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

The presence of depression in consecutive admissions with life-threatening illness was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS). The 211 patients had one of four conditions, myocardial infarction (N = 100), subarachnoid haemorrhage (N = 41), pulmonary embolism (N = 40), and acute upper gastrointestinal haemorrhage (N = 30). Depression was measured using both the standard MADRS, and a modified version excluding somatic items which might be influenced by the underlying illness. The patients were also assessed for severity of illness and cognitive dysfunction. The results showed that immediately following a life-threatening illness approximately 34% of the patients were depressed, using the modified scale, but that the depressed group did not have a more severe physical illness. However, the depressed patients had a significantly poorer outcome over the 28 days following admission, with 47% of the depressed patients dying or having life-threatening complications, as opposed to 10% of the non-depressed group. This study demonstrates that the psychological state of an individual can affect their individual risk of mortality following physical illness.
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PMID:Depression increases mortality and morbidity in acute life-threatening medical illness. 229 Jan 37

A total of 247 consecutively evaluated geriatric medical patients was administered a battery of neuropsychological and psychological tests as part of their diagnostic workup for unexplained deterioration in their functioning. Depression was assessed with a short form of the MMPI, the Brief Symptom Inventory, and the Geriatric Depression Scale. By Research Diagnostic Criteria, most suffered from major (59%) or minor (21%) depressions; some degree of cognitive impairment was seen in 80% of the patients, defining a population of "vulnerable" geriatric patients typical of referrals to a general medical hospital setting. Using both conventional score cutoff criteria and discriminant analyses, false-negative rates up to 53% for major depression and 100% for minor depression were found. Psychometric misrecognition of depression was not related to degree of dementia or education but on some measures was positively associated with verbal intelligence level and patient age. Contrary to previous suggestions that psychometric measures overestimate depression in the elderly, these findings suggest that there may be a subgroup of elderly in which treatable affective distress is not appreciated.
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PMID:Psychometric assessment of depression in an elderly general medical population. Over- or underassessment? 229 35

The chronic, progressive nature of multiple sclerosis (MS) often interferes with effective psychosocial adjustment. When presented with physical limitations and/or cognitive impairment, the client with MS may experience problems such as depression, family dissolution, and loss of important roles. However, some persons are able to adjust positively and enjoy life. This article explains a model for assessing psychosocial adjustment of those with MS and describes its practical application for the rehabilitation nurse.
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PMID:Nursing assessment of positive adjustment for individuals with multiple sclerosis. 234 78

In 1984-85, 1855 elderly residents of an urban community responded to a comprehensive baseline interview that included questions regarding an extensive set of sleep characteristics and problems. During the subsequent 3 1/2 years of follow-up, 16.7% of the respondents died and 3.5% were placed in nursing homes. The predictive significance of each sleep characteristic for mortality and for nursing home placement was determined separately for males and females, using Cox proportional hazards models. Selected demographic and psychosocial variables were also entered into the models. Age, problems with activities of daily living (ADL), self-assessed health, income, cognitive impairment, depression and whether respondents were living alone were controlled for statistically. Of the many variables analyzed, in males insomnia was the strongest predictor of both mortality and nursing home placement. For mortality, the relative hazard associated with insomnia exceeded the hazards associated with age, ADL problems, fair-poor health and low income. For nursing home placement, the hazard associated with insomnia exceeded that associated with cognitive impairment. The relationships of insomnia to mortality and nursing home placement were U-shaped, with a worse outcome if insomnia complaints over the preceding 2 weeks were either prominent (numerous or frequent) or absent. For females, insomnia was a borderline predictor of mortality and did not predict nursing home placement at all. Symptoms of the restless legs syndrome predicted mortality for females in some Cox regression models. Reported sleep duration, symptoms of sleep apnea and frequent use of hypnotic drugs did not predict mortality or nursing home placement in either sex.
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PMID:Sleep problems in the community elderly as predictors of death and nursing home placement. 235 10

