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

Electroencephalographic (EEG) sleep patterns were examined in 27 psychotic and 79 nonpsychotic subjects with major depression to evaluate the validity of the psychotic-nonpsychotic subtype dichotomy. Sleep in psychotic depression was characterized by increased wakefulness, decreased rapid eye movement (REM) sleep percentage, and decreased REM activity even after controlling for clinical differences in age, severity, and agitation. Psychotic depressive subjects also were more likely to have extremely short sleep-onset REM latencies. In psychotic depression EEG sleep varied as a function of total illness duration. Patients with recent-onset syndromes had profiles characterized by marked initial insomnia, increased stage 1 sleep percentage, and long REM latency; patients with illnesses of longer duration had extremely short REM latencies. Demonstration of selected EEG sleep variables discriminating between psychotic and nonpsychotic depression further supports psychotic depression as a distinct subtype of major affective disorder.
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PMID:Electroencephalographic sleep in psychotic depression. A valid subtype? 375 66

The Inventory to Diagnose Depression (IDD) is a self-report scale designed to diagnose DSM-III major depressive disorder (MDD). In our analysis, its test-retest reliability and internal consistency were high. The IDD was significantly associated with other self-report and interviewer rated depression scales and was sensitive to clinical change. Diagnostic agreement between the IDD and clinician's diagnosis of MDD was as high as that found in studies examining the interrater reliability of the diagnosis of MDD. Moreover, our results suggested that the IDD may aid clinicians in detecting secondary depression and distinguishing psychotic depression from nonaffective psychoses. The IDD may be particularly useful in light of the recent evidence that American psychiatrists continue to underdiagnose depression and overdiagnose schizophrenia.
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PMID:A self-report scale to diagnose major depressive disorder. 376 97

A brief, selective review of a broad range of evidence bearing upon biological distinctions between neurotic and psychotic forms of depression is presented. It includes a somewhat detailed presentation of clinical neurophysiological findings obtained in the author's laboratory over three decades of research. The available evidence is taken to support the discontinuity position of the continuity-discontinuity controversy about neurotic vs psychotic depression. It is concluded that more than one process underlies clinical depression, and that there may be several kinds of depressive disorders.
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PMID:Neurophysiological evidence for different types of depression. 611 65

The use of major tranquillisers as antidepressants is reviewed and 34 double-blind trials evaluating this were found. Results suggest that some neuroleptics have antidepressant properties, although most studies have been conducted on mixed anxiety-depressive states. Advantages over the tricyclic antidepressants are the early onset of action and relative lack of side-effects. Post psychotic depression following major tranquilliser therapy is considered, and it is concluded that it is likely to be part of the underlying illness and not a drug-induced effect. It is suggested that further work with major tranquillisers in depression may be of value in exploring the mechanism of action of antidepressant drugs.
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PMID:Major tranquillisers used as antidepressants. A review. 612 57

Depression, peptic ulcers, and sexual dysfunction may be exacerbated by a deficiency of melatonin. Stress and dietary habits may lead to deficiencies of both serotonin and melatonin. Melatonin inhibits the release of cortisol via the release of vasotocin. Abnormal circadian rhythms of cortisol may occur in states of decreased melatonin. A circannual rhythm of melatonin has troughs associated with peaks in the incidence of peptic ulcers and psychotic depression. Psychotic depression is an apparent disorder of the locus ceruleus and/or dorsal raphe nucleus.
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PMID:Disorder of the pineal gland associated with depression, peptic ulcers, and sexual dysfunction. 639 Jun 95

The authors compared 65 patients with major depression and psychotic features to 192 patients with major depression and no psychotic features in terms of clinical features, family history, and hypothalamic-pituitary-adrenocortical axis function. In accord with other studies, patients with psychotic depression were more likely to have bipolar depression, psychomotor disturbance, a family history of schizophrenia, and a more severely disordered hypothalamic-pituitary-adrenocortical axis. Whether psychotic depression is best considered apart from nonpsychotic depression or as simply a more severe form of depression remains unsettled. Nevertheless, research to date does give the diagnosis of psychotic depression a practical significance which is enhanced by its simplicity.
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PMID:The clinical and neuroendocrine features of psychotic depression. 647 Jun 94

