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

Biological research in depression has concentrated on 'endogenous' depressions and over the past 30 years has been guided by the amine theory. Neuroendocrine abnormalities in depression have been reported for over 20 years and include changes in the hypothalamic-pituitary-adrenal and thyroid axes, in growth hormone and prolactin secretion. As neurotransmitters regulate neuroendocrine secretion, inter-relationships between neurochemical and neuroendocrine abnormalities may provide a window for understanding the pathophysiology of depression. The availability of these biological markers for depression opens new possibilities for research in psychiatric diagnosis and for management.
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PMID:Neuroendocrine changes in depression. 241 36

51 patients on chronic dialysis, awaiting transplantation, were assessed using a standardised psychiatric interview, together with measures of anxiety, depression, locus of control and social adjustment. 33% of the patients warranted a psychiatric diagnosis. During the study period, 30 patients received a transplanted kidney and 18 could be followed up 12 months after transplantation, when only 3 had a psychiatric disorder (17%). Previous psychiatric history was the main predictor of psychiatric symptomatology and of psychiatric referral during follow-up. However, symptomatology at follow-up also correlated with affective symptoms and selected aspects of social adjustment at initial interview.
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PMID:Psychiatric morbidity in renal transplantation. 248

Previous studies of psychological symptoms and psychiatric diagnoses in fibromyalgia have methodologic shortcomings. Although depressive and somatic symptoms are common, they are not more prominent than in other chronic medical conditions. There may be an association of depression with fibromyalgia, but this is not a causal one. The vast majority of patients with fibromyalgia do not meet criteria for a current psychiatric diagnosis.
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PMID:Psychological symptoms and psychiatric diagnosis in patients with fibromyalgia. 260 8

The high prevalence of mental disorders such as depression and dementia in institutionalized elderly patients warrants screening for psychiatric diagnosis in patients newly admitted to long-term care facilities. The diagnostic accuracy of the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) was evaluated against a standardized psychiatric interview. The MMSE was found to be 81% sensitive and 83% specific in screening for dementia using a previously established cutpoint of less than 24/30 points. Adjusting MMSE scores for physical disabilities precluding completion of specific tasks on the MMSE did not significantly change the diagnostic accuracy of the test. The GDS was 47% sensitive and 75% specific in screening for depression using the suggested cutpoint of greater than 13/30 points. The MMSE was significantly correlated with functional status (r = 0.48, P = .0001), but not with the scores on the GDS or the clinical diagnosis of depression. The GDS did not correlate with functional status. In summary, the MMSE is a good screening test for dementia in institutionalized elderly, but the GDS is not sensitive for depression in this population.
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PMID:Instruments for screening for depression and dementia in a long-term care facility. 266 89

This paper discusses the presence of important uninvestigated assumptions in every aspect of depression research. It is suggested that a general phenomenon-oriented strategy might reduce the number of assumptions, if pursued in accordance with the requirements of natural science, which aims at maximizing the accuracy of our ideas about phenomena. Possible consequences of this strategy are: (1) the provisional selection of single, well-established, target and criterion variables, together with comparison variables, all suggested by special investigations and previous research results; (2) maximizing the phenomenological validity of current observation procedures, in the light of results of research into questionnaire and interview methods; (3) inclusion of hitherto neglected, but scientifically legitimate, individual-centred, experimental and longitudinal specific strategies: the strategies of choice for the investigation of psychological processes; (4) invention of tactics to facilitate the ethically acceptable use of scientific method in investigations of clinically relevant psychological phenomena; (5) explication and eventual testing of all assumptions; (6) focus upon the understanding, prediction and control of well-established clinically relevant phenomena, with theory playing a secondary role of facilitating systematic investigation; and (7) immediate restriction, and eventual cessation, of the use of current forms of psychiatric diagnosis in fundamental depression research.
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PMID:A phenomenon-oriented strategy in depression research. 269 Sep 91

Although recent studies refute the assumption that hysterectomy and sexual sterilization are associate with psychiatric morbidity and longterm psychological sequelae, it is important that gynecologist be familiar with their clients' psychiatric histories, if any. A past history of a psychiatric disorder repeatedly has emerged as the major predictor of an adverse psychiatric outcome following gynecological surgery. The outcome of hysterectomy is influenced more by the presence of a pre-existing psychiatric diagnosis than by physical or demographic factors, including marital status, age, and parity. Hysterectomy candidates with a past or current history of minor or neurotic psychiatric disorders should be monitored for 18 months after surgery for possible depression or anxiety. For women suffering from a major mental disorder, such as schizophrenia or manic-depression, the hysterectomy should be delayed until the psychiatric condition is under control. There is also strong research evidence linking preoperative psychiatric status to adverse reactions to sterilization, especially regret and a deterioration in psychosexual functioning. Interval sterilization appears to be associated with a lower risk of subsequent mental disturbance than procedures performed postabortion or postpartum. Since psychological problems often decrease a woman's capacity to cope with symptoms that would otherwise be tolerable and increase subjective feelings of distress, an assessment should be made as to which is more basic--the gynecological symptoms or the emotional disorder. attention to psychiatric history is also important since mental problems may interfere with treatment and delay recovery from surgery.
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PMID:Psychological aspects of gynaecological surgery. 270 Jan 40

