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

15 operational definitions for melancholic depression and their validation studies are reviewed. None of these definitions have yet been conclusively validated. Using a different approach, we attempt to validate melancholic symptoms rather than operational definitions for melancholia. The aim is to define, by means of a review of genetic, biological and therapeutical studies, a "biological symptomatic profile" that responds to somatic therapies. Psychomotor and appetite disturbances, early awakening, anhedonia and psychotic symptoms seem more likely to reflect this biological dysfunction in melancholia. Confounding variables such as symptom stability, severity of depression and possible subtypes of melancholia are also discussed.
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PMID:[Reevaluation of melancholic depression]. 307 10

Masked depression refers to a concept of a phenomenological state, either endogenous or psychogenic where somatic symptoms replace sadness: Thirty patients were evaluated by RDC (22 endogenous and 8 masked depressions) wherein in the latter dysphoria was replaced by a nonreactive persistent somatic complaint. They were rated on Beck and Hamilton Depression Scales, on Hamilton and Trait-State Anxiety Scales and the NOSIE. All patients presented with insomnia, anorexia, loss of weight, diminished libido and anhedonia. Initial ratings were similar for both diagnostic groups except for a significantly higher agitation factor and lower retardation in masked depression. Although 59.9 percent of the subjects are positive on the dexamethasone test, only 1 masked depression did not suppress secretion of cortisol. After a randomized 30-day drug trial where patients were assigned to Clomipramine or Desipramine, patients in both groups show significant improvement on rating scales but diagnostic group drug treatment interaction exists on anxiety and agitation criteria.
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PMID:[Comparison of masked and endogenous depression using psychometric scales, endocrinological markers and pharmacological responses. Masked depression versus endogenous depression]. 309 93

The Zung Self-Rating Depression Scale (SDS) was presented to 99 depressed inpatients. The patients were categorized according to DSM-III as suffering from minor depression, major depression without melancholia and major depression with melancholia and/or with psychotic features. Differences in self-reported symptoms between these categories were studied with multivariate statistical techniques including linear discriminant analysis (LDA) and statistical isolinear multiple components analysis (SIMCA). Patients with minor depression rate themselves significantly less depressed than those with major depression. Patients with major depression without melancholia are less depressed than those with melancholia and/or psychotic features. The three DSM-III depressive categories can be regarded as belonging to a clinical continuum in which they form relevant levels with quantitative differences in self-reported symptoms. These differences are not only defined by gradual shiftings in the overall severity of illness, but also by quantitative differences in the severity of some target symptoms, i.e. agitation, retardation, diurnal variation, loss of libido, fatiguability, insomnia, anorexia, sadness and anhedonia.
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PMID:Self rated depression in relation to DSM-III classification: a statistical isolinear multiple components analysis. 334 93

The internal construct validity of the endogenous sub-type of major depression was investigated by statistically modelling the RDC endogenous and DSM-III melancholia diagnostic criteria. Data consisted of symptom ratings on 788 patients with major depression from NIMH Collaborative Depression Study. Results indicated that the symptoms in the criteria do not specify a dichotomous classification, melancholic-non-melancholic or endogenous-nonendogenous. Results did support the existence of two sub-typings, one related to anhedonia, and one related to vegetative symptoms. The vegetative sub-type rarely occurred in non-anhedonic patients. Previous studies may have found support for a simple endogenous sub-type because of this hierarchical relationship and as a result of methodological differences.
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PMID:The endogenous sub-type of depression: a study of its internal construct validity. 345 65

The clinical observations on alexithymia which were initiated by Sifneos and Nemiah in the earlier 1970s have given rise to a host of studies with implications beyond the psychosomatic field of enquiry. Is alexithymia a pathology of affect or a character neurosis; is it primary or secondary; genetic or developmental? Is it an adaptational deformation related to social class and low psychological sophistication, a life style or a cerebral deficit? Is it global and consistent (trait) or partial and temporary (state)? Is it part of the necessary and sufficient condition for the development of a psychosomatic symptom or is it a nonspecific autoplastic alteration? It is quite possible that alexithymia is one of several mediating processes between stress and disease along with genetic susceptibility, developmental variables, context and reaction to untoward life events, coping dispositions, psychosocial support and sociocultural factors. Therapeutic approaches would depend on whether we are dealing with a primary affectless condition or a secondary one. A differential diagnosis is essential since self-numbing following psychic trauma or a pathological grief, masked and atypical depression are treatable. Blocking of affect may have dire effects on the psychosomatic economy and on the capacity for intimacy. Muscular and psychological rigidity, weariness, ennui and anhedonia may be the only clues to the presence of alexithymia. Since we may be dealing with a spectrum disorder, there is no single treatment modality. There are no controlled studies on the use of psychotropic drugs and psychoanalytic-oriented and behavioral approaches have been shown to be of some benefit.
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PMID:Alexithymia, clinical and therapeutic aspects. 360 41

The Chapman physical anhedonia (AN) and perceptual aberration (AB) scales were intended to identify high risk for schizophrenia. Although schizophrenic-like dysfunctions have been reported in association with each, the issue is clouded by possible relationships with depression. We recently reported psychophysiological patterns distinguishing depression from schizophrenia. Schizophrenics showed reduced orienting response (OR) to innocuous stimuli in both electrodermal (SCR) and finger pulse (FPV) components, normalizing in both to significant signals. Depressives showed deficient, non-normalizing SCR, but normal FPV, implicating SCR/cholinergic rather than OR deficits. 16 AN, 18 AB, and 17 control students received an innocuous (habituation) tone series followed by a significant (alternating-press) series. ANs displayed schizophrenic-like rather than depressive-like response patterns, but ABs showed no coherent pattern. Findings in ANs were somewhat attenuated compared with schizophrenics, perhaps reflecting the small percentage of schizophrenics-to-be in this risk group. The absence of clear deficit in ABs agrees with studies showing OR deficits to be associated with more negative symptoms in schizophrenia.
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PMID:Psychophysiological response patterns in college students with high physical anhedonia: scores appear to reflect schizotypy rather than depression. 360 12

