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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The objective of this study was to compare the safety and efficacy of paroxetine with imipramine and placebo in depressed outpatients. Following a 4- to 14-day placebo washout, patients were randomized into treatment groups and received study compound for up to 42 days. At Day 42, paroxetine was significantly more effective than placebo (p less than .05) in several observer- and patient-rated scales: the Retardation and Anxiety/Somatization factors of the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Asberg Depression Rating Scale (MADRS), the Raskin Depression Scale, the Covi Anxiety Scale, the Clinical Global Impressions (CGI) Improvement Scale, the Symptom Checklist-56 (SCL-56) Total, and the Patient's Global Evaluation (PGE). There were no significant differences between paroxetine and imipramine. Significantly more imipramine (75%) than paroxetine (35%) or placebo (23%) patients reported anticholinergic side effects, including blurred vision (5%, 0%, and 0%, respectively), constipation (35%, 8%, and 15%, respectively), and dry mouth (63%, 25%, and 15%, respectively). The data from this study indicated that paroxetine is a safe, well-tolerated, effective treatment for major depressive disorder.
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PMID:A placebo- and imipramine-controlled study of paroxetine. 214 97

In comparison with older adults living in the community, elders who are institutionalized are older, sicker, and more likely to have no living family members, factors that place them at risk for suicide. Somatization, or physical suffering, is a frequently overlooked symptom of elderly depression, perhaps because it is falsely assumed that such symptoms expressed by the older adult are normal concomitants of aging. Strengthening and extending existing family roles in supporting the elder who is suicidal and depressed is vital to reducing loneliness, emotional pain, loss of independence, and to increasing self-concept. An expanded knowledge of mental health needs of older adults and their families is critical in suicide prevention. A major step toward prevention is the recognition of depressive symptomatology and key elements and clues to suicide in the institutionalized elderly.
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PMID:The suicidal patient in long-term care institutions. 230 71

The level of dyspnea reported by the patient with chronic obstructive pulmonary disease is related to both the physiologic and psychologic state of the person at the time. The purpose of this pilot study was to explore, from a psychophysiologic perspective, the differences in anxiety, depression, and somatization during times of high and low levels of dyspnea. Six male subjects with chronic obstructive pulmonary disease, with a mean age of 64 years and a mean forced expiratory volume in 1 second that was 44% of predicted, completed the study. They were assessed for clinical signs and their level of dyspnea indicated on a vertical visual analogue scale, after which they completed the Spielberger State Anxiety Inventory and the Brief Symptom Inventory. Arterial blood was then drawn for blood gas analysis and determination of cortisol level. All measures were repeated twice, once when the subject reported a high level of dyspnea and once when he reported a low level. Analysis of the data by use of t tests for paired groups indicated that during times of high dyspnea levels subjects had greater anxiety, accessory muscle use, cortisol level, and PCO2 level. Subjects receiving oral prednisone had high depression levels that increased during times of severe dyspnea. Somatization, PO2, respiratory rate, depth of respiration, and other clinical signs did not change with dyspnea level. These results indicate that dyspnea is accompanied by both psychologic and physiologic changes that can be targeted to assist in alleviating this distressing symptom.
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PMID:Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study. 234 Dec 63

This exploratory study investigates the overlap of somatization and depressive symptoms among older Jewish-Soviet immigrants to the United States. It has been suggested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatization subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Compared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.
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PMID:Somatic symptoms among older Soviet immigrants: an exploratory study. 262 79

Coping strategies used by 315 persons providing care to a spouse diagnosed with Alzheimer's disease were characterized as either emotion-focused (wishfulness, acceptance, intrapsychic) or problem-focused (instrumental). Models in which coping strategies were postulated as having mediator, moderator, and independent main effects were tested using multiple indexes of mental health. Wishfulness and intrapsychic strategies mediated the relationship between degree of stress and CES-D, Anxiety, and Depression. Wishfulness had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; intrapsychic strategies had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; and instrumental strategies had a direct effect on Positive Affect. Hierarchical regression analyses indicated that stressors and coping strategies explained between 12% and 40% of the variance on mental health indexes.
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PMID:Mental health of caregiving spouses: coping as mediator, moderator, or main effect? 269 19