The impact of clinically diagnosed depression on recovery in activities of daily living over a 2-year follow-up was examined in a prospective study of 63 stroke patients. Although impairment in activities of daily living, neurologic diagnoses and findings, lesion location and volume as measured on computed tomographic scan, demographic variables, cognitive impairment, and social functioning were comparable between depressed (n = 25) and nondepressed (n = 38) patients during their acute hospitalization, the two groups had different patterns of recovery in activities of daily living. At 2 years after suffering a stroke, patients with an in-hospital diagnosis of depression (either major or minor depression) were significantly more impaired in both physical activities and language functioning than were non-depressed patients. Among patients with major depression, this disparity in the recovery profile was present even after the depression had remitted. This study emphasizes the need for early recognition and treatment of poststroke depression.
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PMID:The impact of poststroke depression on recovery in activities of daily living over a 2-year follow-up. 235 59

We interviewed 120 elderly hemiplegic patients 1 year after their acute stroke to assess cognitive impairment using the Mini-Mental State Examination, functional autonomy using the Barthel Index, mood disorders using the Hamilton Rating Depression Scale, and social integration using the Social Functioning Exam. Of the 76 patients admitted to this study, eight (12.1% of those testable) had significant cognitive impairment, 41 (53.9%) were functionally self-sufficient, 27 (35.5%) showed depressive symptoms, and 44 (57.9%) had problems in social and family integration. We suggest that a complete rehabilitation program aimed at producing a good quality of life for elderly hemiplegic patients should take into account all these aspects of human existence.
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PMID:Social and family integration of hemiplegic elderly patients 1 year after stroke. 236 2

In order to investigate the hypothesis that migraine has a detrimental effect on cognitive functioning, 37 female migraine patients and 34 nonheadache female controls underwent a battery of neuropsychologic tests. No significant difference in test performance between groups was found. There was no relation between the length of migraine history or medication use and the level of impairment of cognitive abilities. The patient and control groups differed significantly on several self-report measures known to interfere with performance. Patients reported higher trait and state anxiety levels, higher debilitating anxiety and state depression, and less vigor. Statistical correction for these variables, however, did not result in significant group differences of cognitive performance. The results suggest that the general population of female migraine patients show no indication of cognitive impairment.
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PMID:Migraine patients cognitively impaired? 237 Jan 37

One hundred and twenty-nine cases of Wilson's disease (WD) were assessed at index admission and two follow-ups (F1 and F2) on a range of clinical and biochemical variables. The commonest psychiatric symptoms throughout were incongruous behavior, irritability, depression, and cognitive impairment. Among psychiatric cases, most improvements occurred in the interval index-F1, with subsequent leveling off. Significant improvement occurred only with incongruous behavior and cognitive impairment. Psychiatric cases whose psychiatric symptoms persisted to F2 differed from those who responded, in particular showing more dysarthria, incongruous behavior, and hepatic symptoms. Neuropsychiatric cases displayed more dysarthria and incongruous behavior than patients with neurological symptoms alone. Further evidence for associations between dysarthria and abnormal behavior emerged from this study.
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PMID:Wilson's disease: a longitudinal study of psychiatric symptoms. 237 28

We examined magnetic resonance (MR) scans of the heads of 8 patients with late onset psychosis and 8 aged controls. Although some patients had mild cognitive impairment, none had depression or a history or examination suggesting focal brain disease. Thus, all patients met DSM-III-R criteria for late-onset schizophrenia. All 8 patients showed significant leukoencephalopathy or vascular pathology on MR imaging, and temporoparietal and occipital lesions were especially prominent. Little such pathology was evident on control scans. We suggest that focal brain disease of vascular origin may be associated with late-onset psychosis, and that MR scanning of such cases may provide important clues to pathogenesis.
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PMID:Cerebral white matter disease in late-onset paranoid psychosis. 237 29

The presence of depression and cognitive impairments was examined in seventy patients with Parkinson's disease (PD). Forty nine patients of this original cohort were re-examined between three and four years after the first evaluation. While both depressed and non-depressed patients showed a significant decline in cognitive function during the follow up period, intellectual decline was significantly more severe for the depressed group. Depressed patients also showed a faster rate of progression of motor signs (mainly tremor) than the non-depressed group. Patients that died during the follow up period showed significantly more cognitive impairments than patients who were alive at follow up. These findings suggest that either there may be two forms of PD: one with depression and rapid cognitive decline and one without depression and a gradual cognitive decline; or that the mechanisms of cognitive impairment in PD and depression may interact to produce a more rapid evolution in cognitive impairment among PD patients with a previous depression than among patients without a previous depression.
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PMID:Cognitive impairments and depression in Parkinson's disease: a follow up study. 239 25


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