Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Understanding the validity of structured psychiatric diagnostic interviews in medically ill patients will advance the ability to conduct research into the treatment and management of these disorders in general medical settings. We compared the University of Michigan version of the CIDI (Composite International Diagnostic Interview) for major depression to a clinical gold standard, derived through Spitzer's Longitudinal, Expert, All Data (LEAD) criteria based on the SCID-III-R. A convenience sample of medical inpatients was administered the SCID-III-R and the CIDI for major depression in random order. A physician panel reviewed the SCID interview and other pertinent data and determined whether patients had a lifetime or current (past month) diagnosis of major depression. The CIDI was scored with and without hierarchical exclusions for mania, hypomania, substance use, or medical illness. When the UM-CIDI was scored for a lifetime diagnosis of major depression without hierarchical exclusions, agreement above chance (kappa) was very good (kappa = 0.67) between the CIDI and the physician panel and good (kappa = 0.46) when the UM-CIDI was scored with exclusions. Agreement above chance for diagnosis of a recent disorder was better for UM-CIDI scoring with exclusions (kappa = 0.51) compared to scoring without exclusions (kappa = 0.43). Predictive value-positive was excellent in both scoring versions for a lifetime diagnosis (82%) and good to very good for current depression (46% and 62%). In all cases predictive value-negative was very good to excellent (77-93%). Discordant cases were almost uniformly due to difficulties in attribution of symptoms to medical illnesses. We conclude that the CIDI can perform acceptably as a research instrument to diagnose major depression in medically ill patients, potentially supplemented by clinician review of cases identified by the CIDI with current disorder.
 ...
PMID:Diagnosing depression in the medically ill: validity of a lay-administered structured diagnostic interview. 984 51

The purposes of this study were: (1) to examine the characteristics of 447 cocaine dependent, first admission outpatients in relation to their AIDS risky behavior at intake; (2) to ascertain whether there was a reduction in risky behavior at follow-up 9 months after admission; and (3) to determine whether reductions in risky behavior were related to patient characteristics, group as compared to individual treatment, or time in treatment. In this sample of cocaine dependent patients entering outpatient treatment, those engaging in higher AIDS risky behaviors were not characterized by any particular demographic profile or by a lack of knowledge about HIV/AIDS. They did have higher scores on the SCL-90-R symptom scales, the Beck Depression Inventory, and higher ratings on the Drug, Alcohol, Family, and Medical scales of the ASI. At 9-month follow-up, AIDS risky behaviors as measured by the RAB were found to have decreased significantly. The degree of improvement was not associated with demographic variables but was predicted by higher intake problem severity and psychological symptomatology scale scores. While improvement in risky behavior was not related to type of treatment or duration of treatment, it was related to decreased substance use. The individuals whose risky behavior decreased were those whose substance use had decreased. Improvement, then required not only being in a treatment program, but also participation and involvement in the program. Treatment and not merely attendance would seem to be critical.
 ...
PMID:Does intensive outpatient cocaine treatment reduce AIDS risky behaviors? 984 32

This study tested the specificity of parent alcoholism effects on young adult alcohol and drug abuse/dependence, anxiety, and depression, and tested whether adolescent symptomatology and substance use mediated parent alcoholism effects. Participants were from a longitudinal study in which a target child was assessed in adolescence and young adulthood with structured interview measures (N = 454 families at Time 1). Results showed unique effects of parent alcoholism on young adult substance abuse/dependence diagnoses over and above the effects of other parental psychopathology. There was some evidence of parent alcoholism effects on young adult depression and of maternal alcoholism effects on young adult anxiety, although these were not found consistently across subsamples. Mediational models suggested that parent alcoholism effects could be partially (but not totally) explained by adolescent externalizing symptoms.
 ...
PMID:A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression. 1006 97