The present experiment investigates in 'normal' subjects the relationship between personality characteristics (anhedonia versus hedonia) and the influence of the affective value of acoustic stimuli (positive, negative, neutral) on various electrophysiological indices reflecting either tonic activation or phasic arousal (EEG power spectra, contingent negative variation: CNV, heart rate, skin potential responses: SPR) as well as on behavioural indices (reaction time: RT). Eighteen subjects were divided into two groups according to their scores at two self-rating questionnaires, the Chapman's Physical Anhedonia Scale (PAS) and the Beck-Weissman's Dysfunctional Attitude Scale (DAS) that quantifies cognitive distortions presumed to constitute high risk for depression: 9 with high scores at both scales formed the A group (Anhedonic-dysfunctional), 9 with low scores at both scales, the H group (Hedonic-adapted) The electrophysiological indices were recorded during 3 situations: the first one was a classical CNV paradigm with a motor reaction time task in which one of 3 tones of different pitch represented the warning stimulus S1; during the second, conditioning phase, two of these tones were associated with either a success (and reward) or a failure (and punishment) during a memory task in order to make them acquire either a positive or a negative affective value; the third situation consisted in the repeating of the first CNV paradigm in order to test the effect of the positive and the negative stimuli versus the neutral one on RTs and electrophysiological data. Significant between-group differences were found regarding tonic activation as well as phasic arousal indices from the very beginning of the experiment when all stimuli were neutral ones, the anhedonics exhibiting higher activation and arousal than the hedonics at the cortical (increased CNV amplitude, increased power in the beta frequency band), cardiovascular (higher heart rate habituating more slowly) and behavioural (faster RTs) levels. Significant between-group differences were also found concerning reactivity to affective stimuli during the third situation: both the orienting response (but only at the cortical level: early CNV) and the motor preparation processes (late CNV) were in the A group significantly less reactive to affective stimuli (especially to the positive one) than in the H group, in particular concerning the frontal (Fz) data.
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PMID:Electrophysiological changes elicited by auditory stimuli given a positive or negative value: a study comparing anhedonic with hedonic subjects. 361 Jul 27

Results of the dexamethasone suppression test (DST) are frequently abnormal in depression but not always. We performed the DST in 95 depressed inpatients to determine whether abnormal DST results were associated with individual symptoms of depression, latent behavioral "factors," melancholia, or severity of depression. Initial insomnia, agitation, loss of sexual interest, and weight loss correlated significantly with nonsuppression. Using multiple regression, these four symptoms contributed independently to the variance in DST results and more closely associated with the DST results than did severity or the diagnosis of melancholia or endogenous subtype. Factor analysis failed to identify a factor that correlated with the DST results more significantly than did the individual symptoms. Our findings and a literature review suggest that DST nonsuppression associates with certain vegetative signs of depression but not with such symptoms as loss of interest or anhedonia nor with "psychological" symptoms such as guilt, worthlessness, helplessness, hopelessness, or suicidal ideation.
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PMID:Does the dexamethasone suppression test relate to subtypes, factors, symptoms, or severity? 363 50

Symptom frequency and severity were compared in two sequential clinically referred samples of 95 children and 92 adolescents, aged 6 to 18 years, all medically healthy, assessed with the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present Episode, who met unmodified Research Diagnostic Criteria for major depressive disorder (MDD). There were no significant differences between the two groups in the majority of depressive symptoms. However, prepubertal children had greater depressed appearance, somatic complaints, psychomotor agitation, separation anxiety, phobias, and hallucinations, whereas adolescents had greater anhedonia, hopelessness, hypersomnia, weight change, use of alcohol and illicit drugs, and lethality of suicide attempt, but not severity of suicidal ideation or intent. Adolescents with a duration of the depressive episode of two years or greater had significantly higher rates of suicidal ideation and intent, lethality, and number of suicide attempts than youngsters with depressive episodes of shorter duration. A principal components factor analysis of psychiatric symptoms was carried out in all 296 youngsters evaluated during the same period who met DSM-III criteria for any Axis I diagnosis. The majority had an affective disorder. Factors were quite similar for both adolescents and children and included an "endogenous" and an "anxious" factor, as in many studies of adult depression. In addition, three other factors were found: negative cognitions, appetite and weight changes, and a conduct factor. Suicidal ideation was a component of both the negative cognitions factor and the conduct factor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The clinical picture of major depression in children and adolescents. 366 42

In most research dealing with biological abnormalities in depression, the clinical diagnosis of depression is made and the occurrence of a biological abnormality, for example, reduced REM latency, is documented. In this study, that design was reversed; REM latency was used as a grouping variable to assess empirically the "biological" priority of Research Diagnostic Criteria endogenous symptoms. We found that terminal insomnia, pervasive anhedonia, unreactive mood, and appetite loss were most likely to discriminate among "reduced" and "nonreduced" REM latency depressions at various threshold values. Contrary to expectation, diurnal mood variation was found equivalently in all categories of REM latency studied. Implications for clinical decision making based on endogenous symptoms are discussed.
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PMID:Which endogenous depressive symptoms relate to REM latency reduction? 369 37


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