Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The long-term efficacy of digoxin maintenance therapy must be determined individually for patients with normal sinus rhythm who have a history of congestive heart failure but no remaining signs or symptoms. Predictive factors for successful discontinuation of the agent in the elderly include normal mental status (including absence of depression), ability to adequately perform activities of daily living, general feelings of well-being, absence of multiple organic disease, absence of multiple drug use, and no evidence of existing congestive heart failure or atrial fibrillation. Our findings indicate that physicians and patients need to reexamine the concept that congestive heart failure is necessarily a chronic disease. Certainly, evidence exists that continuing digitalis therapy indefinitely is inappropriate and may be harmful. Further investigation may prove that congestive heart failure in the elderly, like pneumonia, is a common acute occurrence and in many cases not a chronic state for which patients are destined to receive medication indefinitely. We hope that the findings from our small sample will stimulate other investigators to question the indiscriminate long-term use of digitalis in the elderly.
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PMID:Digitalis for congestive heart disease in the elderly. A family practice view of the efficacy of long-term therapy. 310 Oct 52

An adequate history from the patient and a family member, an examination for signs and symptoms suggestive of contributing organic disease, plus an individualized diagnostic battery of laboratory tests are sufficient workup for most patients presenting with the dementia syndrome. Electroencephalography, computerized axial tomographic scanning, or psychometric testing are not usually required. The results of eight studies investigating demented individuals are reviewed. Across these studies, 56 percent of cases were attributable to primary dementia, 15 percent were secondary to reversible causes, 13 percent were secondary to irreversible conditions, and 15 percent of individuals had been wrongly labeled demented. Of reversible dementias including depression, 56 percent of patients improved with therapy. Metabolic disorders were associated with about 25 percent of reversible dementias and accounted for less than 5 percent of all patients investigated for the dementia syndrome.
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PMID:Evaluation of the demented patient. 310 30

Symptoms of masked depression are often localised in the otorhinolaryngeal field. Headache, facial pain, dysphagia, burning sensations in the tongue, tinnitus, vertigo and voice and respiratory disorders were frequent complaints of 48 patients at our out-patient clinic between 1980 and 1985. After careful exclusion of organic disease, they proved to be due to endogenous depressive disorder. An increase in the number of such cases has been noted. One patient is described as an example of the problems of diagnosis.
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PMID:[Otorhinolaryngologic manifestations of masked mono- or oligosymptomatic depressions]. 317 Feb 84

Monoamine oxidase-B (MAO-B) activity of platelets of an age- and sex-matched group of controls was compared with several groups of inpatients having non-familial dementia of Alzheimer type (DAT), Parkinson's disease (PD), multi-infarct dementia (MID), mixed types of these 3 diseases and a group of other central nervous system (CNS) organic disorders. All patients were subjected to several psychometric tests, including the Sandoz Clinical Assessment--Geriatric Scale, Hamilton Rating Scale for Depression, Mini-Mental State Examination and the Organic mental Disorder Scale (OMDS). A statistically significant enhancement of MAO-B activity could be observed in DAT patients and in PD patients, whereas the MID group showed a mean activity similar to that of the control group and the group with other organic CNS disorders. In DAT patients the degree of dementia in the OMDS test and the enhancement of MAO activity were positively correlated, but PD did not show such a correlation. It is concluded that the increase of MAO activity in PD and in DAT might be due to a disease-related enhanced affinity to oxygen and to such oxygen-derived radicals as superoxide or hydroxyl radicals. However, a possible drug-induced enhancement of MAO activity in PD cannot be excluded. Furthermore, the MAO-B activity values in platelets of individual patients or controls are not indicative of diagnosis or prognosis of any of these diseases and are of no disease-related specificity.
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PMID:Platelet MAO-B activity and the psychopathology of Parkinson's disease, senile dementia and multi-infarct dementia. 322 31

Seventy patients presenting to the gastroenterologist with upper abdominal pain were examined by a psychiatrist to establish the presence of psychiatric disorder, illness behaviour and to record in detail their symptom pattern. The 37 patients who had no organic cause for their abdominal complaints were subdivided into those with and without psychiatric disorder. The former (21 patients) demonstrated more illness behaviour, they complained of more abdominal symptoms and their pain was both more severe and more persistent than in the patients with organic disease and those with non-organic illness who did not have psychiatric disorder. The latter group reported no symptoms of 'psychoneurosis' and should probably be regarded as a separate group if the aetiology of functional abdominal pain is to be clarified. Those with non-organic abdominal complaints who had psychiatric illness could be distinguished by the presence of three symptoms, namely depression, anxiety and fatigue. Detection and treatment of their psychiatric disorder might lead to a decrease in their symptomatic complaints and illness behaviour.
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PMID:Symptom complaints, psychiatric disorder and abnormal illness behaviour in patients with upper abdominal pain. 327 Aug 33

Many commonly used drugs can interfere with male sexual function, either by decreasing libido, interfering with erectile function, or causing absent seminal emission or retrograde ejaculation. Although drug-related effects on sexual function may be difficult to distinguish from the effects of organic disease, anxiety, or depression, it is important for the physician to be aware of the drugs most commonly associated with sexual dysfunction. This article considers these drugs and the potential mechanism by which they exert their adverse effects.
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PMID:Drug-induced male sexual dysfunction. 327 73

This paper reviews recent psychological studies of patients with the irritable bowel syndrome (IBS) or 'functional abdominal pain'. Many studies have used unreliable or invalid methods of assessment and some have confused personality with treatable psychiatric illness. Reliable and valid measures have indicated that 40-50% of patients with recently diagnosed functional abdominal pain have demonstrable psychiatric illness; these patients have a worse prognosis than those who are psychologically normal. When psychiatric disorder is diagnosed in a patient with IBS there are three possibilities: (1) The patient may have developed abdominal and psychiatric symptoms simultaneously in which case treatment of the latter may relieve the bowel symptoms. (2) