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

To determine if specific sets of dysfunctional attitudes were related to suicidal ideation, the 100-item Dysfunctional Attitude Scale (DAS) was administered to 908 psychiatric outpatients along with the Beck Depression Inventory (BDI), Hopelessness Scale (BHS), Self-Concept Test (BST), and Scale for Suicide Ideation (SSI). The SSI was used to classify the outpatients into 97 (10.7%) suicide ideators and 811 (89.3%) nonideators, and the DAS was scored for nine subscales described by Beck, Brown, Steer, and Weissman (1991). None of the DAS subscales discriminated the ideators and nonideators or was significantly related to SSI total scores of the suicide ideators after controlling for sex, age, diagnosis of a mood or panic disorder, comorbidity, presence of a personality disorder, a history of a past suicide attempt, the BDI, the BHS, and the BST. The contributions of sets of dysfunctional attitudes for identifying and explaining suicidal ideation were overshadowed by a history of a past suicide attempt and hopelessness.
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PMID:Dysfunctional attitudes and suicidal ideation in psychiatric outpatients. 847 28

30 girls aged 13-19 who met criteria DSM-IV for anorexia nervosa were investigated by using a semistructured diagnostic interview assessing general psychopathology as well as anorectic and bulimic behavior, The Yale-Brown Obsessive-Compulsive Scale. The Eating Disorder Inventory, The Anxiety Hamilton Scale, The Depression Hamilton Scale. The comparison group consisted of 30 healthy girls aged 13-19. 1/3 of the girls with anorexia nervosa met the DSM-IV criteria for OCD, 1/10 subjects had OCD and depressive disorder. The comorbidity of eating disorder and OCD or OCD and depressive disorder worsened the course of anorexia nervosa and prognosis.
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PMID:[Obsessive-compulsive disorder in girls with eating disorders]. 865 Feb 81

The efficacy and tolerability of fluvoxamine (100-300 mg/day) and clomipramine (100-250 mg/day) were compared in a randomized, double-blind, parallel-group study of 79 patients with obsessive-compulsive disorder (OCD) without coexisting major depression. After a 2-week placebo lead-in period, patients were randomized to fluvoxamine (37 patients) or clomipramine (42 patients) for 10 weeks. Efficacy was evaluated with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the National Institute of Mental Health Obsessive-Compulsive scale, and Patient and Clinical Global Improvement scales. Hamilton Rating Scale for Depression scores and somatic symptoms were also assessed. Seventy-eight percent of fluvoxamine patients and 64% of clomipramine patients completed the study. At the end of treatment, 56% of fluvoxamine patients were classified as responders (> or = 25% decrease in Y-BOCS score), compared with 54% of clomipramine patients. Both groups showed steady improvement throughout the study; no statistically significant differences were observed between the groups for any efficacy variable at any time. A similar percentage of patients in both groups withdrew because of adverse events. No serious adverse events related to drug occurred with either drug. Insomnia, nervousness, and dyspepsia were more statistically frequent with fluvoxamine; dry mouth and postural hypotension were more frequent with clomipramine. In this study, fluvoxamine and clomipramine were equally effective in reducing OCD symptoms over a 10-week treatment period but displayed different side effect profiles.
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PMID:Fluvoxamine versus clomipramine for obsessive-compulsive disorder: a double-blind comparison. 869 Aug 27

The reliability and validity of the Japanese version of the Yale-Brown Obsessive-Compulsive Scale (JY-BOCS) were determined by 20 raters for 12 Japanese patients with obsessive compulsive disorder at four institutions. Interrater reliability for the total JY-BOCS score was excellent, and the intraclass correlation coefficient was high (ICC = 0.960). Internal consistency was also excellent (Cronbach's alpha = 0.889). Concurrent and discriminant validity of the JY-BOCS was examined by comparing the scores on the JY-BOCS with those on the Maudsley Obsessional Compulsive Inventory (MOCI) and scales for depression and anxiety. A slight correlation was found between scores on the JY-BOCS and MOCI, but no significant correlations were found between scores on the JY-BOCS and those on scales for depression or anxiety.
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PMID:Reliability and validity of the Japanese version of the Yale-Brown Obsessive-Compulsive Scale. 872 28

The effects of chronic stress on the hypothalamic-pituaitary-adrenocortical (HPA) axis were studied in five inbred rat strains, i.e. Brown Norway (BN), Fischer (FIS), Lewis (LEW), Spontaneously Hypertensive (SHR) and Wistar Kyoto (WKY). Previously, these rat strains had been shown to display clear behavioral differences in the forced swimming test that presumably measures depression-like behavior, BN and WKY being more passive than the other strains. Here we test the hypothesis that the differences in behavioral immobility might be associated with an abnormal HPA response to chronic immobilization (IMO) stress. In stressnaive rats under basal conditions (morning) there were no differences among strains in adrenal weight, serum adrenocorticotropin hormone (ACTH) and corticosterone (B) levels, cortictropin-releasing factor (CRF) mRNA in the hypothalamic paraventricular nucleus (PVN) and hippocampal glucocorticoid and mineralocorticoid receptor (GR and MR) mRNA. After chronic IMO, basal serum ACTH levels were increased in LEW, SHR and WKY, but not in BN or FIS rats, whereas basal B levels were increased in BN, FIS, SHR and WKY rats, but not in LEW. The increase in adrenal weight was also strain dependent and correlated negatively with chronic IMO-induced hypercorticosteronemia. These peripheral differences among strains were not observed at central levels. Thus, chronic IMO increased the CRF mRNA content in the PVN, analyzed by in situ hybridization, similarly in all strains. In addition, after chronic IMO no differences were found among strains in hippocampal GR mRNA and RM mRNA contents. Considering data from all strains together, chronic IMO reduced the GR mRNA (50-60%) content in the hippocampal CA1, CA3 and DG areas, and slightly diminished (11-13%) MR mRNA levels in CA1 and CA3 areas. The present results indicate that: (i) chronic IMO down-regulates GR mRNA in the hippocampus and slightly up-regulates CRF mRNA in the hypothalamic PVN similarly in all strains; (ii) after chronic IMO interstrain differences were observed in serum ACTH and B levels as well as adrenal hypertrophy; (iii) some changes are probably located at the adrenal level since changes in serum B level and adrenal weight were not related to changes in ACTH; (iv) in LEW and WKY rats, B hyporesponsiveness to chronic IMO might be linked to low adrenal sensitivity to ACTH, and (v) HPA axis changes induced by the chronic IMO procedure are not related to previously reported data on depressive-like behavior of BN and WKY in the forced swimming test.
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PMID:Hypothalamic-pituitary-adrenal response to chronic stress in five inbred rat strains: differential responses are mainly located at the adrenocortical level. 873 88

Some inbred strains of rats showed behavioural differences in the forced swimming test, which is considered a putative animal model of depression. In the present work, the behavioural and physiological responses to forced swimming were studied in male and female rats of five inbred strains of rats: Brown-Norway (BN), Fischer 344 (FIS), Lewis (LEW), Spontaneously Hypertensive (SHR) and Wistar-Kyoto (WKY). Physiological measures were aimed at characterizing emotional reactivity, a very important issue which has usually been approached by studying a single endocrine system, and its relationship to the forced swimming behaviour. The four indices of reactivity to stress used were serum glucose, ACTH, corticosterone and prolactin. No behavioural differences between sexes were observed in the forced swimming test. In addition, BN and WKY rats showed passive behaviour compared with the other three strains, the FIS strain being the most active. Whereas only minor differences were found in the resting levels of the variables studied with regard to either sex or strain, pituitary-adrenal (PA) and glucose responses to 15 min forced swimming differed among sexes and strains. Stress-induced hyperglycaemia was lowest in WKY and highest in SHR, being lower in females than in males. The lowest ACTH and corticosterone responses to forced swimming were observed in LEW and the highest in FIS. Female rats showed a clearly higher PA response to stress in all strains. Prolactin response to stress was very similar between sexes and strains. It might thus be concluded that: (i) there are important inter-strain differences in the forced swimming behaviour, with no differences between sexes; (ii) the various physiological indices of emotional reactivity follow a different trend and no warranted conclusion on differences in emotional reactivity should be based upon a single endocrine system or even only upon physiological measures; (iii) we cannot be sure, therefore, whether or not there are differences in emotionality between the strains studied in spite of well-established inter-strains differences in the forced swimming behaviour.
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PMID:Comparison of the behavioural and endocrine response to forced swimming stress in five inbred strains of rats. 883 94

