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

The Diagnostic and Statistical Manual of Mental Disorders (DSM-III) has expanded descriptions of anxiety and includes new categories with definitive diagnostic criteria. It has also eliminated its previous psychodynamic and psychoanalytic approach to psychopathology. The new anxiety classifications reflect the growth of knowledge in neurochemistry, especially cell-membrane binding sites and specific pharmacologic actions of certain drugs. Many research conclusions have become questionable as a result in large part of their reliance upon the obsolete versions of DSM (I and II). Among major findings in research on anxiety are its relatively common incidence, especially in family practice, and its relationship to secondary depression and increased association with physical disorders, particularly if the anxiety disorder is of long duration. Family and genetic studies have revealed a high incidence of anxiety within families, though there is little evidence of heritability. The pathophysiology of anxiety is only beginning to be studied productively. Research in drug therapy and psychotherapy have supported the need for both therapeutic modalities in most circumstances.
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PMID:Anxiety disorders. 612 79

All depressive syndromes include physical as well as psychological features. Physical symptoms in major "endogenous" depression are well known. In other forms, called masked depressions, various physical disorders are the patients main complaint and may be misleading. Localized pain and paresthesia are common. Behaviour disorders may mask depression in adolescents. Mood disturbances (loss of interest, anhedonia) as well as the personal and family histories, should be precisely assessed in order to establish diagnosis. Masked depression is not a minor form of depressive syndrome and antidepressant drugs should be used in correct doses over a sufficient period of time.
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PMID:[Masked depression and paucisymptomatic depression (author's transl)]. 627 36

The definition, recognition, and management of chronic depression are briefly reviewed. An ongoing prospective study of the long term (5-15 years) use of doxepin indicates that this tricyclic antidepressant is feasible, efficacious, and safe in the treatment of this population. Advantages of doxepin therapy include its lack of adverse interactions with prescription and non-prescription drugs taken by these patients and the high degree of safety seen in patients with concomitant cardiovascular and other physical disorders. Thus, doxepin appears to be an excellent choice in the long-term maintenance outpatient treatment of chronic depression.
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PMID:Long-term treatment of chronic depression: 15-year experience with doxepin HCl. 636

DSM-III diagnoses were established for 100 patients with chronic insomnia. Principal and additional diagnoses on axis I and II (psychiatric and personality disorders) were extremely prevalent. Only five patients had a principal diagnosis on axis III (physical disorders). The most common diagnoses on axis I were dysthymic, anxiety, somatoform, and substance use disorders. Compulsive personality disorder or trait was the most common axis II diagnosis. Ninety-five patients had multiple diagnoses. This study confirms that patients with chronic insomnia have a high prevalence of psychopathology and characteristic internalizing patterns of anxiety, depression, obsessive-compulsiveness, phobia, and excessive somatic concerns.
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PMID:Biopsychobehavioral correlates of insomnia. IV: Diagnosis based on DSM-III. 670 98

Depression is the mental health disorder most commonly seen in the primary health care setting. Estimates of the prevalence of people who are depressed but are seeking treatment for physical disorders in the primary care setting range from 12% to 55% of total patients. We conducted a study to determine the number of women with high depressive symptoms who were seeking treatment for physical disorders and compared this group with women with no depressive symptoms who were also seeking physical health care. The women with high depressive symptoms (n = 122) and the women with no depressive symptoms (n = 115) were similar in age, economic status, occupation status, and lifestyle. The depressed women reported significantly more physical complaints, increased disability, increased functional limitations, and increased use of health care services than did the nondepressed women. They disclosed a variety of physical complaints in all organ systems, had had more life events, and had a diminished belief in their ability to control their environments. The results of this study support the view that large numbers of women with depression that is unrecognized present themselves to the health care system for physical complaints. Health care providers need to extend their view of women as whole beings, instead of as a somatic complaint.
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PMID:Women and somatization: unrecognized depression. 764 86

This study examined the temporal stability of the measurement structure of the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) in 813 individuals with rheumatoid arthritis. Participants completed the CES-D (Radloff, 1977) on three occasions 1 year apart. Structural equation models and polyserial correlations were used to address methodological limitations of previous studies. Four competing measurement structures were tested with one factor, three factors, four factors, and a single second-order factor underlying the four-factor model. The four-factor and the second-order-factor models provided the best fit at Time 1. When cross-validated at Times 2 and 3, the four-factor and the second-order-factor models remained invariant. Researchers can now more confidently use the CES-D to examine how distress changes in chronic physical disorders.
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PMID:The measurement structure of the Center for Epidemiologic Studies Depression Scale. 776 Feb 58

Depression is a frequent and treatable disorder, but it is insufficiently recognized. A generally used classification system is lacking. In a consensus meeting the following terms were defined: a normal feeling of depression, depression as a symptom and depression as an illness. The use of the term 'masked depression' was advised against. The undertreatment mentioned is caused by the following factors: presentation of physical symptoms by depressive patients, unfamiliarity of patients with depressive disorders and difficulties of patients and GPs in labelling depression as mental. Depressive disorders have various causes. For scoring the severity of depression the Bech version of the Hamilton Depression Rating Scale is preferred. There is no valid laboratory test for diagnosing depression. Laboratory tests are recommended to exclude physical disorders, for choosing an antidepressant and for the follow-up of drug treatment. Cognitive Behavioural Therapy and Interpersonal Therapy are preferred psychotherapeutic methods because of their scientifically proved efficacy. Women suffer from depression twice as frequently as men, which is due to social factors rather than to genetic or hormonal factors. Therefore hormonal therapy is not indicated, a more equal doctor-patient relationship is. Patients with a depressive disorder may consider suicide; this should regularly be discussed with them.
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PMID:[Consensus depression in adults. Dutch Association for Psychiatry]. 747 1

