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

The paper is concerned with a study of age variants of depersonalizational disturbances in schizophrenia children of early preschool age and preschool age. Depersonalizational disorders proper were found in 25 cases, disturbance of the self-conscious and its deterioration in 59, retardation in the development of the self-conscious formation--in 32 cases. Depersonalizational disturbances appear in children over 3 years, i.e. following the first physiological age crises. The following types of depersonalizational disturbances were distinquished: 1) moderately expressed loss of the self-conscious with disorders in the differentiation of the "I" from the associates; 2) a deeper disorder of the "I" with a substitution of the personal "I", by another "I"; 3) phenomena of estrangement of the self-conscious with a state similar to the splitting of the self-conscious, up to the appearance of the phenomena of a twin; 4) a change of the self-conscious expressed in a pathological play transformation and a substitution of the "I" by another "I", or a splitting of the self-conscious into the syndrome of play transformation near to a delusional; 5) derealization; 6) loss of the conscious of personal sex; 7) estrangement of the conscious of personal actions; 8) disturbance of self-conscious of a physical whole; 9) disturbance of the self-conscious in a deep depression with a loss of "I-vitality" appearance near to "anaesthesia psychica dolorosa" and "nihilistic delusions"; 10) loss of "I" conscious and regress of speech, motor activity, behaviour; 11) retardation in the formation of "I" conscious.
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PMID:[Depersonalization disorders in schizophrenic children]. 71 28

To specify the clinical picture, criteria for differential diagnosis and for medicolegal estimation of transitory psychogenic psychoses, 26 servicemen admitted irresponsible in respect to the actions committed in a state of psychosis were examined. Responsible servicemen who committed crimes in a state of physiological affect (n-26) or at the moment of acute situational personality reactions (n-26) were examined as reference groups. It has been established that transitory psychogenic psychoses occurred in servicemen with a definite personality and mental disposition (inhibited pathocharacteristic features and phenomena of residual organic brain injury) in a chronic (from 3 to 12 months) psychotraumatizing situation of permanent ill treatment and humiliation, causing long sleep deprivation. 3 stages were distinguished in the development of psychosis: stage I (preneurotic) was partial mental disadaptation; stage II (neurotic) involved further development of the phenomena of partial disadaptation and was characterized by well-defined asthenoneurotic and depressive dysphoric syndromes and not infrequently by syndromes of autistic aggressive fantasies; stage III was complete mental disadaptation marked only by transitory psychoses. The latter stage was short-lived (commonly lasting several hours), characterized by psychotic depth and by unmarked phenomena of agitated depression and pathological interpretations. Psychogenic psychosis that occurred in the presence of the above symptoms manifested, as a rule, by a depressive raptus with severe psychomotor excitation, vital melancholy, fragmentary hyperquantivalent depressive delirium, and phenomena of deep depersonalization and derealization.
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PMID:[Transient psychogenic psychoses in servicemen]. 133 64

Little consensus or systematic research exists regarding the symptoms that constitute depersonalization and its association with affective and perceptual dysfunctions. A scale was constructed to measure depersonalization experiences reported in the literature and four items representing psychotic symptoms. Five factors representing different types of depersonalization emerged: Inauthenticity, Self-Negation, Self-Objectification, Derealization, and Body Detachment. Based on the factors, scales were constructed; these scales have internal consistency ranging from .78 to .84. Each of these factor scales was factorially distinguishable from psychosis and correlated between .48 and .58 with the Jackson and Messick (1972) Feelings of Unreality Scale, suggesting divergent and convergent validity. Inauthenticity, the most frequent and pervasive form of depersonalization experience, was best predicted by a cognitive style featuring intense, critical examination of self and others. In contrast, Self-Objectification was best predicted by thought disorganization and perceptual distortion and was experienced somewhat infrequently by relatively few subjects. All forms of depersonalization were associated with depression, except Inauthenticity.
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PMID:Toward the clarification of the construct of depersonalization and its association with affective and cognitive dysfunctions. 143 64

Forty-four veterans with posttraumatic stress disorder (PTSD) from World War II and Vietnam were compared. The groups were comparable on many socioeconomic and combat measures and age at onset of PTSD. Vietnam veterans exhibited more severe PTSD symptoms, higher Hamilton depression scores, and higher scores on the hostility, psychoticism, and "additional symptom" Symptom Checklist-90 (SCL-90) scales. They also had more survivor guilt, impairment of work and interests, avoidance of reminders of trauma, detachment/estrangement from others, startle response, derealization, and suicidal tendencies. Differences were noted between the groups as to the nature of upsetting experiences. Vietnam veterans had a greater lifetime frequency of panic disorder and an earlier age of onset for alcoholism. In other respects, the two groups were diagnostically similar, with PTSD being related to the sequential emergence of psychiatric diagnoses in similar manner for World War II and Vietnam patients.
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PMID:Symptom and comorbidity patterns in World War II and Vietnam veterans with posttraumatic stress disorder. 231 83

