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

Parent, teacher, and child reports were used to identify situational and personal factors associated with school refusal in 114 3- to 13-year-old Venezuelan children. The sample consisted of 57 school refusers and 57 nonrefusers matched on age, school, and sex. As compared with nonrefusers, the refusers had changed schools more often, were rated as more dependent, had more school-related fears, and were perceived by their parents as more difficult to manage. Stepwise multiple regression analyses revealed that school refusal status could be predicted by both situational and personality variables including the child's fear level, dependency, depression, frequency of school changes, history of refusal in the family, and other variables. Refusal onset frequently coincided with situational stress (e.g., the beginning of the school year, a new school or teacher, or trouble with a teacher or peers). Categories of refusal resembled those of other studies and included adjustment reaction, school phobia, and emotional disturbance. In the future, these risk factors can be used to identify and treat potential school refusers.
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PMID:Characteristics of Venezuelan school refusers. Toward the development of a high-risk profile. 359 67

This paper reports the results of principal components and stepwise discriminant analyses of anxiety, depression and fear scores for 74 phobic and anxious-depressed psychiatric patients. Factor analysis indicated a coherent agoraphobia factor, with less coherent blood-injury and social phobia factors. Discriminant analysis showed a high degree of correct classification of diagnosed agoraphobic, blood-injury and social phobic patients particularly for agoraphobia. A frequency distribution of the phobia scores indicated an all or nothing quality to agoraphobic fears. The results indicate that agoraphobia is a fairly coherent syndrome, but that more work is needed on the concepts and measurement of blood-injury and social phobias.
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PMID:The relationship between agoraphobia, social phobia and blood-injury phobia in phobic and anxious-depressed patients. 360 5

Nervous bladder symptoms without any established organic causes would appear to be a psychosomatic illness that usually affects married women in midlife. The majority of these patients manifest serious neurotic disorders such as anxiety neurosis, hysteria, phobia, and depression or larvate depression. It is often possible to identify psychosexual disorders in these patients. The predominant situations that seem to trigger irritable bladder symptoms are: sexual intercourse that ends unsatisfactorily for physical or psychological reasons, a partnership conflict, or even a separation conflict. Patients with a hysterical personality structure who are dominated by Oedipus or phallic problems and who, by inhibiting the sexual impulse, frequently suffer from sexual disorders may, in a situation experienced in such an atmosphere of conflict, regress to the stage of urethral erotism; at this stage, the symptoms serve as self-punishment as well as reduction of the fear of guilt and punishment; the unconscious vexation and frustration manifest themselves in these symptoms. In the case of depressive patients, unconscious anger and helplessness can be manifested as irritable bladder symptoms. As a result of the close connection between these urinary disorders and sexual disorders, irritable bladder symptoms without any established organic causes would appear not to be a urological but rather a covert functional sexual disorder.
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PMID:[Psychosomatic aspects of irritable bladder. A review]. 371 43

This article has reviewed clinical and demographic features of the primary anxiety disorders and other psychiatric and medical disorders that often are associated with anxiety symptoms, highlighting differential diagnosis. In summary, phobic disorders (exogenous anxiety) are characterized by anxiety reliably elicited by specific environmental stimuli; the stimuli involved determine which type of phobia is diagnosed. In contrast, panic attacks and generalized anxiety (endogenous anxiety) involve symptoms of anxiety not associated only with specific eliciting stimuli. Panic disorder is differentiated from generalized anxiety disorder by the presence of discrete attacks; both disorders usually have some level of persistent anxiety. Obsessive-compulsive disorder is characterized by recurrent unwanted but irresistible thoughts and the ritualized repetitive acts resulting from these obsessions, in the absence of preexisting psychosis or depression. Finally, posttraumatic stress disorder involves various anxiety (and other) symptoms as a direct result of an obvious stressor. Depressive symptoms are frequently associated with anxiety. It is sometimes impossible to determine which is the primary disorder. Overlap of syndromes probably also occurs with other primary psychiatric disorders, especially somatoform disorders, adjustment disorder with anxious mood, and several personality disorders. Finally, primary anxiety can be confused with several medical syndromes, especially when the medical disorder has not been recognized. Nevertheless, research with patients with pheochromocytoma suggests that medical causes of anxiety may be qualitatively different from primary anxiety disorders, especially the psychic anxiety component. Attention to the clinical and demographic features listed in Table 4, as well as the use of newly-developed structured diagnostic interviews should usually lead to a correct diagnosis, as illustrated by the following examples. The onset of a fear of public speaking in mid-adolescence suggests an uncomplicated social phobia, whereas the onset in the mid-twenties of several social and other situational anxieties in a person with a previous history of panic attacks would be strongly suggestive of the panic-agoraphobia syndrome. The new onset of generalized anxiety symptoms and depression in a 45-year-old patient who has had a previous significant depression would suggest that this person's anxiety is part of, and secondary to, the affective disorder and not a primary anxiety disorder.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The differential diagnosis of anxiety. Psychiatric and medical disorders. 388 37

