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)

Grade of Membership (GOM) analysis, a multivariate technique for studying disease, was used to explore depressive typology and relationships between depression and anxiety. One hundred and ninety patients with RDC diagnoses of major or minor depression were assessed by the Hamilton and SCL-90 symptom rating scales, the Newcastle diagnostic indices for endogenous depression and for anxiety and depression. Demographic, family and treatment response information were used as external validators. Five pure types provided the most satisfactory solution to these data. One group corresponded to classical melancholia, occurring in older, stable, in-patients, who lacked panic-phobic symptoms. All patients with agoraphobia fell into two distinct in-patient and out-patient groups, which differed from each other in several ways. In one group, a link was found between panic attacks, agitated melancholia and familial pure depression. The second group was less symptomatic and had more atypical vegetative symptoms. Two more groups comprised mildly symptomatic, hypochondriacal, depression, and a highly neurotic, obsessive, anxious, non-phobic depression, which was commonly related to a physical stressor.
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PMID:A study of depressive typologies using grade of membership analysis. 336 37

Thirty-four consecutive patients with panic disorder or agoraphobia with panic attacks were treated with nortriptyline at the LAC-USC Medical Center's Anxiety Disorders Clinic. Fourteen (67%) of the 21 completers totally lost their panic attacks, five (24%) showed partial improvement, and two (10%) showed no improvement. The relationship of treatment outcome to pretreatment and posttreatment measures of depression is discussed, in addition to the potential role of nortriptyline in treating panic attacks in clinical practice.
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PMID:Nortriptyline in the treatment of panic disorder and agoraphobia with panic attacks. 337 45

Sixty-five patients with panic disorder and 37 matched controls collected 24-hour urine specimens for measurement of urinary free cortisol. Although patients with panic disorder had significantly higher urinary free cortisol levels than control subjects, this difference was accounted for by panic disorder patients with concomitant depression, agoraphobia, or both. Urinary free cortisol excretion was not related to the age of onset of panic disorder, the number of spontaneous panic attacks, or the degree of impairment associated with the disorder. They were related, however, to the level of symptoms on both the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety in the entire group of panic patients, but this relationship disappeared when those patients with the complications of agoraphobia and depression were excluded. These data suggest that, as with primary depression, depression secondary to panic disorder, as well as to agoraphobia in panic disorder patients, is associated with hyperactivity of the hypothalamic-pituitary-adrenal axis.
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PMID:Relationship of urinary free cortisol levels in patients with panic disorder to symptoms of depression and agoraphobia. 340 39

Phenelzine and imipramine were evaluated in a 5-week double-blind study of outpatients with major depression. Median daily doses of phenelzine 75 mg and imipramine 150 mg were employed. Of 27 patients 26 completed the 5-week study. Both drugs produced an equal overall effect, as measured by the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory (BDI). When patients were grouped on the basis of panic attack symptoms, phenelzine was found to be more effective than imipramine (p less than .05 for all patients on the BDI; p less than .05 for women on both rating scales).
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PMID:An outpatient evaluation of phenelzine and imipramine. 354 5

The fear questionnaire (Marks and Mathews) is presented in an original french translation. The questionnaire's validity, sensibility and reliability are studied in four groups: agoraphobia with panic attacks, obsession-compulsion, social phobia and control. The scale has a good empirical validity especially for agoraphobia measurement. However in our study the boundaries between obsession compulsion and social phobia appear questionable. Principal components analysis yields four factors similar to those found by Marks and Mathews: agoraphobia, blood and injury phobia, social phobia, and anxiety-depression (including one panic item).
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PMID:[Validation and factor analysis of a phobia scale. The French version of the Marks-Mathews fear questionnaire]. 358 63

Sixty-one adolescents hospitalized on an inpatient psychiatric unit were evaluated to determine whether they met criteria for panic and affective disorders according to Research Diagnostic Criteria. Ten (16%) and 15 (24%) met criteria for definite or possible panic disorder. Fifteen (24.5%) had major depressive disorder (MDD) endogenous subtype, 10 (16%) had MDD nonendogenous subtype, 8 (13%) had minor depressive disorder (mDD), and 27 (44%) had no diagnosable mood disorder. Four adolescents with definite panic disorders were diagnosed as having MDD endogenous subtype, three MDD, two mDD, and one had no diagnosable depressive disorder. The mean total score on the Hamilton Rating Scale for Depression (HRSD) was significantly higher among those subjects with definite panic attacks compared with those with either possible or no panic. Patients with definite panic disorder showed significant increases on the HRSD items of guilt, decreased work and interest, psychological and somatic anxiety, and weight loss compared to these samples.
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PMID:Panic and depressive disorders among psychiatrically hospitalized adolescents. 360 14

