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

Clinical and basic research units depressive disorders in late life have expanded our knowledge base appreciably in recent years. In the process, some clinical impressions have been confirmed (e.g., the association of depression and physical disorders); others have been refuted (e.g., depression increases with age); and now phenomena have been identified (e.g., the discovery of leukoencephalopathy in depressant elders who respond to ECT). The field of study now encompasses a range from neurobiology to sociocultural factors. The latter twentieth century is an exciting and optimistic era for clinicians working with depressed elders. As Sir Martin Roth has often said, "Where there is depression in late life, there is hope."
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PMID:Depression in late life: an update. 251 65

Sir Martin Roth has stated, "where there is depression, there is hope," to emphasize the fact that depression can be a treatable source of excess disability, even when it is superimposed upon irreversible chronic medical illness. Both the potential benefits and the risks of antidepressant medications are increased in the frail elderly. This article presents an approach toward defining who should be treated and for ensuring that elderly patients receive adequate treatment.
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PMID:Use of antidepressants in the frail elderly. When, why, and how. 327 92

1 Roth et al. (1972) have proposed that within the affective disorders there are two distinct syndromes--anxiety and depression--differentiated by the relative predominance of these symptoms, the presence or absence of premorbid maladaptive traits, and the natural outcome of the disorder. 2 Goldberg (1982) on the other hand has suggested that there is a substantial overlap between the two syndromes, and the symptoms of anxiety and depression correlate highly with each other. 3 Patients tend to be treated with an anxiolytic or an antidepressant drug according to the predominance of anxiety or depressive symptoms. 4 There is conflicting evidence regarding the relative effectiveness of tricyclic antidepressants in psychotic (or endogenous) and neurotic (or reactive) depressive illness. Paykel (1972), however, found that the psychotic-neurotic dichotomy was not helpful in predicting outcome, whereas anxious depressives tended to respond poorly. 5 In three patients with affective illness, tested at regular intervals over the course of several weeks, anxiety and depressive symptoms fluctuated in a way which suggested that they were yoked to each other. A worsening indicated simultaneous deterioration of these symptoms. When they improved, this may have been due to the beneficial effects of the antidepressant drug administered. These findings suggest that antidepressants act, or fail to act, in a fundamental manner on the illness itself rather than on individual symptoms.
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PMID:Observations on the relationship between anxiety and depressive symptoms during the course of depressive illnesses. 682 50

A test of memory and learning with guaranteed initial stimulus-processing was validated and is here presented with norms for 70-79 year old and 80-89 year old community residents vs. nursing-home residents. The test procedure also allows incidental observation of stereognosis, object-naming, and left-right orientation, screens for depression, and elicits rapid retrieval of words from semantic categories--all common aspects of evaluation for dementia. A validation study showed a significant difference between 21 moderately impaired and 21 unimpaired elderly nursing home residents grouped by their scores on Blessed, Tomlinson and Roth's (1968) "mental test". Reliability was determined by coefficient alpha, which yielded an estimated correlation of .84 between recall (retrieval) scores and errorless true scores. Storage scores were correlated .72 with retention after three weeks (p. less than .01), and storage and retrieval were not significantly correlated with each other when mental status was partialed out. Storage impairment appeared more significant in dementia than retrieval impairment, which occurred in normal aging as well. Norms for community-active vs. nursing-home-residing 70 and 80 year olds are provided which allow the separate evaluation of total recall, storage, retrieval, and response to reminders.
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PMID:Guaranteed stimulus-processing in the evaluation of memory and learning. 747 66

The subject of mixed anxiety depression has been the topic of a somewhat confused discussion. At one point, it was held that anxiety and depression were both manifestations of an underlying affective disorder, but systematic work by Martin Roth and others clearly demonstrated that anxiety disorders could be separated from depressive disorders via a multivariate scale. Interestingly, spontaneous panic attacks were among the highest loading items on this scale. Nonetheless, it was plain that many patients were simultaneously anxious and depressed. Interest then grew in understanding the evolution of these syndromes over time. In general, anxiety syndromes antecede depressive syndromes, although there are many exceptions. For instance, some people only develop panic attacks when in the midst of a depressive episode. To attempt to understand these complexities, detailed family studies have been attempted with often contradictory results. We shall present family study data indicating that patients with comorbid panic disorder and depression have different familial patterns from those with panic disorder alone. In addition, a practical question is whether there exist patients, primarily in private settings, who present with symptoms of anxiety and depression but do not meet full criteria for any of the currently defined syndromes. Such patients are often referred to as subsyndromal or subthreshold patients. Epidemiological data indicates that such patients exist and that their symptomatology is associated with social and functional impairment. Recently the DSM IV field trial has specifically addressed this issue by clinical investigations of primary care and psychiatric facilities. These results will be reported.
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PMID:Mixed anxiety depression. For and against. 829 49