Most previous research on mitral valve prolapse investigated its prevalence in patients whose primary diagnosis was one of the anxiety disorders. This study explored the inverse, i.e., the prevalence of anxiety disorders in patients manifesting mitral valve prolapse. There were no significant differences between patients (N = 48) and control subjects (N = 49) in panic disorder, phobic disorder, or generalized anxiety disorder or in the Zung depression score. The patient group scored significantly higher than control subjects on the Zung Anxiety Scale but significantly lower than Zung's patients with "anxiety neurosis". These results cast doubt on the hypothesis that mitral valve prolapse is etiologically related to the pathogenesis of the anxiety disorders.
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PMID:Prevalence of anxiety disorders in patients with mitral valve prolapse. 395 70

In a prospectively constructed study 29 patients with cardiac phobia were examined prior to hospitalization and again after a follow-up period of 2.5 years. When first examined a high percentage (82.8%) of these patients showed a depression in addition to suffering from anxiety symptoms. The findings demonstrate that an additional affective disorder constitutes a prognostically unfavorable factor, particularly in the case of a 'secondary' depression. Compared with patients suffering from a 'primary' depression these patients more frequently exhibited a chronic course of the depression (at the 1% level of significance) and had a significantly smaller chance of being free of cardiophobic complaint (p = 0.002) at the last examination. An attempt to categorize cardiac phobia according to DSM-III revealed that the present classification does not provide a satisfactory solution. The frequent presence of a depression in these patients strongly indicates that a clarification of the controversial opinions which continue to exist with regard to a linkage between depressive disorders and anxiety disorders would need further research; in such studies it would seem preferable not to employ a hierarchic classification procedure, in view of the fact that all cross-sectional psychopathological symptoms should be taken into consideration. Our findings also point to the advisability of paying closer attention to course traits in studying this question.
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PMID:The influence of depression on the outcome of cardiac phobia (panic disorder). 405 87

A representative sample of 456 persons from the normal population aged 22 and 23 years was used to study the overlap of depression with anxiety disorders. The 1-year prevalence rate for major depression (DSM-III), minor depression, and anxiety disorder together was 16.4%. The observed cases of major depression occurred in 36% with anxiety disorder, the cases with minor depression in 60%. On the level of symptoms assessed by a semistructured clinical interview and on the level of self-assessed items of the symptom check list SCL-90, the overlap was even greater. The main finding was that subjects with both diagnoses, depression and anxiety disorder, were more severely affected in general. Discriminant analyses of the SCL-90 scales together with the qualitative distribution of SCL items characterizing depression, anxiety, or phobia, did not disprove the hypothesis of a continuum.
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PMID:The Zurich Study. VI. A continuum from depression to anxiety disorders? 409 15

Seventy-six white agoraphobic women, 21 to 45 years old, were treated with combined group exposure in vivo and imipramine or placebo in a randomized double-blind study. A majority of the patients in both the placebo and imipramine groups showed moderate to marked improvement. However, imipramine therapy was significantly superior to placebo therapy on three of the four reported measures of improvement: primary phobia, spontaneous panic, and global improvement. There was a negative correlation between depression and outcome; ie, the more depressed patients fared worse on several outcome measures than those who were less depressed. A comparison of these patients with agoraphobic women previously treated with imipramine and imaginal desensitization showed a superiority of exposure in vivo midway in treatment, but no significant difference between the two groups at the completion of therapy.
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PMID:Treatment of agoraphobia with group exposure in vivo and imipramine. 610 35

Behavioral and biological issues in agoraphobia are reviewed. New classifications of agoraphobia based on longitudinal studies appear promising. Genetical studies bring some data suggesting that agoraphobia and panick attacks may be a familial and genetical disease. The effects of antidepressants on agoraphobia and panick attacks are still a disputed issue. Exposure in vivo appears as the effective component of behavioral treatment of anticipatory anxiety and allows a significant withdrawal of medication (eg antidepressant and/or benzodiazepine). A personal study on 27 agoraphobia cases is reported showing a significant rate of withdrawal after behavior therapy (p less than .05). Some examples of single case designs are reported to study the covariation of depression, phobia and panick attacks. Multicenter studies are needed to clarify the problem of effectiveness and specificity of antidepressant action on agoraphobia and panick attacks.
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PMID:[Agoraphobia and panic attacks. Biological and behavioral approaches]. 614 79

Systematic clinical examination, 7 rating scales for severity and the Newcastle Anxiety Depression Scale were applied in 117 patients with depressive, anxiety or phobic neurosis. "Endogenous" (autonomous) depressions were excluded. Principal component and discriminant function analysis were used to determine whether the depressive and anxiety syndromes could be differentiated from each other. With the aid of discriminant function analysis, separation of the 2 groups was achieved in the full sample and in 2 randomly derived sub-samples. The most powerful discriminators in all analyses were the Hamilton Depression Scale and the Newcastle Anxiety Depression Scale. Discriminant function analysis of the items from the Hamilton Depression Scale showed that it was possible to allocate 90% of the patients to the groups to which they had originally been classified by clinical diagnosis.
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PMID:Studies in the relationship between depressive disorders and anxiety states. Part 1. Rating scales. 621 91


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