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

Past and current debates about applying medical diagnoses to psychological difference in society are examined. Beginning with a brief historical overview from antiquity to 'anti-psychiatry' and a summary of recent debates, the article then offers two case studies of common diagnoses ('depression' and 'schizophrenia'). The main challenge for social science is no longer about what is wrong with psychiatric diagnosis (that is now well rehearsed) but how to account for how and why it has survived. In answering this question about survival, inter-disciplinary work could attend to the pre-empirical positions of mental health researchers; the ways in which mental disorders are similar and different to physical disorders; and the interest work of different social groups defending or attacking psychiatric diagnoses in varying contexts.
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PMID:The survival of psychiatric diagnosis. 1747 Mar 81

About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses. Such estimates have drawn attention to the importance of mental disorders for public health. However, because they stress the separate contributions of mental and physical disorders to disability and mortality, they might have entrenched the alienation of mental health from mainstream efforts to improve health and reduce poverty. The burden of mental disorders is likely to have been underestimated because of inadequate appreciation of the connectedness between mental illness and other health conditions. Because these interactions are protean, there can be no health without mental health. Mental disorders increase risk for communicable and non-communicable diseases, and contribute to unintentional and intentional injury. Conversely, many health conditions increase the risk for mental disorder, and comorbidity complicates help-seeking, diagnosis, and treatment, and influences prognosis. Health services are not provided equitably to people with mental disorders, and the quality of care for both mental and physical health conditions for these people could be improved. We need to develop and evaluate psychosocial interventions that can be integrated into management of communicable and non-communicable diseases. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on existing programmes and activities, such as those which address the prevention and treatment of HIV, tuberculosis, and malaria; gender-based violence; antenatal care; integrated management of childhood illnesses and child nutrition; and innovative management of chronic disease. An explicit mental health budget might need to be allocated for such activities. Mental health affects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS. Mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning, and delivery of primary and secondary general health care.
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PMID:No health without mental health. 1780 63

Depression is the most frequent psychiatric disorder in old age. Some patients have had depressive episodes or other psychological disorder in an earlier part of their life span. Older people show more somatic or cognitive complaints compared to younger depressives. Risk factors for depression in old age are (incident) physical disorders, sleep disorders or loss of spouse. Depression worsens course and prognosis of comorbid somatic disorders. A major consequence is the high suicide rate in the elderly. Depression is also a risk factor for other disorders like dementia or institutionalisation. The interplay between depression and dementia and other organic brain disorders is complex und still unresolved. Depression in the elderly is a challenge for our health system. Recognition and treatment rates are still too low. Integrative treatment plans for depression with comorbid physical disorders or in various settings should be developed. With the growing elderly population the available evidence for treatment urgently has to be increased. In current practice drug therapies--mostly inadequate--dominate. Psychotherapy should be promoted and the number of old age psychotherapists increased.
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PMID:[Depression in old age]. 1834 72

Depression in older people slightly differs from younger subjects adults. Generally, typical depressive symptoms are overlooked by other symptoms. The most frequent ones are excessive preoccupation with health and complaints about physical symptoms. Anxiety is a common accompaniment of depression in later life. Poor subjective memory or dementia-like and psychotic symptoms are also common in depression in the elderly. The exogenous depression, the most common forms of depression in elderly people, has a little response to antidepressants. The endogenous depression is associated with high risk of suicide. Depression in older people often coexists with physical disorders. The most frequently encountered is Parkinson's disease. Depression could also be one of the side effect of the use of drugs for physical illnesses. The Tricyclic antidepressants (TCAs) are generally too toxic for elderly people and should not be considered as drugs of first choice. Currently, the drugs of choice are the serotonin-selective reuptake inhibitors (SSRIs). They have an antidepressant effect similar to that of (TCAs), but they are less toxic. The antidepressant treatment in the elderly is usually initiated at a low starting dose, ideally no more than half the usually recommended for the adults. For psychotic depression a combination of an antidepressant used in conjunction with antipsychotic drug is more effective than an antidepressant administered alone. The treatment should be continued for six months at least in order to reduce the risk of relapse. Moreover, long-term treatment is recommended because of the high risk of recurrence.
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PMID:[Clinical and therapeutic particularities of depression in the elderly]. 1844 39

We aimed to compare disability rates associated with physical disorders versus psychiatric disorders and to establish treatment rates of both classes of disorder in the South African population. In a nationally representative survey of 4351 adults, treatment and prevalence rates of a range of physical and psychiatric disorders, and their associated morbidity during the previous 12 months were investigated. Physical illnesses were reported in 55.2% of the sample, 60.4% of whom received treatment for their disorder. Approximately 10% of the samples show a mental illness with 6.1% having received treatment for their disorder. The prevalence of any mental illness reported was higher than that reported individually for asthma, cancer, diabetes, and peptic ulcer. Mental disorders were consistently reported to be more disabling than physical disorders and the degree of disability increased as the number of comorbid disorders increased. Depression, in particular, was rated consistently higher across all domains than all physical disorders. Despite high rates of mental disorders and associated disability in South Africa, they are less likely to be treated than physical disorders.
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PMID:Disability and treatment of psychiatric and physical disorders in South Africa. 2006 63