In the psychotherapy of depression a knowledge of causative factors is essential for both practical aspects of interventions and the design of refined outcome studies. Outcome studies, which should go beyond simple pre-post comparisons, require such detailed hypotheses about the underlying pathogenetic mechanism which is addressed by a therapeutic technique. Thus, for this purpose psychopathological classification has to be supplemented by a pathogenetic classification. In the first section of this paper the most influential conceptual models of depression are discussed, including loss and grief, inhibited and reversed aggression, disturbed attachment, narcissistic crisis, the disturbed "prolepsis", structural dynamic restriction, learned helplessness, the social role model and Brown's sociological 3-factor model. In the second part, a reduction to three models is suggested and elucidated--the melancholic type, the narcissistic structure and depressive structure--in order to achieve a selection of specific intervention strategies. These are explained by a number of case vignettes. This pathogenetic structural diagnosis should be worked out in addition to the cross-sectional psychotherapeutic work. An additional "staging" of the long-term course provides more precision to the pathogenetic focus and accordingly to the selection of an adequate intervention strategy. In the third section the empirical literature is reviewed of those studies which have adopted objective assessment methods. No consensus has yet been found regarding appropriate methods and results are still rather inconsistent. We emphasize the necessity for a pathogenetic focus agreed upon by both patient and therapist and the consideration of the psychotherapeutic impact of biological treatment components with regard to self-image, allocation of heteronomy, and the patient's disease concept.
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PMID:[Psychotherapy of depressive disorders: on theoretical background and practice relevance]. 933 26

We used receiver-operator characteristic (ROC) curve analysis to evaluate predictors of response to clomipramine in obsessive-compulsive disorder (OCD). Previously, we identified response predictors among 230 OCD patients who received clomipramine in a placebo-controlled, multicenter clinical trail. We found that at baseline a later age of OCD onset, low scores on the Hamilton Depression scale, and high scores on items 3 and 8 of the Yale-Brown Obsessive Compulsive Scale predicted good response. Certain early side effects also predicted outcome. We fitted a logistic regression model containing baseline information and then calculated each patient's estimated response probability by substituting individuals' values in the regression equation. Next we compared the estimated response risks with each patient's known outcome. Finally, we produced a ROC curve by plotting the true positive and false positive rates for various cutoff points of the risk scores. The same steps were followed for Weeks 1 through 4, adding information about early side effects and weekly response. We found that baseline information predicted outcome better than chance, and predictive ability increased with data on side effects and early response.
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PMID:Use of receiver-operator characteristic (ROC) curve analysis to evaluate predictors of response to clomipramine therapy. 892 67

The amended (revised) Beck Depression Inventory (BDI-IA; Beck & Steer, 1993b) and the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) were self-administered to 140 psychiatric outpatients with various psychiatric disorders. The coefficient alphas of the BDI-IA and the BDI-II were, respectively, .89 and .91. The mean rating for Sadness on the BDI-IA was higher than it was on the BDI-II, but the mean ratings for Past Failure, Self-Dislike, Change in Sleeping Pattern, and Change in Appetite were higher on the BDI-II than they were on the BDI-IA. The mean BDI-II total score was approximately 2 points higher than it was for the BDI-IA, and the outpatients also endorsed approximately one more symptom on the BDI-II than they did on the BDI-IA. The correlations of BDI-IA and BDI-II total scores with sex, ethnicity, age, the diagnosis of a mood disorder, and the Beck Anxiety Inventory (Beck & Steer, 1993a) were within 1 point of each other for the same variables.
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PMID:Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. 899 72

The aim of this study was to investigate whether obsessive-compulsive patients previously treated successfully with clomipramine or fluvoxamine could tolerate reduction of the daily dosage without worsening of the clinical condition. Thirty informed obsessive-compulsive patients, given a diagnosis according to DSM-III-R criteria, were recruited consecutively into the study. Patients were blindly assigned to one of the groups of treatment with different rates of reduction of the previously effective daily drug dosage: group 1 (control group, no reduction), group 2 (reduction of 33-40%), and group 3 (reduction of 60-66%). The entire study lasted 102 days. From baseline to the end of the study, the clinical condition was evaluated by the administration of standardized tests (Yale-Brown Obsessive-Compulsive Scale, Hamilton Rating Scale for Depression, Clinical Global Impression [CGI] scale), and blood samples were collected for plasma drug level determinations. The criterion for discontinuation of the study was the worsening of obsessive-compulsive symptoms, arbitrarily defined by an increase of > 5% from the baseline total Yale-Brown Obsessive-Compulsive Scale score, as measured in two successive assessments, and a worsening of global clinical condition as measured by the CGI scale. The main result of the study was borne out from the survival analysis. There were no significant differences in the cumulative proportion of patients from each group of treatment who did not worsen during the 102 days of observation. This preliminary result, which needs to be confirmed in larger samples, suggests that long-term maintenance therapy for obsessive-compulsive disorder might be provided with lower dosages of the antiobsessional drug, with clear advantages for tolerability and compliance.
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PMID:Long-term pharmacotherapy of obsessive-compulsive disorder: a double-blind controlled study. 900 50


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