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

Depression in the physically ill is common and may even be caused by certain physical disorders (eg, hypothyroidism, pancreatic cancer) or the use of some types of drugs. It should not be dismissed because it is "understandable" in particular situations, but rather, it should be differentiated from overlapping symptoms of the physical disorder and treated. The effect of psychosocial factors should be carefully considered.
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PMID:Depression in physically ill patients. Don't dismiss it as 'understandable'. 151 51

Serum testosterone concentration (S(T)) and four nutritional parameters were measured in patients with pancreatic adenocarcinoma (19), other malignancy (17) and other non-malignant conditions (29). In females neither the diagnosis nor the nutritional parameters correlated with the S(T). In males significantly lower S(T) were found in those with malignant conditions. Also, in males poor nutritional status correlated significantly with low S(T). Those patients with pancreatic adenocarcinoma did not have significantly lower S(T) than those with other cancers. A covariate analysis of the results supports the conjecture that it is primarily the poor nutritional status of cancer patients which leads to depression of S(T). This study provides no evidence to support the existence of a direct relationship between pancreatic cancer and testosterone metabolism.
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PMID:Pancreatic carcinoma and low serum testosterone; a correlation secondary to cancer cachexia? 337 70

One hundred and seven patients with advanced pancreatic cancer and 111 patients with advanced gastric cancer, stratified for key medical and sociodemographic variables, were assessed with the Profile of Mood States before beginning combination chemotherapy in a national cancer clinical trials group. The pancreatic cancer patients had significantly higher self-ratings of depression, tension-anxiety, fatigue, confusion-bewilderment, and total mood disturbance; no difference was found in vigor or anger-hostility. These data support prior observations that patients with advanced pancreatic cancer experience significantly greater general psychological disturbance than patients with another type of advanced abdominal neoplasm.
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PMID:Comparative psychological disturbance in patients with pancreatic and gastric cancer. 352 79

The subject of aged people and stress was discussed from both clinical and basic points of view, mainly by introducing our research results, beginning with our immunoneuroendocrine studies on aging and stress. Stress stimulates the secretion of two adrenal hormones, cortisol and dehydroepiandrosterone-sulfate (DHEA-S). Both hormones are metabolized and excreted from the kidney, respectively converting to 17-OHCS and 17-KS-S in the urine. We have found that the two adrenal steroids reflect the physiology and pathophysiology of stress and aging, thereby suggesting that the simultaneous analysis of these parameters could be utilized as new biological markers for stress and aging. It was speculated that a disturbed balance between cortisol and DHEA-S would result in various aging- and stress-related disorders. Furthermore, clinical problems in aged people with stress-related diseases such as psychosomatic diseases, neurosis and depression were illustrated by some interesting cases. In particular, much data about peptic ulcer disease in the aged, a typical psychosomatic disease, were presented. In addition, clinical characteristics of old people with irritable bowel syndrome, aerophagia, neurogenic abdominal distention and depression were described. Data of our research to determine why pancreatic cancer is accompanied with depression so frequently were also presented. Finally, it was emphasized that a holistic approach, paying to sufficient attention to psychosomatic aspects, is very important for the management of stress diseases in the aged.
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PMID:[Aged people and stress]. 802 98

Forty-three patients with irresectable advanced pancreatic cancer were randomized to receive chemotherapy using a combination of 5-fluorouracil, Adriamycin and mitomycin or no chemotherapy. Groups were well matched with regard to age, extent of disease and performance status on entry. Chemotherapy was well tolerated and, although common, side-effects were usually mild. Psychological measurements based on the Hospital Anxiety and Depression score were made in 31 patients. These showed significantly less depression but not anxiety in the treated group immediately after randomization and following 2 months of chemotherapy. Median survival in the treated group was 33 (range 9-80) weeks compared with 15 (range 1-62) weeks in the untreated group (P < 0.002). Chemotherapy should be considered in all patients presenting with advanced inoperable pancreatic cancer.
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PMID:Chemotherapy prolongs survival in inoperable pancreatic carcinoma. 804 10

Oestrogen-binding sites are present in tissue samples of adenocarcinoma of the pancreas. Uncontrolled studies have suggested that survival of patients with this tumour may be extended by using the antioestrogen drug tamoxifen. Forty-four patients with biopsy-proven irresectable adenocarcinoma of the pancreas were recruited into a randomized placebo-controlled clinical trial of tamoxifen 20 mg twice daily. All patients were assessed at the time of diagnosis and at monthly intervals using the Karnofsky and the Hospital Anxiety and Depression scores for quality of life. Analysis of survival by life-tables and the log rank test revealed no significant difference in the duration of survival of patients treated with tamoxifen or placebo. Quality-of-life assessment revealed no significant difference between the groups. Tamoxifen does not confer significant benefit to patients with irresectable pancreatic cancer.
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PMID:Clinical trial of tamoxifen in patients with irresectable pancreatic adenocarcinoma. The Yorkshire Gastrointestinal Tumour Group. 840 83

