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

Although depression appears to be common in patients with Briquet's syndrome, there is a paucity of literature dealing with the efficacy of treatment of this depression and the effect of treatment on the overall course of the illness. The author presents two case histories demonstrating the effectiveness of treatment of depression secondary to Briquet's syndrome with antidepressant medications, which resulted in an improvement of the various aspects of the primary illness.
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PMID:Treatment of depression associated with Briquet's syndrome. 746 37

Somatization syndromes were defined in a sample of 102 psychosomatic inpatients according to the restrictive criteria of DSM-III-R somatization disorder and the broader diagnostic concept of the Somatic Symptom Index (SSI). Both groups showed a qualitatively similar pattern of psychopathological comorbidity and had elevated scores on measures of depression, hypochondriasis, and anxiety. A good discrimination between mild and severe forms of somatization was found by using the SSI criterion. SSI use accounted for a substantial amount of comorbidity variance, with rates of 15%-20% for depression, 16% for hypochondriasis, and 13% for anxiety. The results provide further evidence for the validity of the SSI concept, which reflects the clinical relevance of somatization in addition to the narrow definition of somatization disorder.
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PMID:Further evidence for a broader concept of somatization disorder using the somatic symptom index. 763 16

Somatization, the somatic expression of psychological distress, occurs in a large proportion of primary care patients. It is associated with substantial distress and impairment and with increased health care utilization. Some somatizing patients have a history of multiple unexplained complaints (somatization disorder), others are excessively worried about serious illness (hypochondriasis), and still others have psychiatric disorders that present with somatic symptoms (depression and anxiety). In general, somatizing patients are characterized by abnormal illness behavior (eg, failure to respond to treatment, excessive utilization of care) and psychological distress (eg, depressive symptoms, psychosocial stressors). Recognition requires alertness to characteristic features and skillful interview technique. Successful management begins by legitimizing symptoms. Restraint should be used in performing workups and assigning diagnoses to somatizing patients. Treatment goals should be clarified and regular visits scheduled. Also, behaviors that threaten the physician-patient relationship should be dealt with. Depression and anxiety should be treated when present. Pharmacologic and psychological treatments for somatizing patients have been described, although none has proven efficacy.
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PMID:Somatization. Diagnosis and management. 764 46

This review deals with diagnostic problems in DSM-III-R hypochondriasis. A first category of problems is directly connected with the definition of hypochondriasis. The following topics are discussed: the distinction between hypochondriasis and hypochondriacal attitude, the personality aspects of hypochondriasis, and the role of medical findings in the diagnosis. This is followed by a discussion of problems as to the distinction between hypochondriasis and related disorders. This concerns the status of hypochondriasis as a primary or secondary disorder in depression and the relationship with anxiety disorders (especially panic disorder and obsessive-compulsive disorder [OCD]) and the somatization disorder. The DSM-III-R classification of hypochondriasis as a somatoform disorder is disputed. A third category of problems lies in the measurement of hypochondriasis. The scope and quality of the most frequently used questionnaires for measuring hypochondriasis are poor. In research, on the basis of a single questionnaire and without due consideration of medical findings, the diagnosis of hypochondriasis is applied too soon. Finally, it is briefly indicated that the lack of diagnostic clarity affects the way in which the patient is approached in clinical practice.
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PMID:Bottlenecks in the diagnosis of hypochondriasis. 795 88

Chronic low back pain (CLBP) patients often are described as "somatizers", who report multiple somatic complaints beyond back pain itself, but the nature and clinical significance of this observation is poorly understood. To clarify the characteristics, correlates and severity of somatization in CLBP, we rigorously assessed somatization symptoms in a sample of patients not selected for psychiatric or pain clinic referral. Male CLBP patients (N = 97), attending a primary care orthopaedic clinic, and matched healthy controls (N = 49), were assessed using the Diagnostic Interview Schedule III-A (DIS), Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HRSD), McGill Pain Questionnaire (MPQ), Sickness Impact Profile (SIP), and the Pain and Impairment Relationship Scale (PAIRS). Although none of the subjects met strict DSM-III criteria for a lifetime diagnosis of Somatization Disorder, 25.8% of CLBP patients reported a lifetime history of 12 or more somatic symptoms, as compared to only 4.1% of controls. In the less symptomatic ranges, patients still generally reported more symptoms than controls, with 51.5% of patients vs. 8.2% of controls reporting 7-11 symptoms, and 22.7% vs. 87.8% of controls reporting 0-6 symptoms (p < .001). Major depression and alcohol dependence were significantly associated with increased severity of somatization (p < .05). Lower mood and increased impairment, but not pain intensity, were related to greater number of somatic complaints. Symptoms of somatization are prevalent, but not universal, in CLBP and the pattern of these symptoms is reminiscent of the "spectrum of severity" reported in other medical populations. Recognizing this spectrum of somatization may lead to better patient-treatment matching and improved clinical outcomes.
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PMID:Somatization symptoms in chronic low back pain patients. 800 98

