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

Evaluation and treatment of the assaultive adolescent is an important but difficult process. From a psychodynamic perspective, the author reviews factors associated with adolescent violence, including alcohol and substance use, depression and suicidality, overstimulation, sociocultural and family ambience, property damage, threats of violence, and alexythymia. Management and treatment issues are surveyed, such as the necessity to recognize that in some adolescents violence erupts not from narcissitic rage but from strong wishes for affectionate contact. Violent adolescents have little awareness of an inner psychological world, cannot name affects or differentiate one from another, and often confuse thought, feeling, and deed. In psychodynamic treatment, adolescents are helped to experience affect as part of themselves and to develop the capacity to manage affect and use it as a basis for communication and self-understanding.
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PMID:Management of the assaultive adolescent. 160 6

Suicidal syndromes were analyzed in 339 patients older than 45 years. Psychiatric treatment was instituted because of endogenous, neurotic or reactive depression. Differences in the relationship between diagnosis, sex and two age groups are discussed. Violent suicide increases with age concomitantly in all forms of depression. The prevalence of suicide after the age of 45 points toward the significance of particular life events and social influences. Life events and psychodynamic leading to suicidal behaviour are discussed Characteristic arrays of symptoms correlating with suicidal behaviour in endogenous depression are outlined. Special problems in the management of suicidal behaviour in the elderly are discussed.
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PMID:[Suicidal risk in endogenous, neurotic and reactive depression in advanced age]. 169 25

Suicide is a great problem for public health. In France it causes more than 12,000 deaths every year, and it has been estimated that 45 to 70% of these subjects were suffering of affective disorders. Some epidemiological aspects of the links between suicide and depression are analytic and concern the risk factors of suicide among depressed patients: sociodemographic factors: risks are more important for men and for people living alone or suffering of social and affective isolation. Violent suicides increase with age; clinical and evolutive characteristics of the illness: the risk of suicide is correlated with the global severity of the depression, whatever are the nosographic subtypes, with anxiety, sleep disorders and anhedonia, with personal and familial history of suicide; among biological factors, a decrease of 5-HT transmissions has been implicated, but it seems to be more correlated with a modification of the ability to delay, with a poor impulse control. The association of several of these factors increases suicidal risk but it is impossible to describe a specific picture of the depressed suicidal patient, and clinical scales to estimate suicide risk are of limited interest. Finally, the clinical vigilance adapted to each individual case and the quality of the therapeutical relation remain the most important point for preventing suicide.
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PMID:[Prediction of suicide risk]. 180 59

Violent incidents were assessed as part of a prospective study of 1,243 pregnant women. Participants were predominantly poor, urban, minority group women. Seven percent (n = 92) of women reported physical or sexual violence during pregnancy. Most of the women (94 percent) knew their assailant. Victims of violence were at greater risk of having a history of depression and attempted suicide, having more current depressive symptoms, reporting less happiness about being pregnant, and receiving less emotional support from others for the current pregnancy. Comparisons of victims and non-victims showed that victims were more likely to be users of alcohol and drugs. In addition, partners of victims were more likely to use marijuana and cocaine. When possible confounders were controlled using multivariable analyses, a woman's alcohol use during pregnancy and her partner's drug use were independently associated with an increased risk of being a victim of violence during pregnancy. Results of this study highlight the importance of assessing exposure to violence during prenatal care, especially among women who are heavy users of alcohol or drugs or whose partners use these substances.
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PMID:Violence during pregnancy and substance use. 232 35

Based on the relation found to exist between low CSF 5-HIAA and suicide attempt, in particular violent suicide attempt, both in depressed and in so-called nondepressed suicide attempters, the conclusion was drawn that decreased central 5-HT metabolism is related to (auto)aggression, rather than to depression. We challenged this conclusion and that for three reasons: Violent suicide attempt accumulates in certain types of depression making it impossible to conclude whether the biological variable relates to (auto)aggression or to that type of depression as such. Nondepressed suicide attempter is a diagnosis that should be based on presuicidal not on postsuicidal data, in order to avoid false-positive diagnoses. Suicide method is not a reliable index of seriousness of the attempt. Risk/rescue ratio should be used instead. Next the data are discussed that do support the hypothesis that diminished 5-HT metabolism in the brain is related to disregulation of aggression. Finally, the hypothesis is launched that both mood and aggression disorders are related to decreased 5-HT metabolism in the CNS. This would provide a biological explanation for the clinical observation that disorders in mood and in aggression often go hand in hand. Biological research of psychiatric disorders gains in informative value as the psychopathological analysis of the phenomena one studies is more comprehensive. Biological suicide research is no exception to this rule.
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PMID:The serotonin hypothesis of (auto)aggression. Critical appraisal of the evidence. 243 30