DEPRESSION AND CHRONIC PHYSICAL ILLNESS ARE IN RECIPROCAL RELATIONSHIP WITH ONE ANOTHER: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses. Depression associated with physical illness is less well detected than depression occurring on its own, and various ways of improving both the detection and treatment of depression accompanying physical illness are described. This paper is in four parts, the first dealing with the evidence for depression having a special relationship with physical disorders, the second dealing with detection of depression in physically ill patients, the third with the treatment of depression, and the fourth describing the advantages of treating depression among physically ill patients.
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PMID:The detection and treatment of depression in the physically ill. 2014 48

Mental disorders in the elderly often influence their social and physical wellbeing. Depression and anxiety disorders may frequently be found in elderly patients with chronic diseases; however, we now know that this patient group may benefit from psychotherapy. The psychotherapeutic group "40 plus" provides a supportive group intervention for physically and psychically impaired patients in their second half of life. The group intervention allows them to recognize and to activate their resources, as well as the interaction between physical disorders and psychosocial burdens and possible influential aspects to be perceived. An evaluation of 64 patients who participated in this group intervention showed a significant improvement of depression, psychosocial burdens and somatization. The concept of the group "40 plus" presented here may therefore be seen as to effectively bridge a gap in the health care of the elderly.
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PMID:[Psychotherapeutic group intervention for patients in the second half of life]. 2115 73

The aim of this article is to estimate the prevalence and the socio-demographic and health profile of housebound elderly people registered at a Family Health Unit in the urban region of Belo Horizonte (Minas Gerais, Brazil). A household survey was conducted between May and July 2006 with 275 elderly people selected via cluster sampling. The svy suite of commands in Stata 9.0 was used to deal adequately with the cluster sample structure and to allow the incorporation of fractions of expansion in the analyses. Among the 275 elderly, 22.4% (IC95%: 14.7; 32.4) were restricted to their homes. The prevalence of this condition was greater among women, people over 80 and suspected of suffering from cognitive impairment (p-valor < 0.05). The majority of housebound people had incomes below the minimum wage, reported history of falls, depression and indicated physical disorders as the cause of the restriction. The large contingent of low-income housebound elderly with several health problems, reinforces the need for incorporation of proposals for promotion and vigilance of the health of the elderly, which extend beyond the boundaries of the healthcare units.
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PMID:[Prevalence of housebound elderly people in the urban region of Belo Horizonte (Minas Gerais, Brazil)]. 2170 92

The study was designed to explore the non-psychotic morbidity amongst the referred cases with somatic symptoms. After excluding all organic, psychotic and mentally retarded cases 81 patients were assessed by General Health Ouestionnaire-36. Physical Illness Items removed (GHO-36P) and diagnosed according ICD-9, 39 matched subjects were taken as control and was assessed also by GHQ-36P. Anxiety neurosis was more common among these patients who were suffering for less than 6 months whereas depression was more common among patients who were suffering for more than a year. Referred cases had significant differences in GHQ-36P scoring.
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PMID:A study of psychiatric disorders other psychosis in the referred cases with somatic complaints. 2192 70

Internet-based educational and therapeutic programs (e-health applications) are becoming increasingly popular for a variety of psychological and physical disorders. We tested the efficacy of an online Chronic Pain Management Program, a comprehensive, fully self-directed and self-paced system that integrates social networking features and self-management tools into an interactive learning environment. Of 305 adult participants (196 women, 109 men), a total of 162 individuals with chronic pain were randomly assigned unsupervised access to the program for approximately 6 weeks; 143 were assigned to the wait-listed control group with treatment as usual. A comprehensive assessment was administered before the study and approximately 7 and 14 weeks thereafter. All recruitment, data collection, and participant involvement took place online. Participation was fully self-paced, permitting the evaluation of program effectiveness under real-world conditions. Intent-to-treat analysis that used linear growth models was used as the primary analytic tool. Results indicated that program utilization was associated with significant decreases in pain severity, pain-related interference and emotional burden, perceived disability, catastrophizing, and pain-induced fear. Further, program use led to significant declines in depression, anxiety, and stress. Finally, as compared to the wait-listed control group, the experimental group displayed a significant increase in knowledge about the principles of chronic pain and its management. Study limitations are considered, including the recognition that not all persons with chronic pain are necessarily good candidates for self-initiated, self-paced, interactive learning.
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PMID:A randomized controlled evaluation of an online chronic pain self management program. 2213 50


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