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

To examine the contribution of psychopathology to emergency room (ER) visits for atypical chest pain, we administered two screening measures and the Structured Clinical Interview for DSM III-R (SCID) to thirty-five subjects within seventy-two hours of their ER visit. Follow-up SCID interviews were completed in thirty subjects at five to twelve months. Sixty percent of the sample had an initial Axis I diagnosis, predominately affective (34%) and anxiety (46%) disorders. Forty percent had multiple diagnoses initially. The most common diagnoses were panic disorder (31%) and major depression (23%). At follow-up 47 percent had Axis I diagnoses, 30 percent had multiple diagnoses, with only slightly decreases rates for panic disorder (27%) and major depression (17%). Many subjects had lost, gained, or switched diagnoses by follow-up, in spite of one consistent rater and a few subjects seeking treatment. ER physicians often do not recognize these psychiatric disorders in chest pain patients. The high risk of suicide in panic disorder and depression, and the high cost of disability in recurrent chest pain make it essential that ER physicians include these disorders in the differential of atypical chest pain.
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PMID:Axis I disorders in ER patients with atypical chest pain. 206 56

Although appropriate follow-up is an important task in the consultation setting, little attention has been directed to its frequency, or the risk profile for minimal or maximal follow-up. Eight hundred twenty-three patients from 1983 to 1986 were examined at the Mount Sinai Hospital using a computerized psychiatric consultation database that recorded demographic information, reason for referral, DSM-III 5 Axes diagnosis, recommendations and number of follow-up interviews. Forty-two percent of the consultations had three or less (minimum) follow-up visits. The minimum follow-up group were significantly less often referred for depression or diagnosed as depression (p = .01), had fewer psychosocial stressors (Axis III) (p = .03), and recommendations for psychosocial treatment by the psychiatric consultant (p = .0001), but had significantly more personality disorders (Axis II) (p = .04). Sixty-two percent of the consultation patients were correctly classified into the follow-up groups by the variables: 1) marital status; 2) living situation; 3) problem assessed as chronic illness or pain; 4) absence of an Axis I diagnosis or diagnostic uncertainty; and 5) number of recommendations by the consultant.
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PMID:Follow-up of psychiatric comorbidity in the general hospital. 226 85

Symptom frequency and severity were compared in two sequential clinically referred samples of 95 children and 92 adolescents, aged 6 to 18 years, all medically healthy, assessed with the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present Episode, who met unmodified Research Diagnostic Criteria for major depressive disorder (MDD). There were no significant differences between the two groups in the majority of depressive symptoms. However, prepubertal children had greater depressed appearance, somatic complaints, psychomotor agitation, separation anxiety, phobias, and hallucinations, whereas adolescents had greater anhedonia, hopelessness, hypersomnia, weight change, use of alcohol and illicit drugs, and lethality of suicide attempt, but not severity of suicidal ideation or intent. Adolescents with a duration of the depressive episode of two years or greater had significantly higher rates of suicidal ideation and intent, lethality, and number of suicide attempts than youngsters with depressive episodes of shorter duration. A principal components factor analysis of psychiatric symptoms was carried out in all 296 youngsters evaluated during the same period who met DSM-III criteria for any Axis I diagnosis. The majority had an affective disorder. Factors were quite similar for both adolescents and children and included an "endogenous" and an "anxious" factor, as in many studies of adult depression. In addition, three other factors were found: negative cognitions, appetite and weight changes, and a conduct factor. Suicidal ideation was a component of both the negative cognitions factor and the conduct factor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The clinical picture of major depression in children and adolescents. 366 42

Previously, we reported a modest but significant reduction in the concentration of neuropeptide Y in frontal cortices from victims of suicide relative to age-matched natural or accidental death control subjects. The reduction in neuropeptide Y appeared to be greatest in a subgroup of victims of suicide for which there was indirect evidence of histories of depression. We pursued these initial findings in the present study by measuring neuropeptide Y concentrations in frontal cortices from natural or accidental death control subjects and from suicide victims in whom a firm diagnosis of major depression was established by psychiatric autopsy. Because several subjects with major depression had a comorbid diagnosis of alcoholism, a group of victims of suicide that had an Axis I diagnosis of alcohol dependence was also studied. No significant differences in neuropeptide Y concentrations were observed between control subjects and victims of suicide with major depression or victims of suicide with alcohol dependence. These findings do not support a role for neuropeptide Y in major depression.
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PMID:Neuropeptide Y in frontal cortex is not altered in major depression. 756 60

Depressive mood and impulsive-aggressive behavior are relevant to suicidal behavior and have been associated with decreased central serotonergic function. Impulsive behavior and aggression have also been related to abnormal glucose metabolism. To investigate these relationships further, blood serotonin (5-HT), blood glucose measures (glycated hemoglobin (HbA1C) and fructosamine) and self-reported depressive symptoms and anger were repeatedly measured, during a 1-year follow-up, in 106 patients who had recently attempted suicide for at least a second time. A major DSM-III-R Axis I diagnosis or use of antidepressants were reasons for exclusion. Intra-individual variations in blood 5-HT were inversely correlated with variations in depressive mood, self-depreciation, and anger, and positively with variations in fructosamine. Intra-individual variations of HbA1c or fructosamine were not correlated with mood. Mean blood 5-HT levels per patient were positively correlated with mean scores of depression and self-depreciation. The contrast between the intra-individual and the inter-individual correlations may reflect a difference between short- vs. long-term effects. The results do support an association between serotonergic function and mood, but not between glucose metabolism and mood, in recurrent suicide attempters.
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PMID:Mood correlates with blood serotonin, but not with glucose measures in patients with recurrent suicidal behavior. 979 39