Violent sudden separation from their closest family members determined the extent of survivors' individual traumas. Uncompleted mourning and the depression and somber states of mind it created were absorbed by their children from birth on. Children of survivors react to the lack of memories and absence of dead family members. As full adults, an increasing, overt search for better knowledge and understanding is expressed and shared. This seems to contribute to free families of Holocaust survivors of the shame and guilt, and enables a deeper understanding of the entire phenomenon, as it is passed from generation to generation.
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PMID:Mourning and longing from generation to generation. 275 Oct 6

A questionnaire was sent to 206 internists and surgeons asking them to estimate the following: the frequency of psychiatric disorders and behavioral problems among their patients, the type and frequency of psychiatric medication they prescribed, the psychiatric consultation services they most valued, and the type of psychiatric problems they considered emergencies. These physicians estimated that 14% of their patients had significant psychiatric problems; the most frequently mentioned was depression. More than 25% of the physicians prescribed minor tranquilizers, sedatives, and antidepressants at least once a week. Violent behavior was considered a psychiatric emergency by the majority of physicians. There were significant differences between the responses of internists and those of surgeons.
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PMID:Psychiatric components of medical and surgical practice: a survey of general hospital physicians. 729 84

Forty adolescent inpatients with histories of frequent interpersonal violent behavior were compared with 36 hospitalized adolescents without histories of overt violence using self-report questionnaires that measured violence risk, depression, impulsivity, and suicide risk. The two groups did not differ in terms of their demographic characteristics, but the violent patients had a higher prevalence of substance abuse and borderline personality disorder diagnoses. Violent adolescents were more impulsive and at higher suicide risk than nonviolent adolescents. In addition, violent adolescents had more positive histories of suicide attempts and had significantly higher family histories of attempted and completed suicide. In the total sample of adolescents, violence risk was significantly correlated with impulsivity and suicide risk, but not with depression.
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PMID:Correlates of violence risk in hospitalized adolescents. 795 86

This study reports on the use of the Brief Symptom Inventory, a shortened version of the Symptom Check List-90-Revised, to measure psychopathological symptoms that predict male domestic violence. A sample of 152 men and their partners reported on the severity of violent behavior present in their relationship. Discriminant analysis indicated variation in men's violent status as a function of psychopathological symptoms. Violent men evidenced higher scores on 7 of the 9 subscales of the Brief Symptom Inventory, namely, Depression, Anxiety, Hostility, Phobia, Paranoid Ideation, Interpersonal Sensitivity, and Psychoticism.
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PMID:Utilization of the Brief Symptom inventory to discriminate between violent and nonviolent male relationship partners. 896 15

This study represents a first attempt to identify some of the clinical and pathoanatomical correlates of violent outbursts in patients with cerebrovascular accident. Subjects were selected from a population of patients hospitalized with acute stroke. Although we did not have behavioral measures of violent behavior, patients who reported having had violent outbursts were identified based on clinical ratings on a structured interview. Subjects were asked if they had experienced episodes of anger accompanied by behaviors ranging from shouting to violence during the time since their stroke. These patients were compared with controls matched for demographic variables. Violent patients had higher total Present State Exam and Hamilton-D scores. The percentage of patients with cognitive impairment in the angry outburst group (66%) was greater than the control group (22%). Outburst patients had a higher frequency of left-hemisphere lesions (46.7%) compared with controls (29.4%). When lesion volumes were statistically equated, proximity of lesion to the frontal pole was one of the factors related to the self-reported irritable/violent behavior. To determine whether depression explained our findings, we carried out two-way analyses of variance with angry outburst and major depression group membership as factors. Effects of left anterior lesion location and cognitive impairment on violence remained present. These findings suggest that the potential for anger and violence in patients with stroke has multiple clinical and neuropathological correlates, including greater cognitive impairment and left anterior hemisphere lesions.
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PMID:Self-reported aggressive behavior in patients with stroke. 899 58


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