, compared with 30- to 44-year-olds, ranged from 0.26 to 0.71). A history of cardiac symptoms, shortness of breath, depression or a major grief episode, drug abuse or dependence, alcohol abuse or dependence, and seizures were each strongly associated with panic attacks. A history of cardiac symptoms was more strongly associated with attacks in which cardiovascular symptoms were experienced than with attacks in which psychologic symptoms were experienced (relative odds, 8.36 vs. 2.23). A history of seizures was more strongly associated with attacks with psychologic symptoms than with attacks with cardiovascular symptoms (relative odds, 5.21 vs. 1.58).
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PMID:Risk factors for the onset of panic disorder and other panic attacks in a prospective, population-based study. 229 82

The effectiveness of an integrated treatment program utilizing cognitive-behavioral therapies for Panic Disorder was examined. Treatment was comprised of Cognitive Model of Panic-derived procedures, Cognitive Therapy and Applied Relaxation Training. Subjects meeting DSM-III-R criteria for Panic Disorder received thirteen 2.5-hr sessions of outpatient therapy in small groups, over a 12-week period. Subjects were given an extensive rationale of the etiology, development and maintenance of Panic Disorder, within the framework of the Cognitive Model of Panic, and controlled behavioral experiments in panic evocation to internal panicogenic cues, cognitive reappraisal of somatic and ideational cues, breathing retraining, Applied Relaxation Training and Cognitive Therapy to identify and remediate maladaptive beliefs and dysfunctional cognitive schemas. A comprehensive assessment battery was given at pre-mid-post-treatment which included measures of tripartite functioning, global severity, panic, fear, anxiety, depression and psychiatric symptomatology. Analyses indicated statistically significant improvements across all outcome domains. All subjects were free of spontaneous (uncued) panic attacks at post-treatment, and all met operationalized criteria for high endstate functioning. These findings are discussed, with recommendations for future research.
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PMID:Panic disorder: cognitive-behavioral treatment. 232 32

Adults in a village in Lesotho, Africa, were interviewed to determine the community prevalence of major depression, panic disorder, and generalised anxiety disorder. The prevalence data were compared with data from a large epidemiological study in the United States utilising the same research instrument. There was a significantly higher prevalence of all three diagnoses in Lesotho as compared with the United States. As in the United States, women were at an increased risk for these disorders, although statistical significance was not demonstrated for depression. The majority of people (77%) who had experienced panic attacks said they had sought help for their symptoms, with the majority attending Western-trained doctors. The relationship between explanatory models and help-seeking behaviour was explored in people who had had panic attacks. Less than 40% of those with generalised anxiety disorder said they sought help.
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PMID:Anxiety and depression in a village in Lesotho, Africa: a comparison with the United States. 234 32

Psychopathological analysis of the patterns of symptoms in 176 depressive in-patients disclosed in 73.3% of all patients the presence of anxiety symptoms: of these, 38.6% merely had diffuse anxiety, whereas 34.7% showed either additionally or alone specific anxiety symptoms such as phobias and panic attacks. Similar to the results obtained by dividing the patients into an "endogenous" and "neurotic" group, namely, that there was no difference between the subtypes in respect of triggering the depressive episodes by life events, or in respect of the suicide rate 30 months after discharge and in respect of a chronic course developing during the 2 years following the discharge, there was likewise no difference with regard to these criteria if the patients were subdivided into depressive patients without anxiety and those with anxiety symptoms. However, a subdivision of the depressive patients with anxiety symptoms into a group having only free-floating anxiety and a group with specific anxiety symptoms, resulted in a clear association with these criteria: If a phobia or panic attacks were present, triggering by life events was far more frequent than if there was only free-floating was more often chronic in the first group, but there was no difference in suicidality. The results indicate that it will be necessary to provide for a more differentiated classification of anxiety symptoms before deciding in clinical routine what steps to take wherever depression and anxiety symptoms are present side by side. The same applies to treatment studies.
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PMID:[Depression and anxiety--a study for validating subtypes of depression]. 239 38

Low thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) has been repeatedly described in approximately 25% of patients with major depression. Panic disorder appears related to depression along several dimensions, including prevalence of low TSH response to TRH. The authors divided 46 patients with primary unipolar depression by gender and by presence or absence of concurrent panic attacks and compared their TRH test results with those of 106 normal control subjects, controlling for confounding variables. Depressed patients with panic had higher prevalence of low TSH response and significantly lower mean TSH response than depressed patients without panic. The latter were indistinguishable from normal control subjects.
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PMID:TSH response to TRH in depression with and without panic attacks. 249 97


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