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

Among medical clinic patients consulting for IBS, symptoms of psychologic distress are common, and more than half of these patients are found to have a psychiatric diagnosis in addition to bowel dysfunction. Many investigators have therefore concluded that IBS is a psychophysiologic disorder and proposed that patients with IBS be treated with psychologic techniques. However, recent studies suggest that this association may be spurious; persons in the community who have symptoms of IBS but do not consult a doctor have no more psychologic symptoms than persons without bowel symptoms. This indicates that psychologic symptoms do not cause bowel symptoms, but, instead, influence which persons with bowel symptoms will consult a physician. The bowel symptoms and the psychologic symptoms that coexist in most patients with IBS may be best thought of as comorbid conditions. Neither causes the other, but both may be serious enough to warrant treatment. Moreover, in some patients whose bowel symptoms consist of vague complaints of abdominal pain not specifically related to defecation or to changes in the frequency or consistency of bowel habits, the psychologic disorder may be primary. Psychologic stress may exacerbate IBS whether or not the patient has a psychiatric disorder, and psychologic stress may trigger acute episodes of symptoms similar to those of IBS even in persons without IBS. However, the magnitude of this correlation is modest, suggesting that only about 10% of the variation in bowel symptoms is attributable to stress. Psychologically oriented treatments have a role in the management of IBS. Most patients who consult internists about bowel symptoms have significant levels of depression and anxiety, and they tend to notice and to worry about somatic complaints more when they experience these dysphoric affects. Psychologic treatments that reduce the level of their psychologic distress also frequently reduce the frequency and severity of complaints about bowel symptoms. Tricyclic antidepressants may be tried as a first line of treatment; they have been shown to be superior to placebo for the management of abdominal pain and diarrhea but not constipation. In patients who do not show an adequate response to antidepressants, brief psychotherapy focusing on better ways of coping with current problems, hypnosis, or behavior therapy emphasizing methods of controlling reactions to stress are recommended. Controlled trials show these treatment approaches to be superior to medical management alone. It may appear paradoxical that psychologic treatments aimed at the management of emotions are so frequently found to reduce bowel symptoms, because the motility disorder responsible for the bowel symptoms may be unrelated to the psychologic symptoms that influence the patient to seek treatment.+4
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PMID:Psychologic considerations in the irritable bowel syndrome. 206 51

Eight women and one man affected by the denominated "Dressing Disorder" are described. We show, analyze and discuss their social and demographic features, antecedents, onset and course, acquiring behaviours and its consequences, diagnosis, gnosographic features, results of the psychodiagnostic tests, evolutive relationships with the psychiatric diagnosis and treatment undergone. By the light of these data we propose a pathogenic scheme which remarks the importance of the Depression and Bulimia as precipitations or causative factors, because they give use to a low self-esteem and a use of anomalous defense mechanisms which origin the altered acquiring behaviours. Criteria for its diagnosis are proposed and more appropriate denominations are discussed.
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PMID:[Shopping disorder and the abnormal use of attire]. 207 46

To evaluate the persistence of depression in alcoholic women, depressive symptomatology was assessed systematically via the Beck Depression Inventory at intake, 3, and 6 months of treatment. Fifty-five female alcoholics were diagnosed for concurrent psychiatric diagnosis. Results revealed differences in the course of depression for female alcoholics with (a) no concurrent diagnosis, (b) dysthymic disorder, and (c) personality disorder. Despite a decrease in depression for the sample as a whole, dysthymic alcoholics were consistently more depressed than the other two subgroups and remained depressed during the first 6 months of treatment. Depression did not significantly remit with sobriety.
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PMID:Six-month course of depression in female alcoholics. 213 22

In the 1980s, patients suffering from unexplained fatigue and what seemed like a prolonged attack of acute mononucleosis were given the diagnosis of chronic mononucleosis or chronic infection with the Epstein-Barr virus. Although the diagnosis has great appeal, the Epstein-Barr virus does not cause the syndrome (CFS) of chronic fatigue, which has been renamed and redefined chronic fatigue syndrome to remove the inference that the virus is its cause. From a historical perspective, both syndromes represent the 1980s equivalent of neurasthenia, a disease of fatigue that influenced the development of psychiatric nosology. Because patients with depression and anxiety also have chronic fatigue and because most patients with CFS have an affective disorder, the assessment of organic causes of this syndrome requires careful psychiatric diagnosis and treatment. Defining chronic fatigue syndrome as a medical disorder may deprive patients of competent treatment of their affective disorder.
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PMID:Neurasthenia in the 1980s: chronic mononucleosis, chronic fatigue syndrome, and anxiety and depressive disorders. 218 52

Clinical data from 37 adult males with diabetes mellitus (insulin dependent, n = 22; non-insulin dependent, n = 15) who had undergone psychiatric diagnosis and peripheral nerve conduction studies were reviewed to determine whether psychiatric illness was significantly related to complaints of sexual dysfunction. Main-effects testing revealed that impotence was associated with both neuropathy (P less than 0.01) and psychiatric illness (P less than 0.001). Logistic regression analysis was then used to determine the independent relationships of these two variables with impotence. After controlling for the effects of neuropathy, psychiatric illness (generalized anxiety disorder and depression) remained significantly associated with sexual dysfunction (P less than 0.01). These data allow for the hypothesis that psychiatric illness may be an important contributor to impotence in diabetic men, as it is in nondiabetic men, even when neuropathic complications of the disease are present.
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PMID:Relationship of psychiatric illness to impotence in men with diabetes. 220 27