This study examined psychopathology and substance use in 15 African American adolescents who attempted suicide and 15 African American adolescents who did not attempt suicide (control group). Both groups of adolescents and their parents completed questionnaires that addressed depression, behavior problems, family functioning, and drug and alcohol use. On the basis of group means of the Children's Depression Inventory (Kovacs & Beck, 1977), the Youth Self-Report (Achenbach & Edelbrock, 1987), and the Child Behavior Checklist (Achenbach & Edelbrock, 1983), the suicidal youth were found to have a significant level of depression in addition to a variety of internalizing and externalizing behavior disorders. Similarly, on the Multigating Substance Use Evaluation System (Jurkovic & Bruce, 1991), the suicidal youth were at a high risk for alcohol and drug abuse. The suicidal group reported more alcohol and drug abuse than the control group. The results indicated that suicidal African American adolescents used significant amounts of drugs and alcohol, which may be associated with suicide attempts.
 ...
PMID:The role of drugs and alcohol in urban minority adolescent suicide attempts. 1017 43

Women who abuse drugs and alcohol during pregnancy are an elusive population who often remain unidentified to practitioners and researchers and hence have not been well studied. In trying to understand better the characteristics of women who use drugs during pregnancy, the present article relies extensively on information gathered in studies of women in substance abuse treatment who, as epidemiologic studies show, may be more severely impaired than other substance-abusing women and, therefore, may not be typical of substance-abusing women identified in the course of obstetric practice. Yet, those pregnant women who are actually identified by medical providers as substance users are often those whose behavior raises concerns with health providers (such as presenting for labor having had no prenatal care) and thus also may represent only a relatively impaired group of substance-abusing women. The most objective picture available of the universe of women who use drugs during pregnancy comes from blinded urine toxicology screens conducted at samples of representative hospitals across states and across the country. The startling finding to emerge from these studies is that common perceptions of substance abuse as a problem of poor, ethnic minority, and young individuals is inaccurate and that this perception may all too often be acted on by medical providers in a prejudicial manner. These studies show similar rates of substance use during pregnancy by women of different racial, social class, and age categories. Demographic features are only related to type of substance used, with black women and poorer women more likely to use illicit substances, particularly cocaine, and white women and better educated women more likely to use alcohol, the substance whose teratogenic effects have been most clearly documented. Despite the even distribution of substance use across demographic categories, poor women and women of color are far more likely to be reported to health and child welfare authorities for use of substances during pregnancy than are other women, even when their base rates for use of illicit drugs are considered. Data from both epidemiologic studies and samples of women seeking treatment for substance abuse problems indicate that the lives of substance-abusing women are fraught with difficulties past and present. Substance-abusing women are likely to have been raised by parents who were substance abusers, particularly alcoholics. Although the intergenerational patterns of substance abuse may have some genetic basis, there is also ample evidence suggesting problematic relationships in families with a substance-abusing parent that raises concerns about intergenerational transmission of problematic parenting behavior. Perhaps the most startling research finding reported in studies reviewed in this article is the high proportion of substance-abusing women who have experienced early sexual abuse. Although most studies have not had adequate comparison groups of non-substance-abusing women, the fact remains that most studies suggest a third to a half of substance abusing women experienced some kind of sexual abuse during childhood. Substance-abusing women's lives remain complicated as adults. They are commonly involved with men who are also users of drugs, they are often the victims of domestic violence, and they suffer from a variety of psychiatric disorders. Studies of epidemiologic and treatment populations indicate that the majority of substance-abusing women have one or more types of comorbid mental disorders, with depression being the most common and the most elevated compared with substance-abusing men, but antisocial personality being extremely high compared with samples of non-substance-abusing women. These findings are of great concern given a growing body of research with non-substance-abusing women, suggesting that family violence and maternal psychopathology can have a profound effect on women's parenting and development o
 ...
PMID:Demographic and psychosocial characteristics of substance-abusing pregnant women. 1021 43

