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)

Patients with primary major depression (N = 372) were followed for 2 years to determine the prognostic importance of past manic or hypomanic episodes. While bipolar I and bipolar II patients were more likely to relapse and bipolar I patients were more likely to attempt suicide, these patients resembled nonbipolar depressed patients in likelihood of recovery and psychosocial impairment in various areas. Compared to nonbipolar patients, those with bipolar I depression were much more likely to develop mania, while bipolar II patients were more likely to develop hypomania. Cycling during the index episode predicted a relatively low likelihood of recovery for bipolar I patients but had no apparent prognostic significance for patients with bipolar II illness.
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PMID:The significance of past mania or hypomania in the course and outcome of major depression. 382 29

How common and how significant are brief depressive episodes (BDE) lasting less than 2 weeks? The authors propose splitting the BDE into two groups: one occurring monthly over 1 year of observation, termed 'recurrent brief depression' (RBD), and those occurring less frequently, labeled 'nonrecurrent brief depression' (NRBD). From a medical point of view, the RBD are a relevant group. Different thresholds of definition are tested, the narrowest of which (including occupational impairment and predetermined minimum number of symptoms) is accepted for 'case'-definition. The such defined RBD (SYM) group differs from major depression only by length and frequency of episodes. In a young cohort, its 1-year prevalence rate was found to be 4.4% (males 3.9%, females 4.9%). One-third of these cases needed treatment, a fourth suffered from pronounced subjective and social impairment as well as from persistent suicidal ideation. The self-reporting of subjective impairment, assessed with the SCL-90 symptom inventory and an analog-rating, yields high scores which are in no way inferior to major depression diagnosed with RDC, DSM-III or EDE (SYM) criteria. The RBD (SYM) demonstrate less hypomania than the major depressive disorders. On the other hand, a family history of depression is equally frequent across all groups. The validity of the RBD (SYM) group has yet to be confirmed by a follow-up study, and further research is needed to delineate it from secondary depression. The findings largely support the hypothesis of a continuum from mild and short to more severe, longer lasting depressive syndromes, but they do not exclude heterogeneity of RBD (Angst and Dobler-Mikola 1984b).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The Zurich Study--a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. IV. Recurrent and nonrecurrent brief depression. 387 89

Recent clinical observations and psychiatric diagnostic findings of drug-dependent individuals suggest that they are predisposed to addiction because they suffer with painful affect states and related psychiatric disorders. The drugs that addicts select are not chosen randomly. Their drug of choice is the result of an interaction between the psychopharmacologic action of the drug and the dominant painful feelings with which they struggle. Narcotic addicts prefer opiates because of their powerful muting action on the disorganizing and threatening affects of rage and aggression. Cocaine has its appeal because of its ability to relieve distress associated with depression, hypomania, and hyperactivity.
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PMID:The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. 2349 64

A representative sample of 908 hospital records covering admissions between 1920 and 1982 for depression was analyzed in order to assess the switch rate to hypomania/mania. The results are the following: (1) Over the decades of this century there has been a substantial increase in hospital admissions in Zurich for both depression and mania, but the ratio remained constant. (2) Due to this increase the clinicians can observe more spontaneous switches from depression to mania, which favors the assumption of a causal relationship when treatment is applied. (3) 64 of the 908 patients (7.0%) admitted for depression switched to hypomania or mania. Hypomania was observed in 48 cases (5.3%) and mania in 16 cases (1.7%). (4) The analysis of predisposing factors to a switch has resulted in a simple finding. Bipolar patients (including schizomanics) have an 8-fold higher switch rate (28.9%) than the unipolars (3.7%). The switchers are equally distributed over the two sexes and do not differ in the frequency of a family history of affective psychoses, schizophrenia, schizoaffective disorders, or suicide. (5) Bipolarity correlates positively with 'higher number of previous episodes', with 'readmitted' and with 'switch'. Therefore, studies selecting readmissions [Lewis and Winokur 1982] overrepresent switchers purposely. (6) A loglinear analysis together with some univariate strategies show that over the decades (from 1920 to 1982) there was no significant increase in switches of unipolar or bipolar patients. In conclusion, there is no evidence for a treatment-induced switch. This result is in line with Prien et al. [1973] and with Lewis and Winokur [1982].
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PMID:Switch from depression to mania--a record study over decades between 1920 and 1982. 405 86

The clinical presentation of three patients with meningiomas at different frontal sites is described. They had been ill for 3, 25, and 43 years before the tumour was demonstrated radiologically. Apathy, incontinence, dementia, and fits were seen in association with middle and superior frontal lesions, and may be mistaken for symptoms of involutional depression or presenile cerebral atrophy. In contrast, excitement and hallucinosis were seen in association with a basal frontal lesion, and may mimic psychotic syndromes like hypomania and schizophrenia, particularly if the tumour encroaches on the third ventricle and adjacent structures. Irreversible loss of myelin and axons in the frontal areas of brain surrounding the tumour may have contributed to the clinical picture of the syndrome shown by these patients.
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PMID:Three cases of frontal meningiomas presenting psychiatrically. 496 22

