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

Corroborating a typology of rape proposed 10 years earlier, a recent demographic study of 1,000 incidents of rape concluded that the two predominant types of assault were blitz and confidence rape. Blitz rape is characterized by sudden surprise attack by an unknown assailant using force or the threat of violence to gain control over the victim. In confidence rape, the assailant is known to some degree, however slight, and gains control over his victim by winning her trust. The characteristic details that differentiate one type of rape from the other suggest that the psychological impact on the victim will differ according to the type of rape. Specific clinical approaches for the mental health care of each victim group need to be provided. The immediate concerns of blitz rape victims center around their sense of safety, their fear that the rapist may return, and their dismay at having failed to ward off their attacker. They may respond like typical trauma victims with nightmares, flashbacks, sleep and appetite disturbances, heightened startle responses, anxiety, and depression. Treatment--usually sought soon after the rape--may include psychotherapy, medication, and behavioral desensitization. The confidence rape victims' chief concerns are guilt and self-blame. The rape may be revealed only years later. There is often significant delay between the rape and the victims' request for help. The victims need to be assured that they are deserving of help and need the meaning and definition of rape clarified. Providing services may require active and sustained involvement on the part of clinicians. Confidence rape victims will have strong doubts about their ability to discern who is truly trustworthy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Blitz rape and confidence rape: implications for clinical intervention. 236 37

That cannabis use may provoke mental disturbances is well known to Scandinavian psychiatrists today. A review of the psychiatric aspects of cannabis use is given, and the clinical signs of 70 cases of cannabis psychoses collected in Sweden are described. The bluntness and "amotivation" following chronic cannabis use are discussed. Anxiety reactions, flashbacks, dysphoric reactions and an abstinence syndrome are all sequels of cannabis use. Three risk groups begin to emerge: a) Young teenage cannabis users who lose some of their capacity to learn complex functions and who flee from reality to a world of dreams. With its sedative effect, cannabis could modify such emotions as anger and anxiety and slow down the liberation process of adolescence. b) Heavy daily users, often persons who cannot cope with depression or their life circumstances. c) Psychiatric patients whose resistance to relapses into psychotic reactions might be diminished according to the psychotropic effects of cannabis.
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PMID:Psychiatric effects of cannabis use. 300 Jan 37

Analyses of scaled self-report data from Vietnam War veterans receiving inpatient treatment for Post-Traumatic Stress Disorder drawn during a program evaluation study suggested inpatient treatment as provided by the program resulted in significant improvement in the areas of Anxiety, Anger, Depression, Isolation, Intrusive Thoughts (of combat experiences), Flashbacks, Nightmares (of combat experiences), and Relationship Problems. Comparing the relative effects of the incremental addition of Eye Movement Desensitization and Reprocessing (EMDR), Relaxation Training, and Biofeedback found that EMDR was for most problems the most effective extra treatment, greatly increasing the positive impact of the treatment program.
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PMID:Treatment of Vietnam War veterans with PTSD: a comparison of eye movement desensitization and reprocessing, biofeedback, and relaxation training. 762 47

Recall, awareness, flashback, and nightmares are reported complications of general anesthesia, but flashback and nightmares after regional anesthesia have not been described. Two patients underwent vascular and orthopedic surgery under spinal and epidural anesthesia, respectively. Local anesthetic consisted of bupivacaine, and sedation was achieved with the combination of fentanyl, midazolam, and diphenhydramine. In both patients the anesthetic course was uneventful, but the recovery process was complicated by flashbacks and nightmares leading to depression, physical complaints, and lengthy convalescence. Flashback and nightmares after neuraxial anesthesia are unreported and, therefore, their incidence is unknown.
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PMID:Flashback and nightmares after surgery under neuraxial anesthesia: a report of two cases. 959 2

The concept of a posttraumatic stress disorder (PTSD) has become important for psychiatric diagnosis and research, particularly following US-american studies on Vietnam war veterans. Recently, studies on traindrivers involved in suicide accidents have shown symptoms of anxiety and depression in more than 30% of concerned drivers and typical symptoms of a PTSD in 15%. Here, we present the case of a traindriver who was involved in 6 suicide accidents within 17 years of traindriving (the average is 2 suicide accidents). Following the 3rd accident, the driver developed increasingly symptoms like anxiety, sleep disturbances, flashbacks and irritability. Following the 6th accident, he has been unable to work. A former expert opinion saw no relationship between the symptoms of the driver and the suicide accidents. Therefore, further information about the concept of a PTSD seems necessary to ensure early psychotherapeutic and pharmacological treatment of patients with such a disorder.
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PMID:[Social medicine expert assessment of post-traumatic stress disorder]. 978 74

