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

Electroconvulsive therapy (ECT) has recently been re-examined in randomized, double-blind controlled trials. Although a variable placebo influence has been demonstrated, the effectiveness of ECT in severe depression is now well established. ECT may also have a role in the treatment of resistant schizophrenia. A bilateral convulsion is essential for therapeutic efficiency. Unilateral electrode placement is as effective as bilateral placement and reduces subsequent memory impairment considerably. A reduction in the total electrical energy used to produce the convulsion (with unidirectional squared wave forms and brief pulses) lessens cognitive difficulties after ECT. Long-term memory is not impaired but selective impairment of verbal and non-verbal learning can occur in the short term. Psychopharmacological studies suggest that postsynaptic dopamine transmission may be enhanced by ECT.
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PMID:Electroconvulsive therapy in 1985--a review. 286 40

This paper reviews systematic clinical studies suggesting memory and cognitive impairment in patients suffering from unipolar and bipolar affective disorders treated with lithium. A number of studies failed, however, to demonstrate lithium induced memory deficits. Thus, the results of studies were equivocal. This lack of empirical consensus was in part due to the heterogeneity of samples and a variety of methodological and design problems. The definition of short- and long-term memory was often arbitrary and lacked standard criteria. Some studies revealed a stability of the memory test scores over time and showed that subjective complaints of memory impairment were correlated with depression. The authors also reviewed studies examining the effects of lithium on cognition and memory of healthy control subjects. In animal research it was difficult at times to distinguish between toxic and pharmacologic effects of lithium. There is a need for prospective studies of the effect of lithium in large samples of patients using refined memory tests.
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PMID:Lithium and memory: a review. 311 76

A prospective study of 120 patients newly diagnosed as having Hodgkin's disease and non-Hodgkin's lymphoma was conducted to determine the nature, extent, and timing of the psychiatric and social morbidity associated with the diagnosis and treatment. Patients were interviewed at diagnosis and two, six, and 12 months later by trained interviewers using standardised questionnaires. Psychiatric morbidity was greatest in the three months before treatment, but new episodes of anxiety and depression developed throughout the year of follow up. Altogether 39 patients suffered a depressive illness or anxiety state, or both, and a further 37 experienced borderline anxiety or depression, or both, during the 15 months of assessment. The most common adverse effects of treatment were hair loss, nausea, vomiting, sore mouth, and changes in perception of taste. Toxicity of treatment was associated with psychiatric morbidity. Conditioned responses to chemotherapy were experienced by 32 patients. Social morbidity was low, although difficulties in returning to work and to previous levels of leisure activity were noted. Although most patients were no longer receiving treatment and were free of disease at the one year follow up, 51 patients continued to complain of loss of energy, 24 of loss of libido, 38 of tiredness, 23 of irritability, 18 of poor concentration, and 23 of memory impairment. These results confirm our retrospective study and suggest that a high price is paid for long term survival by a substantial proportion of patients receiving treatment for Hodgkin's disease and non-Hodgkin's lymphoma.
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PMID:Psychological problems associated with diagnosis and treatment of lymphomas. II: Prospective study. 311 24

Clinical observations suggest that anxiety, depression, rage, and alienation might profitably be considered to be criteria for the diagnosis of post-traumatic stress disorder (PTSD). The results of this investigation (N = 69) suggest that inclusion of these variables among the PTSD criteria would be inappropriate. Somatization and/or hypochondriacal fixation, however, appears to be intimately related to combat traumatization and might appropriately be considered for inclusion among the symptoms associated with PTSD. The DSM-III stress-disorder criteria contain five elements that, among substance-abusing veterans, contribute marginally to the diagnosis of PTSD. Accuracy in evaluating for PTSD might not be compromised by considering fitful sleep, concentration problems, memory impairment, memory interference, and survivor guilt to be associated phenomena rather than PTSD criteria. The results are generally consistent with modifications in diagnostic practice suggested in DSM-III-R.
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PMID:Completeness and internal consistency of DSM-III criteria for post-traumatic stress disorder. 319 9

The benefits and side effects of electroconvulsive therapy (ECT) given two vs. three times per week were examined in depressed inpatients. Twenty subjects were randomly assigned to one of two treatment conditions (unilateral ECT two or three times weekly). Examiners without knowledge of treatment condition rated depression and psychiatric status and administered tests of memory and visual-motor problem solving; subjects also provided self-ratings of depression. Measures were collected before treatment and 2 and 4 weeks after treatment began. Both schedules of treatment produced significant and equivalent improvements in psychiatric symptomatology, but visual memory impairment was significantly lower in the twice-weekly group.
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PMID:Effects of ECT given two vs. three times weekly. 360 21

