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

In this article we summarize our current understanding of depression in older (14-18 years old) adolescents based on our program of research (the Oregon Adolescent Depression Project). Specifically, we address the following factors regarding adolescent depression: (a) phenomenology (e.g., occurrence of specific symptoms, gender and age effects, community versus clinic samples); (b) epidemiology (e.g., prevalence, incidence, duration, onset age); (c) comorbidity with other mental and physical disorders; (d) psychosocial characteristics associated with being, becoming, and having been depressed; (e) recommended methods of assessment and screening; and (f) the efficacy of a treatment intervention developed for adolescent depression, the Adolescent Coping With Depression course. We conclude by providing a set of summary statements and recommendations for clinicians.
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PMID:Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. 982 21

There are many physical disorders that have little or no organic basis. Many of these conditions are caused by mental pathology. Certain emotional disorders can magnify the person's ability to perceive pain. Anxiety and depression are often the culprits. It behooves the podiatrist to be aware that anxiety and depression can be a cause of foot and ankle pain or that they can exacerbate true physical symptoms. The podiatrist should be able to perform a rudimentary psychological evaluation in the outpatient clinical setting, and should be prepared to make a timely and proper referral to a mental health professional for additional testing and treatment.
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PMID:Anxiety, depression, and diseases of the lower extremities. 991 83

Disease depresses. As a consequence depressed mood is almost ubiquitous in medicine. This is as true for physical disorders as it is for mental disorders. Depressed mood, moreover, seldom comes alone but is generally accompanied by other troublesome phenomena. In other words, the transition from distress towards depression is a gradual one, at least from the clinical point of view. One could therefore rightfully assume, that most physicians will be well versed in diagnosing and treating depression. Regrettably that is not the case. Depression is an under-diagnosed and under-treated disorder. Hence sophisticated educational programs to enhance the diagnostic and therapeutic skills of those frequently encountering depressive and depressed patients are much in need. The Dep Relief program is a CD-ROM program well suited for this purpose. It is wide-ranging, evidence-based, easily adaptable to various audiences and scrutinized by a panel of international experts. In short, it is an important tool to disseminate up-to-date information about mood disorders.
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PMID:On what evidence should education concerning depression be based? 1046 32

Sexual dysfunction is a very important but often overlooked symptom of multiple sclerosis. To investigate the type and frequency of symptoms of sexual dysfunction in patients suffering from multiple sclerosis, we performed a case-control study comparing 108 unselected patients with definite multiple sclerosis, 97 patients with chronic disease and 110 healthy individuals with regard to sexual function, sphincteric function, physical disorders impeding sexual activity and the impact of sexual dysfunction on social life. Information has been collected from a face-to-face structured interview performed by a doctor of the same gender as the patient. The disability, the cognitive performances, the psychiatric conditions and the psychological profile of patients and controls have been assessed. Sexual dysfunction was present in 73.1% of cases, in 39.2% of chronic disease controls and in 12.7% of healthy controls (P<0.0001). Male cases reported symptoms of sexual dysfunction more frequently than female cases (P<0.002). Symptoms of sexual dysfunction more commonly reported in patients with multiple sclerosis were anorgasmia or hyporgasmia (37.1%), decreased vaginal lubrication (35.7%) and reduced libido (31.4%) in women, and impotence or erectile dysfunction (63.2%), ejaculatory dysfunction and/or orgasmic dysfunction (50%) and reduced libido (39.5%) in men. Seventy-five per cent of cases, 51.5% of chronic disease controls and 28.2% of healthy controls (P<0.0001) experienced symptoms of sphincteric dysfunction. In conclusion, a substantial part of our sample of patients with multiple sclerosis reported symptoms of sexual and sphincteric dysfunction. Both sexual and sphincteric dysfunction were significantly more common in patients with multiple sclerosis than in either control group. Our findings suggest that a peculiar damage of the structures involved in sexual function is responsible for the dysfunction in patients with multiple sclerosis, but the highly significant lower frequency of symptoms of depression and anxiety in healthy controls may also imply a possible causative role of psychological factors.
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PMID:Sexual dysfunction in multiple sclerosis: a case-control study. I. Frequency and comparison of groups. 1061 99