Wrist motor activity and sleep were monitored longitudinally in 15 rapidly cycling and 52 nonrapidly cycling manic-depressive patients. The majority of patients experienced one or more consecutive 48-hour sleep-wake cycles (alternate nights with no sleep) when they switched out of depression into mania of hypomania. During a depressive phase, nine rapidly cycling patients were asked to simulate a 48-hour sleep-wake cycle by remaining awake for 40 hours (one night's total sleep deprivation). Eight switched out of depression, and seven were rated as manic or hypomanic; indicating that sleep loss (such as occurs with spontaneous 48-hour sleep-wake cycles) may help to trigger switches from depression to mania. The 48-hour sleep-wake cycles in patients may depend on a mechanism that is normally present in all humans, since normal persons also spontaneously experience near-48 hour sleep-wake cycles in certain experimental conditions.
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PMID:48-hour sleep-wake cycles in manic-depressive illness: naturalistic observations and sleep deprivation experiments. 612 23

Twenty percent of a cohort of 206 outpatient depressives with no past bipolar history switched during prospective observation. These 41 probands developed manic periods on the average of 6.4 years (median 4, range 1-25) after their first depressive episode. The change in polarity occurred throughout the life span, but was most common in adolescence and early adulthood. The following variables were found useful in predicting this outcome: onset less than or equal to 25 years, bipolar family history, loaded pedigrees, precipitation by childbirth, hypersomnic-retarded phenomenology, and pharmacologically-mobilized hypomania. Although the respective sensitivities of these findings were relatively low (32-71%), their specificities ranged from 69% to 100% for bipolar outcome; the diagnostic specificity of any 3 of these variables when combined was 98%. When compared with nonbipolar depression, bipolar disorder was seldom chronologically secondary to nonaffective psychiatric disorders. These findings suggest that many young depressives with lethargy and oversleeping are not manifesting a "neurotic" disorder, but rather a precursor of primary bipolar affective disorder. Finally, a psychotically depressed adolescent or young adult with positive bipolar family history should be observed for eventual bipolar outcome, especially when the clinical presentation is that of stupor.
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PMID:Bipolar outcome in the course of depressive illness. Phenomenologic, familial, and pharmacologic predictors. 622 91

A small group of patients who had been successfully treated with lithium for a number of years were treated with zimeldine in order to determine whether this antidepressant could be substituted for lithium in patients with a bipolar affective illness. The proposed treatment period of 6 months was not reached by any patient due to depression, hypomania, mania or unusual adverse symptoms. The results of this pilot study suggest that bipolar patients being treated with lithium should not then be treated by antidepressants including those which are potent and selective inhibitors of 5-HT uptake.
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PMID:Treatment of bipolar affective illness with zimeldine, a 5-HT uptake inhibitor. 624 Dec 15

Structured interviews were used to study rates of past suicide attempts among 123 outpatients treated for affective disorders. Subjects met the Feighner criteria for major affective illness, and bipolar and unipolar groups were identified in accordance with the Fieve-Dunner criteria. Although a small group (N = 6), the women with a history of hospitalization for depression and outpatient treatment for hypomania (BP II) had the highest rate of past suicide attempts. (66 percent). This confirms previous findings. Women showed higher rates overall (39 percent vs. 28 percent for men). Suicide attempters were found to be significantly younger than nonattempters, which is in line with previous reports that suicide risk is high early in the course of bipolar illness. A trend for attempters to have received their first treatment at a younger age suggests that early onset may be a risk factor. No differences in marital status were found between attempters and nonattempters. Males and females did not differ in number, seriousness, or lethality of attempts.
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PMID:Attempted suicide in manic-depressive disorder. 648 84

Affective symptoms were evaluated in chronic alcoholics during a 2-week period following detoxification from alcohol. Increased ratings were apparent both on the Manic State Rating Scale (MSRS) and on the Ma Scale of the Minnesota Multiphasic Personality Inventory (MMPI) in a subgroup of these patients. Primary symptoms included grandiosity, irritability, and mildly increased psychomotor activity. Alcoholics who had been detoxified for several months or hospitalized medical patients did not show similar symptoms. Measurements of urinary 3-methoxy-4-hydroxyphenylethylene glycol (MHPG), a metabolite of norepinephrine which has been associated with manic-depressive illness, also showed increased excretion in a subpopulation of recently detoxified patients. The coexistence of depressed mood in these patients may have led to symptoms of hypomania being previously overlooked, although signs of depression are common in mania itself.
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PMID:Altered mood and norepinephrine metabolism following withdrawal from alcohol. 664 96


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