Somatization has been widely reported among refugee psychiatric patients since World War II, and some psychological theorists have viewed somatization as an alternative to depression. These and other theories were tested in a population survey of 97 Hmong refugees who had lived in the U.S. for several years. Four different measures of somatization were employed, including a 12-item self-rating scale, a single-item global rating based on the total interview, and somatic subscales of the two Hamilton interview-rating scales. These data demonstrate that somatization accompanies certain demographic characteristics that are associated with failure to acculturate. Somatization in this non-patient, refugee population was associated with treatment seeking and self-identified "medical problems" and with psychiatric symptoms and disorders, but not with objective evidence of medical disorder.
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PMID:Somatization among refugees: an epidemiologic study. 278 28

Demographic, clinical and psychological characteristics of 92 patients with low back pain were correlated with prolactin and cortisol levels in cerebrospinal fluid (CSF). Somatization and depression scores correlated statistically significantly with the CSF serum ratio of prolactin both in men and in the total group. An increased CSF/serum ratio of cortisol was slightly associated with somatization scores in the total group. Multiple stepwise regression, furthermore, revealed that somatization, anxiety and one of the pain indices contributed to the variance in the CSF prolactin level, which was mostly dependent on the respective serum level. Sex and electromyographic findings (EMG) accounted for 12 and 7%, respectively, of the variance in the afternoon cortisol levels. Women reported more somatization and depression feelings than did men. Most of the data support our earlier assumption that male and female pain patients have different coping mechanisms. In spite of the common underlying endocrine responses to distress in men and women, gender differences in psychological response appear to modify endocrine responses to the experience of low back pain.
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PMID:Prolactin and cortisol responses to the experience of low back pain. 293 25

Clinical observations suggest that anxiety, depression, rage, and alienation might profitably be considered to be criteria for the diagnosis of post-traumatic stress disorder (PTSD). The results of this investigation (N = 69) suggest that inclusion of these variables among the PTSD criteria would be inappropriate. Somatization and/or hypochondriacal fixation, however, appears to be intimately related to combat traumatization and might appropriately be considered for inclusion among the symptoms associated with PTSD. The DSM-III stress-disorder criteria contain five elements that, among substance-abusing veterans, contribute marginally to the diagnosis of PTSD. Accuracy in evaluating for PTSD might not be compromised by considering fitful sleep, concentration problems, memory impairment, memory interference, and survivor guilt to be associated phenomena rather than PTSD criteria. The results are generally consistent with modifications in diagnostic practice suggested in DSM-III-R.
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PMID:Completeness and internal consistency of DSM-III criteria for post-traumatic stress disorder. 319 9

This study was designed to see whether the high vs low serum level of imipramine influenced the outcome of in vivo exposure therapy on patients with agoraphobia. Thirty-six subjects completed the Hopkins Symptom Checklist-90 one week before treatment and weekly throughout treatment. Both groups demonstrated equal improvement. It was noted that the rate of improvement differed for different symptom subscales: (1) Hostility, Paranoia and Psychotic symptom ratings improved over the first three weeks of treatment, (2) Interpersonal Sensitivity, Anxiety and Depression ratings improved throughout the first seven weeks of treatment and (3) Phobic Anxiety, Somatization and Obsessive Compulsure symptom ratings continued to improve throughout the entire 12 week course of treatment. Responsive vs nonresponsive subjects could be significantly differentiated after one week of treatment on the basis of their responses to the Psychoticism subscale.
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PMID:Different rates of improvement of different symptoms in combined pharmacological and behavioral treatment of agoraphobia. 320 96

This study examined the relation of eating attitudes and behaviors to family dynamics and psychological adjustment in a nonclinical group of female university freshmen. Family dynamics variables, which were measured by the Family Environment Scale (FES), included Control, Cohesion, Conflict, Organization, Expressiveness, Independence, Achievement-Orientation, Intellectual-Cultural Orientation, Active-Recreational Orientation, and Moral Religious Emphasis. Psychological adjustment was measured by the Hopkins Symptom Checklist (HSC). Variables on this scale included Anxiety, Depression, Somatization, Obsessive-Compulsive, and Interpersonal Sensitivity. Eating attitudes and behaviors were measured by the Bulimia Test (BULIT), a 32-item self-report inventory. Multivariate analysis of variance indicated that bulimics, subclinical bulimics, and normals could be differentiated on the Hopkins Symptom Checklist. Univariate analyses revealed differences between the groups on all of the HSC measures and the Organization scale of the FES. The results suggest that conclusions about the causal relationships between maladaptive family patterns and bulimia presented in previous research should be viewed with caution.
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PMID:Bulimia: a comparison of psychological adjustment and familial characteristics in a nonclinical sample. 321 22


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