Sexual dysfunction affects a large part of patients suffering from multiple sclerosis, but some aspects of its clinical presentation and aetiology are not clearly defined yet. In an unselected sample of 108 patients with definite multiple sclerosis we investigated the relationship between symptoms of sexual dysfunctioning and sphincteric dysfunction, patients' and disease characteristics, disability and neurological impairment, psychological and cognitive functioning. Sexual dysfunction directly correlated with presence of physical disorders (r=0.37, P=0.0004), low educational level (r=0.32, P<0.002), disability (r=0.31, P<0.003), age at onset of symptoms (r=0.30, P<0.003), sphincteric dysfunction (r=0.30, P<0.003), age (r=0.30, P<0.004), depression (r=0.29, P<0.005), fatigue (r=0.29, P=0.005), cognitive deterioration (r=0.26, P<0.01), primary-progressive course of disease (r=0.25, P<0.02), neurological impairment (r=0.25, P<0.02), marriage (r=0.24, P<0.02), anxiety (r=0. 23, P<0.03), male gender (r=0.22, P=0.03) bladder dysfunction (r=0. 29, P<0.04), and unemployment (r=0.21, P<0.04). Sexual dysfunction correlated inversely with relapsing - remitting course of disease (r=-0.31, P<0.002). No correlation was found between sexual dysfunction and bowel dysfunction, duration of disease, secondary-progressive course of disease, number and frequency of sexual intercourses in the last year, number of partners, number of exacerbations in the last year, number of months since last exacerbation, masturbation, and fertility. In conclusion, the association between sexual dysfunction and sphincteric dysfunction indicates a common aetiology corresponding to the frequent involvement of the spinal cord in multiple sclerosis, but the concomitant correlation between sexual dysfunction and other variables suggests the possible aetiological role of physical, psychological and sociological factors as well.
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PMID:Sexual dysfunction in multiple sclerosis: II. Correlation analysis. 1061

Children can and do have depression which is similar to and continuous with that in adults. It can be diagnosed and treated similarly. Clinical evaluation reveals depression and laboratory tests are not required. It may be comorbid with other psychiatric or physical disorders. It causes considerable distress and impairment and suicide can be one serious sequel. Relapse or recurrences can occur. Etiology of depression is uncertain though hypotheses of psychogenesis or biogenesis exists. Psycho-pharmacological advances have helped in understanding etiology of depression and also in its effective treatment. So far, fluoxetine in the only antidepressant shown to be effective though others are also used. Antidepressants need to be given for one year or more.
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PMID:Pediatric depression and psychopharmacology. 1079 17

The Center for Epidemiologic Studies Depression Scale (CES-D) is frequently used in studies of elderly individuals. One controversy regarding its use turns on the issue of whether the effect of physical disorder on the CES-D total score reflects genuine effects on depression or item-level artifacts. The present article addresses this issue using medical examination data from 506 community-dwelling individuals aged 75 or older. A form of structural equation modeling, the MIMIC model, is used, enabling the effect of a physical disorder on CES-D total score to be partitioned into bias and genuine depression components. The results show substantial physical disorder-related artifacts with the CES-D total score. Caution is required in the use of CES-D (and possibly other) depression scales in groups in which physical disorders are present, such as in elderly individuals.
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PMID:Item bias in the Center for Epidemiologic Studies Depression Scale: effects of physical disorders and disability in an elderly community sample. 1098 92

Late-life depression is a serious health problem that is challenging to manage but generally responds well to pharmacotherapy. Selective serotonin (5-hydroxytryptamine: 5-HT) reuptake inhibitors (SSRIs), the most commonly prescribed antidepressants, are usually used as first-line agents for elderly patients with depression. Like most drugs, SSRIs have not been widely tested in clinical trials that approximate 'real-life' geriatric situations. However, studies completed to date provide valuable information about the efficacy, safety and tolerability of this class of antidepressants among older patients with depression, including those with depression secondary to stroke or dementia and those with other comorbid physical disorders. Although one SSRI may be more efficacious or better tolerated by elderly patients than another, existing data do not support such claims. However, other distinguishing features may influence the choice of agent. For example, fluoxetine, fluvoxamine and paroxetine are more likely to be involved in significant drug-drug interactions than are citalopram or sertraline. In contrast to the other SSRIs, fluoxetine has a half-life well in excess of 1 day, which can be an advantage when weaning the patient off therapy in that it may reduce the incidence of discontinuation symptoms, but a significant disadvantage if the patient cannot tolerate the drug or experiences an adverse drug-drug interaction.
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PMID:Selective serotonin reuptake inhibitors for late-life depression: a comparative review. 1139 44