A prospective, comparative study conducted at a UK teaching hospital investigated whether medical and surgical abortion patients differ, before and after pregnancy termination, in their degree of emotional distress and the extent to which having choice of method affects psychological outcome. 132 women having a medical procedure and 143 scheduled to undergo surgical abortion were enrolled and interviewed before and 4 weeks after the procedure. 58% of women in the medical abortion group and 31% in the surgical group felt they had been given a choice between the two procedures. However, since access to medical abortion was restricted to those with pregnancies under 9 weeks of gestation, choice in this situation may have been based on expediency rather than true preference. There were no significant differences between the two groups either at baseline or at follow-up in levels of anxiety, depression, or general negative affect. One-quarter of women in both groups remained anxious at 4 weeks postabortion. Women undergoing medical abortion reported higher levels of severe pain, bleeding, and disruption of daily activities; moreover, women who saw the fetus were most susceptible to psychological distress, including nightmares, flashbacks, and unwanted thoughts related to the procedure. Women in the surgical group who received general rather than local anesthesia were most likely to report postabortion distress. In the event of a future unwanted pregnancy, 92% of women in the surgical group and 53% in the medical group would select the same process. Exercising choice was not associated with any significant differences in postabortion emotional state or satisfaction. The option of suction termination under local anesthetic offers a combination of desirable factors, including a single appointment, shorter waiting times, no sight of the fetus, less pain, and avoidance of the side effects of general anesthesia.
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PMID:A comparison of medical and surgical termination of pregnancy: choice, emotional impact and satisfaction with care. 988 20

Previous research has identified acute stress symptoms, particularly peri-traumatic dissociative symptoms (the distortion of consciousness, depersonalization, derealization, automatic movements, flashbacks with illusions or hallucinations), as risk factors for the development of later posttraumatic stress disorder. Numerous retrospective assessments and current prospective studies confirm these findings. It is suggested that peri-traumatic dissociation be assessed immediately after traumatic exposure and during the weeks following. But traumatized victims may present other categories of acute reactions; panic attacks, acute depression, conversion reaction, excessive emotional expression, and psychotic reactions. Brief reactive psychosis is a major differential diagnosis with peri-traumatic dissociative experiences. During emergency interventions it may be difficult to distinguish between dissociative and psychotic symptoms. It is cautioned that these disorders be evaluated with a follow-up of several months.
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PMID:[Acute peri-traumatic dissociative experiences: assessment and course]. 1059 89

There is abundant evidence to suggest that doctors are increasingly being exposed to violent incidents at their workplace. The possible effects of aggression on an individual are varied and likely to depend on the severity and frequency of episodes and the perceived vulnerability to further episodes. The reported sequaelae of violent incidents towards doctors include varied psychological disturbances, and changes in behaviour, such as increasing prescribing, ongoing fear of violence at work, and poor staff morale. We investigated the effects of violence against doctors in the accident and emergency departments in Kuwait. Seventy-five (86%) out of 87 doctors exposed to violent incidents reported one or more of the symptoms consisting of: depression, reliving experience (flashbacks), insomnia, and taking 'time off'. The effects lasted for more than 4 weeks in 25, for 3-4 weeks in 17, and for 2-3 weeks in 21. The duration of symptoms was longer in doctors exposed to verbal insults or threats of imminent violence coupled with incidents involving single acts of violence. Out of a total of 101 doctors; 90 (89%) remained worried about violence at work and 72 (71%) thought training to deal with potentially violent situations would be useful.
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PMID:Violence against doctors: 2. Effects of violence on doctors working in accident and emergency departments. 1064 18

If neurotoxicity of MDMA (ecstasy) is now well documented in animals, it is not the same in humans. MDMA intoxication puts the problem of its possible link with the serotonin syndrome and the neuroleptic malignant syndrome. Neuropathological consequences following MDMA intake have been reported, including hemorrhaging and cerebral infarction, cerebral venous sinus thrombosis, and acute inflammatory CNS disease. However, the physiopathology of these complications remains unclear. In the same way, there have been various reports that have attributed MDMA to precipitating the onset of a wide range of psychiatric disorders including sleep disorders, cognitive disorders, panic attacks, depression, flashbacks, psychosis and severe paranoia. Findings suggest that these psychiatric manifestations might be consequences of MDMA induced brain serotonin neurotoxic lesions. All these data are examined from a critical review of the literature.
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PMID:[Neuropsychiatric disorders induced by MDMA ("Ecstasy")]. 1066 3

The psychological adjustment of 57 children (age range, 3 to 12 years) who sustained mutilating traumatic injuries to the face or upper or lower extremities was assessed over a 12-month interval. The injuries had occurred as a result of boating, lawn mower, or home accidents or dog bites. Within 5 days of the traumatic event, 98 percent of the children were symptomatic for posttraumatic stress disorder, depression, or anxiety. One month after the injury, 82 percent were symptomatic. Symptom frequency had declined by the time of the 3-month and 6-month evaluations, but 44 percent of the children continued to report symptoms at 12-month follow-up visits, and 21 percent met the diagnostic criteria for posttraumatic stress disorder. Typical symptoms included flashbacks, fear of re-injury, mood disorders, body-image changes secondary to disfigurement, sleep disturbances, and anxiety. These findings support the importance of psychological evaluation and treatment of children who suffer mutilating injuries that require the attention of plastic surgeons.
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PMID:Psychological adjustment in children after traumatic disfiguring injuries: a 12-month follow-up. 1112 71


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