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

Disabling phobias and phobia like compulsive rituals are surprisingly common in the general population, though only a minority ask for help. Behavioural treatment (exposure) and antidepressants are the most helpful approaches. Most patients can help themselves if they use a self exposure approach systematically under the guidance of a clinician. The method seems well suited for use by general practitioners. Anti-depressants are a useful adjuvant, not a substitute, for exposure when there is evidence of depression complicating the phobias or rituals.
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PMID:Phobias and their management. 311 46

Many recent studies have stressed the importance of maintaining the MAO inhibitors in the therapeutic arsenal for depressive patients. In most cases MAO inhibitors are generally safe and as well tolerated as the cyclic antidepressants. It has been suggested that MAO inhibitors are more likely to benefit depressed patients with atypical vegetative symptoms like gain in weight, sleep or libido. However, they may be therapeutic for a wide spectrum of psychiatric disorders ranging from depression with generalized anxiety or phobia, hysteroid dysphoria and endogenous affective illness refractory to conventional therapies. Because of the hazards: drug-drug and drug-food interactions, the irreversible and unspecific MAO inhibitors are only to be recommended on the condition that a good patient compliance can be obtained.
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PMID:MAO inhibitors: pharmacodynamic aspects and clinical implications. 314 80

The blind test-retest reliability of lifetime prevalence and age of onset of psychiatric diagnoses, based on the SADS-L interview and RDC over a three-to-five year period, was examined in 143 probands and their relatives. Reliability of lifetime prevalence of major depression was excellent; reliability of antisocial personality, panic disorder, drug abuse, GAD, depressive personality, and alcoholism was good; reliability of obsessive-compulsive disorder and phobia was acceptable but lower. The reliability of hyperthymia or cyclothymia was not acceptable. Reliability for major depression did not vary substantially by age or sex of the informant, but recall of major depression was significantly higher in the probands than in their relatives. The test-retest reliability for the age of onset of major depression and panic disorder was excellent, and for phobia, GAD and alcoholism, was acceptable. Both probands and relatives recalled the age of onset of their depression fairly accurately. However, there was a reduction in agreement over time. Recall after 3-4 yr was better than 5-6 yr. There was a tendency for older respondents to systematically increase the age of onset of their depression across the two interviews, although the increase was only a few years. Recall of age of onset did not differ significantly by sex of respondent or whether the respondent was a proband or relative. These findings are discussed in light of several available studies of reliability of lifetime prevalence of psychiatric diagnoses.
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PMID:Lifetime prevalence and age of onset of psychiatric disorders: recall 4 years later. 326 42

There is a need for safe effective alternatives to benzodiazepines in the treatment of panic disorder. Buspirone, a new nonbenzodiazepine anxiolytic, is compared to imipramine and placebo in the treatment of panic disorder in an 8 week double-blind controlled study of 52 randomly assigned patients. Weekly assessments were made using the Hamilton Anxiety Scale, the Sheehan Clinician Rated Anxiety Scale, the Sheehan Patient Rated Anxiety Scale, the Phobia Scale, the Disability Scale, the Hamilton Depression Scale, the Montgomery Asberg Depression Scale, the Investigator Rated Global Improvement Scale and the Patient Rated Global Improvement Scale. Preliminary results of repeated measures Anovas are reported. Imipramine was superior to placebo on many of the outcome measures. Imipramine was superior to buspirone on the Patient Rated Global Improvement Scale and on the Investigator Rated Global Improvement Scale, but not on other measures. Although buspirone appeared to be more effective than placebo, differences were not statistically significant. Some buspirone patients did very well compared to others, suggesting a possible bimodal distribution of response. Patients on buspirone had fewer and less disruptive side effects than those on imipramine.
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PMID:The relative efficacy of buspirone, imipramine and placebo in panic disorder: a preliminary report. 341 3

The authors studied the social networks and psychopathology of 168 patients with diagnoses of substance abuse. Small network size was correlated with higher scores on the Modified Michigan Alcohol-Drug Screening Test, higher symptom reports on the SCL-90 and the Beck Depression Inventory, and more observed psychopathology according to the Brief Psychiatric Rating Scale. Larger network size was correlated with better functioning according to the Global Assessment Scale and DSM-III axis V. The authors conclude that such symptom complexes as paranoia and phobia may undermine the social networks of substance abusers more than such symptom complexes as anxiety and depression.
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PMID:Social networks and psychopathology among substance abusers. 342 49