The purpose of this study was to develop and validate the questionnaire used to measure adolescents' wellbeing and its physical, mental and social dimensions. The questionnaire was composed of two parts: the first part contained wellbeing indicators and the second part contained criterion indicators (health disorders and harmful behaviours). Physical wellbeing scale contained the most common complaints due to psychosocial and life style factors, and was measured by three indicators: headache, abdominal pain and backache. Mental wellbeing scale contained emotional and moral dimensions that were recognised as closely connected with the physical disorders from one hands and the process of socialisation from the other hands. There were eight indicators: fatigue, stress, fear, depression, loneliness, helplessness, feeling of guilt, and low self-complacency. Five indicators: perceived social support, relationship with mother, father, friends and teacher measured social wellbeing scale. Each indicator of wellbeing is scored in three scales: dichotomise scale, five-point Likert scale and visual analogue scale. The cluster sample of 445 schoolchildren aged 14-15 years, randomly selected from the last grade of elementary schools of Warsaw was surveyed in October-November 1999. The physical, mental, social and total wellbeing scales were found to be reliable, but differing in internal consistency. The total and mental scales of wellbeing demonstrated high reliability, while the physical and social scales demonstrated moderate reliability. Analysis of correlation between criterion and tested variables showed acceptable discriminative power of the physical, mental, social and total wellbeing scales. Respondents assessed the five-point Likert scale as easier in comparison to dichotomise and visual analogue scales.
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PMID:[Evaluation of theoretical accuracy, reliability, discriminative power and difficulty for physical, mental and social well-being scales in adolescents]. 1145 45

BACKGROUND: Few studies have systematically compared the relationship between lost work productivity (work impairment) and mental disorders using population surveys. AIMS: (1) To identify the importance of individual mental disorders and disorder co-occurrences (comorbidity) as predictors of two measures of work impairment over the past month - work loss (number of days unable to perform usual activities) and work cutback (number of days where usual activities were restricted); (2) to examine whether different types of disorder have a greater impact on work impairment in some occupations than others; (3) to determine whether work impairment in those with a disorder is related to treatment seeking. METHOD: Data were based on full-time workers identified by the Australian National Survey of Mental Health and Well-Being, a household survey of mental disorders modeled on the US National Comorbidity Survey. Diagnoses were of one-month DSM-IV affective, anxiety and substance-related disorders. Screening instruments generated likely cases of ICD-10 personality disorders. The association of disorder types and their co-occurrences with work impairment was examined using multivariate linear regression. Odds ratios determined the significance of mental disorder prevalence across occupations, and planned contrasts were used to test for differences in work impairment across occupations within disorder types. The relationship between work impairment and treatment seeking was determined for each broad diagnostic group with t-tests. RESULTS: Depression, generalized anxiety disorder and personality disorders were predictive of work impairment after controlling for impairment due to physical disorders. Among pure and comorbid disorders, affective and comorbid anxiety-affective disorders respectively were associated with the greatest amount of work impairment. For all disorders, stronger associations were obtained for work cutback than for work loss. No relationship was found between type of occupation and the impact of different types of disorder on work impairment. Only 15% of people with any mental disorder had sought help in the past month. For any mental disorder, significantly greater work loss and work cutback was associated with treatment seeking, but comparisons within specific disorder types were not significant. DISCUSSION: A substantial amount of lost productivity due to mental disorders comes from within the full-time working population. The greater impact of mental disorders on work cutback compared to work loss suggests that work cutback provides a more sensitive measure of work impairment in those with mental disorders. Work impairment was based on self-report only. While there is evidence for the reliability of self-assessed work loss days, no reliability or validity studies have been conducted for work cutback days. The low rates of treatment seeking are a major health issue for the workforce, particularly for affective and anxiety disorders, which are important predictors of lost productivity. IMPLICATIONS FOR HEALTH POLICIES AND FURTHER RESEARCH: Future research should investigate the validity of work cutback, given its importance as a measure of lost productivity in people with mental disorders. Employers need to be aware of the extent to which mental disorders affect their employees so that effective work place interventions can take place. Treatment should be targeted at people with affective and anxiety disorders, particularly where they co-occur.
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PMID:Lost productivity among full-time workers with mental disorders. 1196 49


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