Reports of characteristic psychiatric symptoms occurring in patients with pancreatic cancer appear regularly in the literature. A review of this literature reveals that symptoms of depression and/or anxiety may appear in approximately 50% of patients with pancreatic cancer before the diagnosis is made. This review proposes that the psychopathology of pancreatic tumors may be linked to tumor-induced changes in neuroendocrine or acid-base systems. Although confirmatory data are lacking, informed speculation centers on the potential role of adrenocorticotropic hormone, parathyroid hormone, thyrotropin-releasing hormone, glucagon, serotonin, insulin, and bicarbonate in the production of depression and/or anxiety in this disease. Elucidation of the pathophysiology of the psychiatric symptoms in patients with pancreatic cancer may provide a marker for early diagnosis of pancreatic neoplasia as well as a probe into the biologic bases of depression and anxiety.
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PMID:Psychopathology of pancreatic cancer. A psychobiologic probe. 849 2

Pancreatic cancer tends to be diagnosed at a relatively late stage of disease and often secondary to significant complaints of pain. In addition there is evidence of higher rates of depressive symptoms at diagnosis in pancreatic cancer than in other forms of cancer. These factors, along with the specific tumor anatomy and pathophysiology of pancreatic cancer make palliative considerations central to the care of patients with the disease. The palliative and supportive approach must first include an aggressive evaluation of pain, mood, and emotional symptoms. Attention should be paid to the specific nature of pain complaints and attempts made to make accurate clinicopathological correlates for the pain. Assessment should be complete and ongoing. Pain treatments include pharmacotherapy, invasive anesthetic and surgical procedures, and supportive attention to side effects and other symptoms of disease and treatment. Depression often appears at higher rates than documented in other cancer patients and can be independent of pain complaints and other symptoms present in the preterminal phases of illness. Depression should be treated with pharmacotherapy and supportive psychotherapy as indicated. Hospice should be considered early on in the treatment relationship and can provide pain and symptom management services as well as play an important role in providing emotional support to the patient and family. Attention to pain, mood, psychological distress, and other quality of life issues can often allow for successful treatment of symptoms and improvement in functioning even in the setting of late stage pancreatic cancer.
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PMID:Palliative and supportive care of patients with pancreatic cancer. 862 59

Many people who are diagnosed with pancreatic cancer react with a normal level of sadness. In others, however, depression represents a concomitant illness, perhaps with a biologic basis. Regardless of their origin, these mood disorders are controllable. The role of the psycho-oncologist is to distinguish normal emotional reactions to having advanced cancer, in which depressive symptoms resolve gradually within a week or two with support from family and friends, from symptoms of comorbid psychiatric illness, which warrant more extensive treatment, such as a combination of supportive psychotherapy, cognitive-behavioral techniques, and psychopharmaceutical agents.
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PMID:Supportive care of the patient with pancreatic cancer: role of the psycho-oncologist. 888 6

Pancreatic cancer is a disease difficult to treat. Diagnosis is late, cancer remaining clinically unapparent even if locally advanced or metastatic. Few patients can be submitted to curative surgery. Even if resection is possible, 5-year survival varies from 0% to 18% according to series. Some data suggest that chemotherapy with or without radiotherapy could influence disease free survival but a benefit on overall survival has not been demonstrated. For locally advanced disease, the results of a trial published in 1968, showed that a combination of radiotherapy and 5-Fluorouracil (5FU) improved median survival as compared to radiotherapy alone (5.5 versus 10 months). Since then, no progress has been achieved. At the present time, survival of patients with metastatic pancreatic cancer cannot be improved. Very recently, a new agent, gemcitabine, has been compared to 5FU. Criteria for activity were based on clinical improvement analgesia consumption, performance status and weight gain. Twenty-four percent of the patients treated with gemcitabine had a clinical benefit as compared to 5% for those treated with 5FU. Other studies comparing chemotherapy to best supportive care show a significant decrease of depression and anxiety as well as an improvement in quality of life for patients being treated.
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PMID:[Non surgical treatment of pancreatic cancers]. 949 45


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