Data are presented that describe the clinical characteristics of 96 patients treated at the C.F. Menninger Memorial Hospital, Topeka, Kansas, from November 1983 to June 1989. Their Axis I eating disorder diagnoses were as follows: 53 had diagnoses of bulimia; 21 had anorexia nervosa; 2 had both diagnoses; 17 had atypical disorders or eating disorders not otherwise specified; and 2 had a diagnosis of psychological factors affecting physical conditions. Seventy-three percent of the cohort were found to have either Axis I or Axis II disorders or both, comorbidity. Borderline personality disorder was found in 46% of the sample, although 20% of the patients with borderline disorders were diagnosed retrospectively. Depression was the largest comorbid Axis I diagnosis. Patient variables for sexual abuse, drug and alcohol addiction, purgative behaviors, and interpersonal relationships are also described. The authors conclude that a substantial subpopulation of eating disordered patients are significantly comorbid for other psychiatric illnesses. This high incidence of comorbidity may help explain the frequency of refractoriness of many eating disordered patients who do not respond to outpatient or short-term inpatient hospitalization. The authors recommend that additional research studies address the problems of the comorbid eating disordered patient and suggest that the findings be taken into account by clinicians and payers.
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PMID:Comorbidity in an inpatient eating disordered population: clinical characteristics and treatment implications. 1012 39

Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychological problems after OHT have been described in many studies. Little is known, however, about the relationship between the psychological state of the patient and time after surgery. The present study involved 41 consecutive OHT patients that underwent transplantation from January 1991 to December 1992, with a retrospective review of pretransplant psychiatric evaluations to define a Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised (DSM III-R) Axis I diagnosis. Patients completed the Beck Depression Inventory (BDI-13), Spielberger's State Trait-Anxiety Inventory (STAI-Y), and the General Health Questionnaire (GHQ-28) between 1 and 41 months after transplantation. For comparison, 29 presumably healthy volunteers were given the same questionnaires. The study confirms the occurrence of abnormal psychological scores in the OHT group as compared to the reference population. Psychological scores, however, do not appear to be related to the time they were recorded after surgery.
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PMID:Psychological distress of surgical patients after orthotopic heart transplantation. 1179 36

The aim of this study was to evaluate the effects of comorbid subthreshold anxiety on the course and the treatment of Depressive Disorders. The sample studied comprised four groups defined by the DSM-IV Axis I diagnosis: (1) Patients with a Major Depressive Disorder (MDD) and an Anxiety Disorder (DA); (2) patients with MDD and a subthreshold Anxiety Disorder (Da); (3) patients with subthreshold depression and an Anxiety Disorder (dA); (4) patients with subthreshold depression and subthreshold anxiety (da). HAMD, HAMA and CGI rating scales were administered monthly for 12 months while patients were treated with different antidepressants. Significant differences were found among the four groups with respect to the baseline depressive symptoms: Da presented more frequently suicidal ideation (chi2=9.568, d.f.=3, p=0.023), psychomotor retardation (chi2=12.568, d.f.=3, p=0.006), sexual dysfunctions (chi2=7.761, d.f.=3, p=0.05), hypochondriacal ideation (chi2=13.633, d.f.=3, p=0.003), weight loss (chi2=9.520, d.f.=3, p=0.023), and diurnal variation of symptoms (chi2=13.258, d.f.=3, p=0.004). With respect to the treatment response Da patients showed an overall worse response to antidepressants, having a longer latency and a lower reduction of symptoms. These results suggest that patients with Major Depression and subthreshold anxiety present with a more severe baseline clinical picture and seem to have a less efficient response to antidepressants.
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PMID:Does comorbid subthreshold anxiety affect clinical presentation and treatment response in depression? A preliminary 12-month naturalistic study. 1546 68

The present study describes Personality Assessment Inventory (PAI) profiles for women with posttraumatic stress disorder (PTSD). Four groups of women were sampled: single Axis I diagnosis of PTSD; PTSD and major depressive disorder (MDD); PTSD, MDD, at least one other Axis I disorder; and controls with no Axis I disorder. Higher comorbidity rates were associated with higher mean profile elevations and broader range of endorsed symptoms. The group with the highest rate of comorbidity produced profiles most similar to previously published reports of patients with PTSD. This is in contrast to women with a single diagnosis of PTSD, who produced relative mean elevations only on subscales measuring distress caused by trauma and physiological symptoms of depression. Thus, published profiles may be more reflective of PTSD with comorbidity than a single diagnosis of PTSD.
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PMID:Influences of Comorbid Disorders on Personality Assessment Inventory Profiles in Women with Posttraumatic Stress Disorder. 2143 98

The benefits, and variables influencing the benefits, of short-term dynamic psychotherapy for chronic major depression versus nonchronic major depression were examined for 49 patients. The two diagnostic groups started at the same level on the Beck Depression Inventory (BDI) and Global Assessment of Functioning Scale (GAF) and benefited similarly. The bases for the benefits were examined by linear models explaining 35% of termination BDI variance and 47% of termination GAF scores. By far the largest contributor to outcome was initial GAF, followed by presence of more than one comorbid Axis I diagnosis. Initial level of depression on the BDI was not a significant predictor of termination BDI. The chronic/ nonchronic distinction accounted for less than 1% of explained variance, and little was added by personality disorder, age, or gender.
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PMID:Factors in Outcomes of Short-Term Dynamic Psychotherapy for Chronic vs. Nonchronic Major Depression. 2270 Feb 74


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