The primary objective was to determine whether Vietnam veterans who had alcohol or drug use problems prior to, during, or immediately after the war used Veterans Administration (VA) health care services more intensively during the next two decades than Vietnam veterans without these behaviors. The secondary objective was to identify predictors of VA health services utilization among data collected at service discharge. Logistic and ordinary least squares regression were used to model the effect of predisposing, enabling, and need factors on utilization of VA health services (N = 571). Results show that Vietnam veterans who had substance use problems either before or immediately after Vietnam used VA health care services more intensively during the next two decades than Vietnam veterans without these behaviors. Depression and psychiatric care seeking were also important predictors. More research is needed to evaluate the impact of health system characteristics and private sector use on the predictive ability of the models.
 ...
PMID:Substance abuse as a predictor of VA medical care utilization among Vietnam veterans. 1023 Jan 42

Risk factors for homelessness were examined prospectively among recent participants in a substance abuse treatment program. Low levels of support from friends, greater depression, and recent substance use were bivariately associated with homelessness two months following completion of the program. However, friend support was the only factor associated with homelessness after controlling for other significant bivariate predictors.
 ...
PMID:Predictors of homelessness among participants in a substance abuse treatment program. 1023 92

The aim of this study was to investigate the prevalence of substance use disorder in young adult patients with borderline personality disorder (BPD) and antisocial personality disorder (APD) and to ascertain the specific substances each of these groups choose to abuse. An additional aim was to assess whether alcohol and drug abuse in the patients related to their psychopathology and hostility. The study subjects were 41 hospitalized patients with BPD and 44 hospitalized patients with APD. The diagnoses of personality disorders and substance use disorders were made using DSM-III criteria. Psychopathology patterns were assessed using the Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety Inventory. Hostility was assessed using the Hostility and Direction of Hostility Questionnaire. Abuse of one or more substances was reported by 76% of BPD patients and 95% of APD patients. There was no difference between the two groups in terms of alcohol abuse, but certain substances (such as benzodiazepines, anticholinergics, cannabis, and opioids) were abused more than twice as often by APD patients versus BPD patients. APD patients were more likely than BPD patients to be multiusers. In BPD patients, the number of substances abused showed a negative association with depression, while in APD patients it was positively related to state anxiety. In both patient groups, there was no correlation of the number of abused substances with the degree of extroverted or introverted hostility.
 ...
PMID:Substance abuse patterns and their association with psychopathology and type of hostility in male patients with borderline and antisocial personality disorder. 1042 87

This study examined negative HIV-related expectancies, AIDS-related bereavement, and the interaction of expectancies and bereavement as predictors of the onset of significant HIV-related symptoms among previously asymptomatic HIV-positive gay men. From a longitudinal psychobiological investigation, 72 men were selected who had been HIV-positive and asymptomatic from study entry (approximately 3 years). Participants were followed for an additional 2 1/2 to 3 1/2 years after psychosocial assessment, with symptom status assessed every 6 months. The interaction of negative HIV-specific expectancies and bereavement was a significant predictor of symptom onset. Negative HIV-specific expectancies predicted the subsequent development of symptoms among bereaved men, controlling for immunological status, use of zidovudine, high-risk sexual behavior, substance use, and depression.
 ...
PMID:Negative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men. 1043 36

Examined the impact of childhood psychiatric disorders on the prevalence and timing of substance use and abuse and tested for sex differences. A representative population sample of 1,420 children, ages 9, 11, and 13 at intake, were interviewed annually. American Indians and youth with behavioral problems were oversampled; data were weighted back to population levels for analysis. By age 16, more than half the sample reported substance use, and 6% had abuse or dependence. Alcohol use began by age 9, and smoking in the 13th year. Mean onset of dependence was 14.8 years, and mean onset of abuse was 15.1 years. Substance use began earlier in boys, but not girls, who later developed abuse or dependence. Disruptive behavior disorders and depression were associated with a higher rate and earlier onset of substance use and abuse in both sexes, but anxiety predicted later onset of smoking. Family drug problems were the strongest correlate of early onset. Despite differences in prevalence of psychopathology, boys and girls showed more similarities than differences in the course of early substance use and abuse, and its associations with psychopathology.
 ...
PMID:Development of psychiatric comorbidity with substance abuse in adolescents: effects of timing and sex. 1044 79


<< Previous 1 2 3 4 5 6 7 8 9 10