Cerebrospinal fluid (CSF) amine metabolites were measured in 37 male subjects with major depressive disorder. Scores on the Hamilton Rating Scale for Depression (HRSD) correlated significantly with 5-hydroxyindoleacetic acid (5HIAA) and with homovanillic acid (HVA). In addition, the single suicide item of the HRSD correlated significantly with 5HIAA. Further, 5HIAA and HVA correlated significantly with each other. There was a significant positive correlation between HVA and two HRSD items, the depersonalization/derealization item and the paranoid item. Since lumbar CSF metabolite concentrations may reflect central nervous system activity of parent amines, these data suggest a relationship between depression and decreased dopaminergic and serotonergic activity.
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PMID:CSF amine metabolites and depression. 244 71

One hundred fifty patients with Panic Disorder (PD) with or without Phobic Avoidance were subdivided into two groups on the basis of presence/absence of derealization and/or depersonalization (D-D) during panic attacks. D-D was found in 34.7% of the sample. By comparing the two groups, the patients with D-D were found to be younger and had an earlier onset of the disorder; they had a higher prevalence of avoidance behavior and a higher severity of the agoraphobic spectrum phobias. They were also more frequently subject to concomitant disorders such as Generalized Anxiety, Obsessive-Compulsive, and depressive symptomatology. The authors have hypothesized a correlation between the presence of D-D during panic attacks and a more frequent clinical evolution toward agoraphobia. This view is supported by finding that D-D in panic attacks corresponds to severer forms of PD, both in terms of the earlier onset of PD, and because PD shows higher levels of anxiety, depression, and disability.
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PMID:Derealization and panic attacks: a clinical evaluation on 150 patients with panic disorder/agoraphobia. 292 66

Schizotypal and borderline personality disorders (SPD and BPD, respectively) appear to be different at follow-up, yet they are poorly discriminated from each other by current DSM-III symptom criteria. In the Chestnut Lodge Follow-up Study, three axis II study cohorts (pure SPD, n = 10; pure BPD, n = 81; mixed SPD/BPD, n = 18) with distinctive outcomes are defined using current borderline systems. This study compares the relative frequency with which individual symptom criteria from each system discriminate across study cohorts. Findings suggest that for SPD, the most characteristic (core) DSM-III symptoms are odd communication, suspiciousness/paranoid ideation, and social isolation, while the least discriminating symptom is illusions/depersonalization/derealization; the core DSM-III symptoms for BPD are unstable relationships, impulsivity, and self-damaging acts, while the least discriminating symptoms are inappropriate anger and intolerance of aloneness; depression as a symptom does not discriminate between SPD and BPD; and transient psychoses and brief paranoid experiences and/or regression in treatment discriminate for SPD but against BPD and therefore fit better as SPD criteria. Results support the retention of some, but the elimination of other, DSM-III symptom criteria for the diagnosis of SPD and BPD.
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PMID:Testing DSM-III symptom criteria for schizotypal and borderline personality disorders. 381 9

The improvement in the clinical methods of identifying borderline subjects makes it necessary to reevaluate the efficacy of the treatment offered them. A random sample of 52 borderline and schizotypal patients was treated with two major neuroleptics, thiothixene and haloperidol, in a double-blind study. Eighty-four percent were markedly to moderately improved at 3-month follow-up; the patients responded better to thiothixene than to haloperidol. The main areas of positive response were those of cognitive disturbance, derealization, ideas of reference, anxiety, and depression. The patients also showed improvement in self-image and social functioning. There was no significant relationship between diagnosis and outcome of treatment.
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PMID:Response of borderline and schizotypal patients to small doses of thiothixene and haloperidol. 638 63

Thirty-one (43%) of 68 patients with primary depression were found to have a blunted thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH). Increased thyroid activity, as measured by the free thyroxine index (FTI), was present in 16 (24%) of the patients. Patients with blunted responses had a higher mean FTI level than those with normal responses. Patients with blunted responses were significantly more likely to exhibit the symptoms of depersonalization, derealization and agitation. There was no clear association between blunting and any particular diagnostic category of depression. Patients with blunted responses and high FTI values were more likely to report significant long-term environmental difficulties than patients with blunted responses and normal FTI values. It is suggested that there may be more than one mechanism responsible for blunting of the TSH response in depressed patients. In some patients blunting may be due to negative feedback from increased output of thyroid hormones, possibly released as part of a stress response. In other patients blunting may be due to a different mechanism, possibly involving pituitary gland dysfunction. These mechanisms would not necessarily be mutually exclusive in any one patient.
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PMID:Endocrine changes and clinical profiles in depression: II. The thyrotropin-releasing hormone test. 644 18

Panic disorder is a subtype of anxiety manifested by discrete periods of apprehension or fear and at least four of the following somatic symptoms: dyspnea, palpitations, chest pain, choking, dizziness, depersonalization or derealization experience, paresthesias, hot and cold flashes, sweating, faintness, trembling, and fear of dying, going crazy, or doing something uncontrolled during an attack. Because the patient with panic disorder often selectively focuses on one of these somatic symptoms and may minimize or deny psychosocial distress, panic disorder is frequently misdiagnosed. As a result of the frightening nature of the symptoms, a pattern of overutilization of medical care systems frequently ensues. Panic disorder is usually precipitated by stressful life events, most commonly separation or loss, in a patient with a genetic or acquired vulnerability. As with other psychophysiologic illness (depression, duodenal ulcer) resolution of the acute stressful life event may not lead to resolutions of the physiologic changes. Two specific tricyclic antidepressants, imipramine and desipramine, have been shown to be effective therapeutic agents in treating panic disorder.
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PMID:Panic disorder. 663 52


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