Sodium lactate infusion provokes panic attacks in panic disorder patients but not in normal controls. We have previously shown that patients who develop panic disorder during a major depressive episode are similar to panic disorder patients in their rate of panic attacks with lactate. In the present pilot study, nine patients with major depression without panic attacks underwent lactate infusions. These patients differed significantly from panic disorder patients but not from controls in their response to lactate. This argues for the specificity of lactate sensitivity for the phenomenon of panic attacks and gives further evidence for biological differences between panic and depression.
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PMID:Lactate infusions in major depression without panic attacks. 368 59

The effects of one night's sleep deprivation on mood and behavior were evaluated in 12 patients with panic disorder, ten depressed patients, and ten controls. In contrast to the improvement in symptoms of anxiety and depression shown by the majority of depressed patients, the response of patients with panic disorder as a group did not differ from that of normal controls, although a subgroup did experience noticeable worsening in their symptoms of anxiety, with 40% experiencing panic attacks on the day following sleep deprivation. Electroencephalographic recordings with nasopharyngeal electrodes on the day following sleep deprivation were normal, further suggesting that patients with panic disorder do not have seizure activity characteristic of temporal lobe epilepsy.
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PMID:Effects of one night's sleep deprivation on mood and behavior in panic disorder. Patients with panic disorder compared with depressed patients and normal controls. 375 67

One hundred++ ninety-five primary care patients were screened for panic disorder utilizing the National Institute of Mental Health Diagnostic Interview Schedule (DIS) as well as four additional questions that screened for core autonomic symptoms of panic disorder. A spectrum of severity of panic disorder was found. A subgroup of patients, labeled in the study as having simple panic, was found to have anxiety attacks associated with four or more autonomic symptoms, but they did not meet DSM-III recurrence criteria (three anxiety attacks within a 3-week period). Compared to primary care patients without panic attacks, patients with both simple panic and panic disorder exhibited multiple phobias, avoidance behavior, a high lifetime risk of major depression, and elevated scores on self-rating scales of anxiety and depression. The four autonomic screening questions that the authors added to the DIS interview increased the sensitivity of the DIS in identifying patients with panic disorder. Patients with panic disorder who selectively focus on their frightening autonomic symptoms may not be identified by screen questions that only focus on the cognitive awareness of anxiety.
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PMID:Panic disorder. Spectrum of severity and somatization. 380 66

This article has reviewed clinical and demographic features of the primary anxiety disorders and other psychiatric and medical disorders that often are associated with anxiety symptoms, highlighting differential diagnosis. In summary, phobic disorders (exogenous anxiety) are characterized by anxiety reliably elicited by specific environmental stimuli; the stimuli involved determine which type of phobia is diagnosed. In contrast, panic attacks and generalized anxiety (endogenous anxiety) involve symptoms of anxiety not associated only with specific eliciting stimuli. Panic disorder is differentiated from generalized anxiety disorder by the presence of discrete attacks; both disorders usually have some level of persistent anxiety. Obsessive-compulsive disorder is characterized by recurrent unwanted but irresistible thoughts and the ritualized repetitive acts resulting from these obsessions, in the absence of preexisting psychosis or depression. Finally, posttraumatic stress disorder involves various anxiety (and other) symptoms as a direct result of an obvious stressor. Depressive symptoms are frequently associated with anxiety. It is sometimes impossible to determine which is the primary disorder. Overlap of syndromes probably also occurs with other primary psychiatric disorders, especially somatoform disorders, adjustment disorder with anxious mood, and several personality disorders. Finally, primary anxiety can be confused with several medical syndromes, especially when the medical disorder has not been recognized. Nevertheless, research with patients with pheochromocytoma suggests that medical causes of anxiety may be qualitatively different from primary anxiety disorders, especially the psychic anxiety component. Attention to the clinical and demographic features listed in Table 4, as well as the use of newly-developed structured diagnostic interviews should usually lead to a correct diagnosis, as illustrated by the following examples. The onset of a fear of public speaking in mid-adolescence suggests an uncomplicated social phobia, whereas the onset in the mid-twenties of several social and other situational anxieties in a person with a previous history of panic attacks would be strongly suggestive of the panic-agoraphobia syndrome. The new onset of generalized anxiety symptoms and depression in a 45-year-old patient who has had a previous significant depression would suggest that this person's anxiety is part of, and secondary to, the affective disorder and not a primary anxiety disorder.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The differential diagnosis of anxiety. Psychiatric and medical disorders. 388 37


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