In the management of depression only two forms of the condition need consideration: psychotic depression (usually severe) requiring treatment with antidepressants, ECT or both; and 'other' depressions, for which psychotherapy is the treatment of first choice. The selection of therapy depends on the personality integration of, and the stresses on, the patient. General practitioners are encouraged to understand and use crisis intervention and supportive therapy techniques. If the depression does not respond to these techniques within a few weeks the diagnosis should be reviewed for physical illness, psychosis and drug abuse. Trial of antidepressant drug therapy may be warranted before referral.
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PMID:Treatment of depression in general practice. 666 76

In the National Institute of Mental Health Collaborative Study of the Psychobiology of Depression, six-month follow-up evaluations are available for 24 patients with schizoaffective disorder (depressed type), 56 with psychotic depression, and 274 with nonpsychotic major depression. Outcome for patients with schizoaffective depression was significantly worse than for patients with nonpsychotic depression. The psychotic depression group held an intermediate position on most outcome measures and on psychosocial measures had outcomes significantly worse than those of the nonpsychotic group. Recovery rates assumed a very similar pattern in another cohort admitted more than 40 years ago and followed up without somatic treatment. Follow-ups of 12, 18, and 24 months are available for proportions of each diagnostic group. Survival curves suggest similar outcomes in psychotic depression and nonpsychotic depression, whereas outcomes in schizoaffective depression remain disparate. These trends together with family history studies suggest that a small proportion of patients with schizoaffective disorder, depressed type, will have a long-term course consistent with schizophrenia. Moreover, these data show that outcome studies of schizoaffective disorder must control for follow-up length and the effects of psychosis per se.
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PMID:Outcome in schizoaffective, psychotic, and nonpsychotic depression. Course during a six- to 24-month follow-up. 674 79

The pharmacology, pharmacokinetics, clinical trials, side effects, and dosage of amoxapine are reviewed. Amoxapine is a tricyclic dibenzoxazepine antidepressant that is chemically similar to the antipsychotic agent loxapine. In animal tests, amoxapine and its metabolites block reuptake of the neurotransmitter norepinephrine, with little effect on serotonin. It is rapidly and virtually completely absorbed when administered orally; peak serum concentrations occur one to two hours after ingestion. Amoxapine is widely distributed throughout body tissues and is 90% bound to serum proteins. Aromatic hydroxylation in the liver produces two major metabolites, which are excreted in the urine primarily but also in the feces. Amoxapine's elimination half-life is eight hours; one of the metabolites has a long half-life (30 hours). In clinical trials, amoxapine has been compared with amitriptyline and imipramine in several types of depressed patients. In some studies, amoxapine's therapeutic effects were measurable earlier (at one or two weeks after initiation of therapy) than those of the amitriptyline or imipramine, but generally only a portion of the depression-rating scales yielded statistically significant differences. Side effects noted during amoxapine therapy include hypotension (42%), drowsiness (14%), xerostomia (14%), constipation (12%), blurred vision (7%), fatigue (5%), and vertigo (5%). Amoxapine is approved by FDA for use in patients with neurotic or reactive depressive disorders, endogenous or psychotic depression, and depression accompanied by anxiety or agitation. The usual adult dosage is 200-300 mg daily, either in divided doses or a single bedtime dose. Amoxapine is a safe and effective antidepressant with no striking advantages over other available agents.
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PMID:Evaluation of amoxapine. 676 65

A review of the literature on atypical depression indicated three relatively separate usages for the term: anxiety or phobic symptoms additional to depression, reversed functional shift, and non-endogenous depression. A sample of 160 out-patient depressives was rated on a variety of diagnostic systems measuring these concepts. Inter-relationships between groups selected by the three definitions were found to be low. In addition, although there was moderate consistency within different definitions of endogenous depression and of additional anxiety, reversed functional shift symptoms did not correlate well with each other. These findings suggest that atypical depression may be of limited value as a specific diagnosis within non-psychotic depression.
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PMID:Nosology of atypical depression. 684 58


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