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)

Thirty-four adolescents with mean age 14.25 years who met RDC criteria for major depressive disorder as assessed with the K-SADS, were treated for 6 weeks on a fixed schedule of imipramine hydrochloride titrated to a dosage of 5.0 mg/kg/day except as limited by side effects. Mean dose was 246 mg/day (4.5 mg/kg/day). In spite of good indications of compliance with treatment only 44% of the adolescents improved to the level of no or only slight depressed mood or anhedonia, though most had less depressive symptomatology at the end of treatment. There was neither a linear nor curvilinear relationship between total plasma level of IMI plus DMI and clinical response, despite a wide range of both plasma level (77 ng/ml to 986 ng/ml) and outcome. Adolescents with associated separation anxiety had significantly poorer response to treatment of their depressive disorder than those with major depression alone. Poor response was also weakly associated with being female, having endogenous subtype of depression, and having higher plasma IMI (but not DMI) level. In the context of similar studies of IMI on depression in other age groups, it is hypothesized that high levels of sex hormones during adolescence and young adulthood may interfere with IMI's antidepressant effects. It is concluded that other types of antidepressants should be tested in adolescents with major depression.
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PMID:Imipramine in adolescent major depression: plasma level and clinical response. 371 45

The Pleasure-displeasure Scale is a self-report instrument consisting of 82 items for measuring the intensity of subjects' affective responses to usually pleasant and unpleasant situations. 81 depressed inpatients were compared to 120 normal subjects. The responses of the depressed patients to the Pleasure sub-scale (French translation of the Fawcett-Clark's Pleasure Scale) are more anhedonic than those of the normal subjects; but the difference did not reach statistical significance. Pleasure scores in the depressive group are bimodally distributed; a distinct subset (11% of depressives) is characterised by an extremely anhedonic Pleasure score. The sensitivity to unpleasant stimuli is significantly greater in the depressive group; however this difference seems to be related rather to a low cultural level than to depression itself. Finally pleasure and displeasure scores are closely correlated: this could possibly imply that anhedonia is not an independent symptom but rather belongs to the wider constellation of affective anesthesia.
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PMID:[The Pleasure-Displeasure Scale. Use in the evaluation of depressive illness]. 379 74

Sixty-seven patients (greater than or equal to 55 years of age) with major depressive disorder had pretreatment assays of platelet monoamine oxidase (MAO) activity. As in previous studies, women had higher MAO activity than men, and MAO activity was positively correlated with age. Patients with melancholia (DSM-III) had significantly higher MAO activity than those without melancholia. This finding may reflect the higher MAO activity associated with the symptoms of anhedonia and mood autonomy. Anxiety also was correlated with higher MAO activity, as was a positive family history of depression. In addition, postdexamethasone cortisol levels were correlated with platelet MAO activity.
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PMID:Relationship of platelet MAO activity to characteristics of major depressive illness. 380 23

Although diagnostic and therapeutic difficulties, including countertransference problems, in borderline patients make prognostic estimates hazardous, practical necessity often requires a prognostic judgment regarding treatability. This paper proposes a list of prognostic indicators in borderline patients which may be useful to the psychotherapist in the evaluation of treatability. Unfavorable prognostic indicators include history of brutalized early environment, severe behavior problems in childhood, antisocial behavior, addictions, egosyntonicity, superficial or highly disturbed relationships, marked narcissistic features, injurious social environment; and, in the course of therapy, strong negative reaction of the therapist toward the patient, and antisocial acting out. Suggesting a more favorable prognosis for psychotherapy are: nonspecific personality traits which may promote the therapeutic relationship (likeableness, warmth, reliability, or interest in people), and intact sublimatory outlets (talents, skills). In general, the quality of object relations, especially the therapist-patient relationship, including the countertransference, is crucial to prognosis. The unfavorable prognostic implications of certain atypical forms of anxiety, depression, and dependency, as well as anhedonia and abulia, are discussed. Borderline patients with infantile features probably have better prognosis than is generally recognized; with narcissistic features, a worse prognosis than generally recognized.
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PMID:Prognostic indicators in the psychotherapy of borderline patients. 398 24