Increased glucocorticoid secretion is frequent in mood disorders and is normalized by long-term antidepressant therapy. Many antidepressants act by increasing central serotonin transmission. We investigated the effects of a serotonin precursor, indole-pyruvic acid (IPA), in an animal model of depression based on repeated exposure to unpredictable stress. Rats were divided in groups, and IPA (20 mg/kg), the tricyclic antidepressant imipramine (IMI) (5 mg/kg), or vehicle was administered daily during 3 weeks of repeated exposure to various stressors according to the procedure described by Katz et al [Katz RJ, Roth KA, Carroll BJ (1981): Neurosci Biobehav Rev 5:247-251]. After treatment, rats were evaluated for stress-induced exploratory behavior and killed 24 hr later. Serum corticosterone levels and glucocorticoid receptor (GR) immunoreactivity (IR) in the nuclei of neurons located in the hippocampal subregion CA1 were also measured. Rats exposed to repeated stress showed a lower exploratory behavior score (p < 0.01), higher basal corticosterone levels (p < 0.01), and stronger GR IR in the hippocampus (p < 0.05) than control rats. All of these effects were antagonized by IMI treatment. IPA administration did not affect the behavioral response induced by repeated stress (p < 0.01) but normalized serum corticosterone levels. In addition, IPA treatment produced a decrease in GR IR (p < 0.05 versus control group) that was not modified by exposure to repeated stress.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Indole-pyruvic acid, a tryptophan ketoanalogue, antagonizes the endocrine but not the behavioral effects of repeated stress in a model of depression. 835 66

The authors present their own experience with the use of the behavioural scale elaborated by Blessed, Tomlinson and Roth usually called Blessed Dementia Scale-BS. They examined 76 patients (59 dementia, 17 with major depression, aged 57 - 87 years (mean age 70.3 +/- 7.2 years). The results obtained by BS were compared with WAIS-R, Wechsler's memory scale (WMS) and the MSE cognitive scale (Knopman et al., 1985). They found that BS differentiates satisfactorily patients with dementia and major depression (dementia X = 8.16 +/- 5.4, depression X = 4.41 +/- 2.41, t = 4.07, p < 0,001). The results of examinations by means of BS correlate significantly inversely with the results of examinations of cognitive functions. The closest correlation is between the total BS score and MSE (r = -0.705, p < 0,001). It was confirmed that BS can be used in the diagnosis of dementia for the differential diagnosis of dementia and depressions. Evaluation of partial BS scores (associated with instrumental ADL, basic ADL and personality changes, drives and interests) provides information important for evaluation of the functional capacity of the patient and for the procedure after termination of in-patient treatment. It is important that the total BS score and the partial BS score is not influenced by the patients' age.
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PMID:[Use of behavioral scales in the diagnosis of dementia in the aged]. 864 Apr 88

Barkley and colleagues in 1990 reported large amplitude waves (LAWs) in time series magnetoencephalography (MEG) recordings from migraine patients and inferred that these LAWs arose from spreading cortical depression (SCD). SCD propagates slowly across the cortex in all species in which it has been observed. Previously, we reported that LAWs could be simulated and compared with the recorded signals using the four-sphere model (Wijesinghe and Tepley 1997). We showed that LAWs could arise from the propagation of SCD across a sulcus. In this paper, we model LAWs using a realistically shaped head model based on magnetic resonance images (MRI) (Roth et al. 1993). Simulated signals using this model are similar to the recorded signals. In this model, current dipoles represent the excitable neurons in the cortex and magnetic fields created by these individual dipoles are calculated. The magnetic field arising from the excited area of cortex is obtained by summing the fields due to these individual dipoles.
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PMID:Modeling of spreading cortical depression using a realistic head model. 975 87

The goals of this study were to assess (1) the prevalence of major and minor depression in Alzheimer's disease (AD), ischemic vascular dementia (IVD), and mixed dementia (AD/IVD); (2) demographic and clinical variables that may be associated with depression; and (3) the relationship between depression severity and the level of functional impairment and cognitive decline. Demographic variables, depression diagnoses, Mini-Mental State Examination scores, and Blessed Roth Dementia Rating Scale scores were compared in patients with AD (N = 582), IVD (N = 48), and mixed dementia (N = 61) using analysis of variance and linear regression models. Data were collected using standardized rating instruments at the time of the patients' initial evaluations at the University dementia clinics. The results were that (1) depression was related to lower education, (2) major depression was more prevalent in IVD compared to probable AD, and (3) functional impairment was greater in patients with minor or major depression compared to patients without depression. Our data suggest that the level of functional disability in dementia may be related to severity of depression. Additional studies are needed to validate our results and examine the contribution of additional neurobiologic factors to the pathophysiology of depression in dementia.
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PMID:Depressive syndromes and functional disability in dementia. 1091 28

Proteins used in signal transduction pathways are commonly found in different cell types and organs. However, specific proteins whose expression is highly restricted are also utilized for allowing discrete responsiveness to signals that are otherwise ignored by other cells. How the brain uses common and specific signal proteins for communication within and beyond the cerebrum has been an area of intense study. A new book concentrates on the signaling that occurs in the brain under normal and pathological conditions--memory, apoptosis, neurodegeneration, depression, and drug dependence--and is filled with chapters written by experts in neurobiology and neurophysiology. Bryan Roth reviews the book and discusses in detail several chapters that may lead to promising future research.
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PMID:Neuronal signal transduction pathways: wasteland or the promised land? 1175 3


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