Eighty-one patients (mean age: 66 +/- 9 years) who had been in gerontopsychiatric in-patient care were included in the study. As well as physical, psychiatric and neurological examinations, EEG, brain CT scanning and the determination of the Ischemic Scale were performed, in order to confirm the clinical diagnosis of dementia of Alzheimer type (DAT), dementia of vascular type (DVT) or multi-infarct dementia (MID), and depression in old age, as based on the DSM III criteria. A comprehensive psychological test battery was administered, to one section of the subjects. Our results indicate that EEG and Ischemic Score can differentiate patients with DAT and DVT to a satisfactory degree, whereas CT findings and psychometric assessment were apt to confirm the overall diagnosis of dementia (DAT/DVT) and depression. Patients with dementia showed memory impairment to a greater extent than depressive patients, as could be proved by a memory test (Syndrom-Kurztest). However, a dementia screening test (Information-Memory-Concentration Test) could more accurately differentiate dementia and depression. The application of a comprehensive psychometric testing procedure did not prove to be an effective diagnostic tool in the assessment of various stages of dementia. Short dementia tests and rating scales seem to be appropriate to distinguish depression from dementia, especially in cases of mild to moderate dementia. In patients with very mild and insignificant organic brain disturbances these screening methods fall short of diagnostic validity. Beyond this, there is a current need for assessment instruments in the evaluation of alterations in personality and affectivity, such as are seen in depression.
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PMID:[Interdisciplinary research strategies in geriatric psychiatry--studies and results in dementia and depressed patients]. 366 Sep 17

Seventy-eight subjects suffering from idiopathic Parkinson's disease were studied in 2 separate groups to test the hypothesis that benzhexol affects memory. In study A, 54 subjects were tested by means of a free recall technique; in study B, 24 subjects were given a signal detection memory task. Both studies yielded significant correlations between memory impairment and dosage levels of benzhexol. No correlation was found between memory status and dosage of levodopa, duration of illness or Hamilton depression scores. The implications of these findings are discussed.
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PMID:The adverse effect of benzhexol on memory in Parkinson's disease. 368 79

In a double-blind study of 41 outpatients aged 55 to 80 years with mild memory impairment, the efficacy of dihydroergotoxine mesylate (DEM, Hydergine) at 6 mg per day, administered orally, was tested during a twelve-week period. Specific etiologies for the amnesic syndrome were ruled out by history, physical examination, and laboratory tests. Subjects with a Hamilton Depression Scale rating above 18, ie, possible pseudodementia, were excluded. Physician rating of memory, employing the Inventory of Psychic and Somatic Complaints in the Elderly (IPSC-E), indicated statistically significant improvement of memory function in DEM treated subjects (N = 22) v those on placebo (N = 19), (F = 3.34; df = 1,39; P less than .04). In contrast, structured testing of recent memory using digit symbol substitution and Zahlenverbindungs test (ZVT) showed improvement in both groups (P less than .001) with no significant intergroup differences (P less than .10). Out results indicate that in cases of mild, though subjectively distressing impairment, DEM at higher dosages may help to enhance short-term memory function.
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PMID:A controlled double-blind study of high-dose dihydroergotoxine mesylate (Hydergine) in mild dementia. 381 61

This study uses matched-tasks methodology in order to test memory function in depressed and euthymic patients with major affective disorder. Neither drug-free depressed patients nor lithium-treated euthymic patients show a differential deficit in verbal versus non-verbal recall. However, while euthymic patients show no memory impairment, drug-free depressives do show poor memory functioning. The results support the view that memory deficits observed in affective patients in the depressed state are transient, secondary manifestations of depression and are neither indicative of underlying organic pathology, nor of abnormal hemispheric laterality. This suggests that memory impairment in depression can be treated by treating depressive symptoms, both chemically and behaviourally. The results also support the view that prophylactic lithium treatment has no adverse effects on these memory tasks.
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PMID:Verbal and non-verbal recall by depressed and euthymic affective patients. 382 96

The complex interrelationships among tricyclic antidepressant (TCA) effects, depression, and dementia in elderly patients are reviewed. Although results are mixed, some studies have shown TCA efficacy in elderly patients with organic disorders and associated depressive symptoms, such as forced weeping in pseudobulbar states. Available data, although not clear-cut, indicate that memory deficits or overt confusional states directly attributable to TCAs are relatively rare in patients without preexisting organicity. Studies in normal nonelderly subjects suggest an interaction wherein cognitive improvement due to relief of depression competes at higher doses with drug-induced memory impairment. In older depressed patients, significant relationships have not been found between degree of response to TCA and either baseline cognitive impairment or cognitive impairment during drug trials. Results from an ongoing study comparing imipramine and trimipramine in older depressives suggest that clinical improvement outweighs the anticholinergic effect, resulting in improved memory function.
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PMID:Tricyclic use in the cognitively impaired elderly. 635 72


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