This study was designed to test the hypothesis that there are 2 biochemical subgroups of 'endogenously' depressed patients--serotonin-deficient and noradrenalin-deficient groups--which respond differently to antidepressants depending on relative blockade of serotonin vs. norepinephrine (NE) reuptake. Patients with pervasive anhedonia and autonomy of depressed mood (endogenomorphic depressives) were treated first with the noradrenergic agent desipramine (DMI), then, if still depressed, such patients were randomized double-blind to continued DMI or clomipramine (CMI), a primarily serotonergic agent. Of 34 such endogenomorphically depressed patients 2 responded during a placebo period and 5 dropped out. Of 27 patients completing at least 4 weeks of DMI (mean maximum daily dose 283 mg, range 100-400 mg/d), 23 (85.2%) responded. With only 4 nonresponders, the second, or CMI, part of the study had to be abandoned. Since DMI strongly blocks neuronal reuptake of catecholamines with little effect on serotonin reuptake, these results suggest that endogenomorphic depressives may have a relatively homogeneous catecholamine deficiency. Alternatively, DMI may exert its effect by a mechanism other than blockade of EN reuptake. Eleven of the endogenomorphically depressed patients also met Research Diagnostic Criteria for situational depression (reactive). Ten of these 11 responded to DMI suggesting that presence or absence of a precipitant may be irrelevant in predicting response to tricyclic antidepressants in endogenomorphic depressions. Mean blood levels drawn at equivalent DMI dose were 238 ng/ml (range, 48-712) for responders, and 352 ng/ml (range, 160-877) for non-responders, indicating that patients appear to respond to DMI across a wide range of blood levels and suggesting the absence of a narrow therapeutic window.
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PMID:Efficacy of desipramine in endogenomorphically depressed patients. 621 Jul 22

Levels of depression, anhedonia, and illness behavior, as well as clinical and demographic variables, were measured in two groups of patients with chronic pain, one with facial, the other with back pain. For the total sample, significant correlations (p less than 0.01) were found between illness behavior and pain estimate (r = 0.30), anhedonia and depression (r = 0.33), and pain estimate and pain duration (r = 0.31). Facial pain patients showed illness behavior most strongly related to estimate of pain severity (r = 0.62); back pain patients showed illness behavior significantly related to depression (r = 0.59). Results also show that the physical site of pain relates to illness behavior but not mood of chronic pain patients.
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PMID:Illness behavior, depression and anhedonia in myofascial face and back pain patients. 622 Apr 21

All depressive syndromes include physical as well as psychological features. Physical symptoms in major "endogenous" depression are well known. In other forms, called masked depressions, various physical disorders are the patients main complaint and may be misleading. Localized pain and paresthesia are common. Behaviour disorders may mask depression in adolescents. Mood disturbances (loss of interest, anhedonia) as well as the personal and family histories, should be precisely assessed in order to establish diagnosis. Masked depression is not a minor form of depressive syndrome and antidepressant drugs should be used in correct doses over a sufficient period of time.
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PMID:[Masked depression and paucisymptomatic depression (author's transl)]. 627 36

Evidence from a variety of sources indicates that the mesolimbic-mesocortical dopamine projections may play an important role in some types of reward or reinforcement processes in animals. There is circumstantial evidence that this is also true in humans. Since a reduced ability to experience pleasure or reward (i.e. anhedonia) is a cardinal feature of clinical depression, and since the mesolimbic and mesocortical dopamine projections have been shown to degenerate in Parkinson's disease, it is suggested that damage to these reward-related systems may contribute directly to the high incidence of depression that has been reported in this disease.
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PMID:The neurobiological substrates of depression in Parkinson's disease: a hypothesis. 632 81

Investigated the convergent and discriminant validity of the anhedonia construct using a multivariable-multimethod design. The 100 subjects displayed a wide range of scores on the Physical Anhedonia Scale, many comparable to the original validation sample of diagnosed schizophrenics. Twenty-one variables were assessed by tests, 16 by subject self-ratings and 16 by peer ratings of the subject. The resultant intercorrelation matrix was analyzed by Golding and Seidman's (1974) two-step principal components procedure. Five of the six second-order components showed good and conceptually meaningful cross method convergence and were named: Pleasureless Introversion, Neurotic Maladjustment, Dependency, Hedonic Deficit #1, Hedonic Deficit #2, and Coarctation. Hedonic Deficits #1 and #2 were shown to be independent from neuroticism, depression, and guilt. The high degree of relationship between anhedonia and introversion, long suggested by clinicians, is confirmed and discussed. Notes on the construct validity of Chapman et al.'s (1976) Physical and Social Anhedonia Scales and Watson et al.'s (1970) MMPI Anhedonia Scale are included.
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PMID:Anhedonia: a construct validation approach. 664 29

Five scales were evaluated for the diagnosis of melancholia or endogenous depression. Of 21 total items, none appeared in all five scales, but four items occurred in four of the scales: autonomy of mood, prevasive anhedonia, psychomotor change, and guilt. Vegetative changes were represented inconsistently, with anorexia and weight loss in three scales, as was distinct quality of mood. Thereafter, item agreement between the scales fell off. Scale performance was tested in 50 depressive patients. Major differences were found in frequency of melancholia and scale orientation toward inpatients and outpatients. A number of old controversies remain dormant in these scales. Unresolved are the relationship between melancholia and severity of depression; the relevance of precipitating events, previous depressive episodes, type of onset, and adequacy of personality; and whether to classify by category or continuum. The merits of statistically and consensually derived scales also need to be evaluated.
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PMID:Comparative diagnostic criteria for melancholia and endogenous depression. 672 73


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