Of 161 alcohol-abusing patients who were hospitalized for suicide attempts (attempters) between 1970 and 1975 and followed until 1982, 18 eventually committed suicide. The 143 nonsuiciders were compared to the 18 with respect to 27 background characteristics including their psychiatric diagnosis, Beck Depression Inventory, Hopelessness Scale, and Suicidal Intent Scale (SIS) scores. Only the SIS precautions subscale differentiated those who did and did not eventually commit suicide: the patients who eventually killed themselves had described taking more precautions against discovery at the time of their index attempts than did those who did not commit suicide. Possible explanations for the absence of a relationship between hopelessness or depression with ultimate suicide are discussed.
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PMID:Alcohol abuse and eventual suicide: a 5- to 10-year prospective study of alcohol-abusing suicide attempters. 272 67

Self-administered screening questionnaires are available to assist primary care physicians in detecting undiagnosed depression and anxiety disorders. This study used receiver operating characteristic (ROC) analysis to evaluate three such tests: the General Health Questionnaire (GHQ), the Mental Health Inventory (MHI), and the Somatic Symptom Inventory (SSI). Stratified by the results of a preliminary GHQ, 364 health maintenance organization (HMO) members were given these tests and a Diagnostic Interview Schedule (DIS), the latter used as a "truth" standard for current psychiatric diagnosis. The MHI performed significantly better than the GHQ in detecting mental disorders generally and anxiety disorders in particular, and somewhat better in detecting affective disorders. The SSI performed best in detecting anxiety disorders and was significantly better than the GHQ. When subjects who had participated in a previous study involving repeated GHQ administration were excluded, sensitivity of all tests improved, especially the GHQ. We conclude that the MHI can be a useful tool for screening primary care patients, and that the SSI has additional predictive value with respect to anxiety disorders.
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PMID:A comparison of three psychiatric screening tests using receiver operating characteristic (ROC) analysis. 272 88

The Geriatric Depression Scale (GDS) has been shown to be an effective screening test for depression in selected geriatric populations. However, it has not been evaluated as a screening test for depression among elderly adults with dementia of the Alzheimer type. Over a two-year period 283 patients were seen in a geriatric assessment center and were screened for depression using the Geriatric Depression Scale. They also received a clinical psychiatric diagnosis by one of two geropsychiatrists. Patients with a Clinical Dementia Rating (CDR) of 0 (cognitively intact) (n = 70) and those with mild Alzheimer's disease (CDR of 1) (n = 72) were selected for comparison. The data were analyzed using Receiver Operating Characteristic Curves (ROCs) in order to compare the utility of the Geriatric Depression Scale in these two groups. ROC curves, which plot sensitivity against false positives, have come into increasing use as a method of examining the clinical performance of tests. The area lying beneath the curve (AUC) can be estimated and used as a quantitative measure of test performance (equivalent to the Wilcoxon rank sum). In the intact group, the Geriatric Depression Scale produced a ROC curve with an AUC of 0.85 (percent score = 1), which is significant (z = 7.28, P less than .0001). In the group composed of those with Alzheimer's disease, the Geriatric Depression Scale yielded a ROC curve with an AUC of 0.66, which was not significantly different from chance (z = 1.92, P = NS). This study provides empirical evidence that while the Geriatric Depression Scale is an accurate screening test for depression in cognitively intact geriatric populations, it does not maintain its validity in populations that contain large numbers of patients with dementia of the Alzheimer type.
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PMID:Use of the Geriatric Depression Scale in dementia of the Alzheimer type. 225 77

Thirty-three patients with Parkinson Disease were evaluated neurologically and neuropsychologically. Seventy percent without a previous psychiatric diagnosis, were depressed. This depression was not related to the presence of dementia, stage of the disease, a general estimate of memory and attention, years of Parkinsonism, age, or indices of frontal cortex-related functioning. Because the depression did not positively relate to factors suggestive of advancing disease, it is proposed that the depression is reactive to the disease rather than an integral part of it.
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PMID:Depression type in Parkinson disease. 280 51


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