The purpose of this study was to determine the nature and extent of comorbidity among patients with DSM-III-R hypochondriasis and to examine the relationships between this disorder and coexisting psychiatric illness. For this purpose, patients seen in a general medicine clinic were screened using measures of hypochondriacal attitudes and somatic symptoms. Those scoring above an established cutoff were given a structured diagnostic interview. In this manner, 50 patients who met DSM-III-R criteria for hypochondriasis and 50 age- and sex-matched controls were identified. The presence of other psychiatric disorders (current and past) was determined by means of the same diagnostic interview. More hypochondriacal subjects (62.0%) had lifetime comorbidity than did controls (30.0%). Major depression, the most frequent comorbid disturbance, was usually current and most often had an onset after that of hypochondriasis. Panic disorder with agoraphobia, the most frequent anxiety disorder, was also current but often began before or at the same time as hypochondriasis. Few subjects met criteria for somatization disorder but a third qualified for a subsyndromal form of this disorder. The data show that, in medical outpatients with hypochondriasis, mood and anxiety disorders frequently coexist. This comorbidity is subject to varying interpretations including overlap of symptom criteria, treatment-seeking bias, and the possibility that hypochondriasis predisposes to or causes the comorbid disorder, as seems likely in the case of depression. In some instances hypochondriasis may be an associated feature of another illness.
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PMID:Psychiatric comorbidity among patients with hypochondriasis. 803 97

Forty-one Korean immigrants in Washington, D.C. (of the United States) metropolitan area over age 60 were interviewed using the Diagnostic Interview Schedule (Korean version) with additional questions about culture-specific somatic symptoms identified in previous research with Korean populations. The lifetime and current prevalence were 29.27 percent and 14.63 percent, respectively, for major depression; 9.76 percent and 2.44 percent for generalized anxiety disorder; and 9.76 percent and 7.32 percent for somatization disorder. The lifetime and current rates of co-occurrence of major depression and somatization disorder were 25 percent and 33.33 percent. Subjects who met criteria for depression were more likely to experience culture-specific Korean somatic symptoms than subjects who did not meet those criteria.
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PMID:Prevalence of depression and somatic symptoms among Korean elderly immigrants. 809 92

Prolonged latency in the appearance of REM sleep as a marker of depression has been demonstrated in patients with the sickle-cell disease. To detect the possible existence of depressive disturbances in patients with sickle-cell disease, the Hamilton rating scale for depression (17 items) was used in 30 patients with homozygote sickle-cell disease and 31 carriers of the sickle-cell trait, treated or not with vasodilator drugs. None of the 61 subjects studied presented a score of 18 or more on the Hamilton rating scale, this being the threshold value for confirming the existence of moderate depression. However, analysis of variance showed an increase in mental dullness, agitation and somatization disorder. Dullness was related to the extent of anemia and the number of sickle-cell crises per year. Treatment had an effect on agitation in patients, with pentoxyfylline having a soothing effect unlike cinepazide maleate. Women complained of insomnia in the middle of the night and somatic anxiety and presented higher total scores than men. Men exhibited a higher degree of mental dullness. The findings of this preliminary study indicate that while not associated with frank depression, the sickle-cell gene has psychological repercussions on various depressive parameters and that these patients can benefit from treatment with pentoxyfylline.
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PMID:[Sickle cell disease and depression: preliminary study using the Hamilton rating scale for depression]. 819 26

Chronic pain complaints often reflect or are influenced by psychiatric factors. Physicians commonly encounter "illness-affirming behaviors" in which patient complaints or symptoms go beyond what should be expected from a specific disease process. In this paper, I describe common psychiatric conditions that often feature pain as part of the illness: somatization disorder, hypochondriasis, factitious physical disorders, pain associated with psychological factors (new DSM-IV nomenclature), and malingering. These conditions can be distinguished based on the conscious awareness (or lack of awareness) of both motivation and symptom production. Other psychiatric disorders may strongly influence chronic pain without directly causing it--depression, anxiety, panic, and post-traumatic stress disorders. Except for malingering and factitious pain, chronic pain should be regarded as genuine. Effective management requires psychiatric as well as biological considerations.
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PMID:Psychiatric aspects of chronic pain. 853 83

This study was conducted to examine the rates of somatization disorder (SD) in the chronic fatigue syndrome (CFS) relative to other fatiguing illness groups. It further addressed the arbitrary nature of the judgments made in assigning psychiatric vs. physical etiology to symptoms in controversial illnesses such as CFS. Patients with CFS (N = 42), multiple sclerosis (MS) (N = 18), and depression (N = 21) were compared with healthy individuals (N = 32) on a structured psychiatric interview. The SD section of the Diagnostic Interview Schedule (DIS) III-R was reanalyzed using different criteria sets to diagnose SD. All subjects received a thorough medical history, physical examination, and DIS interview. CFS patients received diagnostic laboratory testing to rule out other causes of fatigue. This study revealed that changing the attribution of SD symptoms from psychiatric to physical dramatically affected the rates of diagnosing SD in the CFS group. Both the CFS and depressed subjects endorsed a higher percentage of SD symptoms than either the MS or healthy groups, but very few met the strict DSM-III-R criteria for SD. The present study illustrates that the terminology used to interpret the symptoms (ie, psychiatric or physical) will determine which category CFS falls into. The diagnosis of SD is of limited use in populations in which the etiology of the illness has not been established.
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PMID:Assessing somatization disorder in the chronic fatigue syndrome. 867 89


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