We started this chapter by examining a simple psychological model that depression was a straightforward reaction to the severity of the physical impairment of Parkinson's disease, and that the relationship between the two factors was essentially linear. Because of the progressive nature of the disease, it followed that any such relationship would also be reflected in factors such as stage of illness and duration. As seen, however, the data have consistently failed to support such a simple reactive model. Examining the equivalent literature on other physical disorders revealed a remarkably similar picture suggesting that the model is largely inadequate in general, as well as in relation to Parkinson's disease. This inadequacy, however, should not be taken as evidence that psychological factors are unimportant. Rather, it suggests only that we need a more comprehensive model linking chronic disabling illness and depression. One revision suggested by the evidence was to consider nonlinear relationships, for example, between depression and stage of illness. Adopting a broader perspective, one may suppose that the risk of depression may change over the course of disease progression. For example, at the very beginning, diagnosis and the process of coming to terms with the fact of having a progressive and disabling illness may be sufficient to cause depression. Later in the course of the illness, progressive deterioration and increasing dependency may once again provoke depression. At any stage, a rapid deterioration (from whatever level) or the development or worsening of treatment complications may cause fresh concerns and require a fresh period of adjustment. Although the depression may be similar in each of these cases, the mediating psychological factor is different. In between these times, the individual may adapt to the illness and its consequences and show less vulnerability to depression. A further modification of the model is to consider the influence of multiple factors. While any one factor may individually predict depression only weakly, in combination, they may explain the observed pattern of depression more accurately. Although little evidence is available, there is the suggestion that a combination of physical and psychological factors may provide a clearer picture of depression severity. The final, major modification suggested is to view the broad consequences of the physical disease, rather than the severity of the symptoms themselves.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Depression in Parkinson's disease: a psychosocial viewpoint. 787 53

Depression is a common condition in the geriatric population. A retrospective study of 30 elderly patients suffering from neurotic depression, who were admitted consecutively to a general hospital psychiatric ward, showed a predominance of females (n = 21) over males (n = 9) and young-old (65 to 74 years, n = 22) more than old-old (75 years or over, n = 8). Their ages ranged from 65 to 85 years with a mean of 71.6 years, SD 5.5 years. Co-existing physical disorders were present in every patient, the average being 1.8 per patient, and half (n = 15) had two or more physical disorders. Cardiovascular diseases (e.g. ischaemic heart disease and hypertension) and diabetes mellitus were present in about seven-eighths of the patients. The two commonest symptoms were low mood (n = 18, 60%) and vague somatic complaints inexplicable by any physical pathology (n = 19, 63%). Sleep disturbance bothered 12 patients (40%), while nine (30%) had attempted suicide. Twenty patients (67%) were prescribed antidepressants and 13 (43%) received benzodiazepines in low dosages, mainly as hypnotics. Electroconvulsive therapy was necessary for two patients with high suicidal risk. The mean duration of admission was 15.3 days, SD 12.9 days.
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PMID:Neurotic depression in the elderly. 794 52

A complex antiaging formula--Antagonic-Stress--was investigated vs. placebo (PL), meclofenoxate (MF)--neurometabolic nootropic and vs. nicergoline (NE)--cerebral vasodilator by comparative multiple trials (double-blind, randomized, and parallel) in gerontopsychiatry (DSM-III-R, 1987 and ICD-10, 1992 criteria). AS vs. PL studies in organic mental disorders--amnestic, depressive, anxiety, associated with axis III physical disorders or conditions, and in multiinfarct dementia were followed by AS vs. MF or NE investigations in senile dementia of Alzheimer's type. A total of 343 old people, distributed in 4 PL groups, 1 MF group, 1 NE group, and 5 AS groups were studied. Multiple investigations, before and after three-month treatments were made: psychometric evaluation by Sandoz Clinical Assessment-Geriatric, Self-Assessment Scale-Geriatric and their 5 subscales; psychopathological rating by Hamilton Depression and Anxiety Scales; as well as psychometric testing by digit symbol of WAIS, Wechsler Memory Scale and Wechsler Adult Intelligence Scale (WAIS). Except PL, prolonged and large dose treatments with these cerebral activators (MF, NE and especially AS) reduced the psychogeriatric-psychopathological scores and the deterioration index, and improved cognitive performance. The therapeutical effectiveness of AS multiple formula in gerontopsychiatry and its superiority vs. monotherapy (MF or NE) are discussed in connection with its complex neurometabolic and synergetic composition, multiple antioxidative combinations, free radical scavengers, lipofuscinolytic agents, the antiischemic action of antioxidants, multivitamin and multimineral supplementation, and with the better efficacy of multitherapy vs. monotherapy in geriatrics.
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PMID:Antagonic-stress. A new treatment in gerontopsychiatry and for a healthy productive life. 803 Aug 48


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