Sixty-two chronically agoraphobic patients completed a controlled study to assess the effects of 1) imipramine up to 200 mg/day (mean = 130 mg/day), 2) 12 weekly therapist-assisted in vivo exposure sessions (flooding), and 3) imipramine plus flooding. The control group received systematic therapeutic instructions for self-directed in vivo exposure (programmed practice). Clinical measures of global severity, phobia, panic, anxiety, depression, and behavioral performance tests were administered before treatment and at Weeks 4, 8, and 12 of treatment. Results revealed significant improvement in all groups on all measures over the course of treatment; almost a third of the control patients showed marked improvement. Imipramine had significant effects on improvement of phobias and markedly increased clinical response rates in patients receiving 150-200 mg/day. Less chronicity and severity of condition also predicted better clinical outcome. Flooding had limited effects above and beyond programmed practice, and no imipramine-flooding interactions effects were found.
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PMID:Agoraphobia: relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine. 351 34

From protozoa to mammals, organisms have been selectively bred for genetic differences in defensive behaviour which are accompanied by differences in brain and other biological functions. Studies of twins indicate some genetic control of normal human fear from infancy onwards, of anxiety as a symptom and as a syndrome, and of phobic and obsessive-compulsive phenomena. Anxiety disorders are more common among the relatives of affected probands than of controls, especially among female and first-degree relatives; alcoholism and secondary depression may also be over-represented. Familial influences have been found for panic disorder, agoraphobia, and obsessive-compulsive problems. Panic disorder in depressed probands increases the risk to their relatives of phobia as well as of panic disorder, major depression, and alcoholism. The strongest family history of all anxiety disorders is seen in blood-injury phobia; even though it can be successfully treated by exposure, its roots may lie in a genetically determined specific autonomic susceptibility. Some genetic effects can be modified by environmental means.
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PMID:Genetics of fear and anxiety disorders. 354 53

Although DSM III has removed the category of neurosis, the implied fragmentation of the generic concept has been regretted by some investigators. Since its introduction in 1769, when the term was used to denote conditions which had a hysterical and hypochondriacal character, the technical use of the term has undergone revisions and reinterpretations which at one extreme have been embedded in psychoanalytic theory, and at the other have resulted in the replacement of the single concept by a proliferation of operationally defined syndromes. The present paper discusses some of the nosological problems implicit in recent trends. Whereas depression appears in 10 ICD9 categories does the psychiatric/neurotic dichotomy in relation to depression still have meaning in the absence of the generic term 'neurotic'? The hierarchical principle is widely accepted as a basis for classification, and yet the hierarchically minor syndromes may be a source of major distress. The paper reviews epidemiological studies of prognosis and follow-up of neuroses, and shows a significant excess of mortality, which is both behavioural and organic in origin. One important difficulty with the loss of the generic term is the potential loss of generic research where, for example, evaluation of treatment of panic disorder is considered distinct from other types of anxiety and phobia. The paper argues for the practical and theoretical benefits of retaining an umbrella term such as 'neuroses'.
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PMID:Perspectives in the study of neuroses in contemporary psychiatric practice. 355 28

The fear questionnaire (Marks and Mathews) is presented in an original french translation. The questionnaire's validity, sensibility and reliability are studied in four groups: agoraphobia with panic attacks, obsession-compulsion, social phobia and control. The scale has a good empirical validity especially for agoraphobia measurement. However in our study the boundaries between obsession compulsion and social phobia appear questionable. Principal components analysis yields four factors similar to those found by Marks and Mathews: agoraphobia, blood and injury phobia, social phobia, and anxiety-depression (including one panic item).
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PMID:[Validation and factor analysis of a phobia scale. The French version of the Marks-Mathews fear questionnaire]. 358 63

For the purpose of identifying masked depression the authors propose the use of a modified and adapted Middlesex Hospital Questionnaire. The Questionnaire consists of 5 blocks of questions and allows the identification of such personality characteristics and psychopathologic manifestations as anxiety, depression, somatization of anxiety, obsession and phobia. The normal parameters have been established following the examination with the help of this Questionnaire of 400 healthy subjects (200 males and 200 females). The Questionnaire can be used in wide-scale field studies of large populations.
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PMID:[Various approaches to the detection of latent depression]. 359 Nov 34


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