The Spielberger State-Trait Anxiety Inventory (STAI) and the Children's Depression Inventory (CDI) were administered to 228 consecutive adolescent clinic patients and provisional physician diagnoses were compared with test scores obtained in 205 valid replies. The age range was 10 to 17 with a mean +/- SD of 14.3 +/- 1.8 years. Racial distribution was 176 white, 21 black, 4 Asian, and 4 other. The provisional diagnoses were categorized as follows: medical diagnosis only, 140; psychiatric diagnosis only, 45; and combined medical/psychiatric diagnosis, 20. Mean scores +/- SD for the entire study population were STAI-State 41.1 +/- 10.9, STAI-Trait 41.3 +/- 11.8, and CDI 10.1 +/- 8.3. Odds ratios showed that patients with only a psychiatric diagnosis had higher STAI scores than those with only a medical diagnosis and those with a combined medical/psychiatric diagnosis; patients with only a psychiatric diagnosis and those with a combined medical/psychiatric diagnosis had higher CDI scores than those with only a medical diagnosis. The medical records of 30 patients in the medical diagnosis category with high STAI and CDI scores were reviewed; of 140 patients with medical diagnoses, screening detected 15 patients (10.7%) who warranted further intervention for psychiatric disorders.
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PMID:Screening for anxiety and depression in an adolescent clinic. 230 78

Twenty-five of 27 patients (93%) who had participated in a study of severe primary obsessive-compulsive disorder with onset in childhood or adolescence, were seen 2-7 yrs after initial examination (mean, 4.4 yrs). They were compared to a group of normal controls matched for age, sex and IQ and followed up for the same period. Continued psychopathology was striking for the patients, with only seven (28%), three males and four females, receiving no psychiatric diagnosis at follow-up. Seventeen subjects (68%) still had obsessive-compulsive disorder, 12 patients (48%) had another psychiatric disorder, most commonly anxiety and/or depression; neither initial response to clomipramine or any other baseline variable predicted outcome.
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PMID:Childhood obsessive-compulsive disorder: a prospective follow-up study. 231 19

Medical records of 81 older patients (65 years of age and over) who underwent electroconvulsive therapy (ECT) at a university-affiliated private geriatric hospital were reviewed to evaluate the safety and efficacy of this treatment for depression in the "young-old" (65 to 80 years) compared with the "old-old" age group (over 80 years), a group that has not yet been adequately studied. Information was obtained regarding demographics, medical and psychiatric diagnosis, medications, indications for ECT, number and laterality of treatments, outcome, and complications. Thirty-nine patients 80+ years of age (mean age, 85 +/- 3.2) were compared with 42 patients 65 to 80 years of age (mean age, 74 +/- 5.2). Statistical analysis was performed using confidence intervals of the difference in proportions of patients in each group. There were no significant differences in the demographics, number and laterality of ECT treatments, indications for ECT treatment, medical diagnosis, medications, or prior history of falls, but psychiatric diagnoses differed slightly. Patients over 80 years had significantly more cardiovascular complications and falls (95% confidence interval) and tended to have a worse ASA (American Society of Anesthesiologists) scale rating and a somewhat less successful outcome. This study confirms the role of ECT as a relatively safe and effective treatment, which may be lifesaving in selected depressed older patients. Prospective studies are needed to understand better the long-term outcome and to prevent the morbidity and mortality associated with ECT in this frail, high-risk older group.
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PMID:Electroconvulsive therapy in octogenarians. 237 Mar 95

A relationship between cigarette smoking and major depressive disorder was suggested in previous work involving nonrandomly selected samples. We conducted a test of this association, employing population-based data (n = 3213) collected between 1980 and 1983 in the St Louis Epidemiologic Catchment Area Survey of the National Institute of Mental Health. A history of regular smoking was observed more frequently among individuals who had experienced major depressive disorder at some time in their lives than among individuals who had never experienced major depression or among individuals with no psychiatric diagnosis. Smokers with major depression were also less successful at their attempts to quit than were either of the comparison groups. Gender differences in rates of smoking and of smoking cessation observed in the larger population were not evident among the depressed group. Furthermore, the association between cigarette smoking and major depression was not ubiquitous across all psychiatric diagnoses. Other data are cited indicating that when individuals with a history of depression stop smoking, depressive symptoms and, in some cases, serious major depression may ensue.
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PMID:Smoking, smoking cessation, and major depression. 239 3

Some terminally ill patients refuse proposed heart transplantation. Forty patients were offered this surgery; six (15%) declined. Candidates refusing surgery were likely to have a psychiatric diagnosis and heart disease longer than 1 year. Factors thought to influence the decision to refuse surgery included (1) depression, (2) ambivalence about surgery or survival, (3) previous negative experiences with surgery, (4) acceptance of the inevitability of death, (5) concerns about postoperative quality of life, (6) organic brain syndrome, and (7) denial of the severity of heart disease. Patient refusal of a heart transplant is often disconcerting for members of the transplant team.
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PMID:Patients who refuse heart transplantation. 239 34


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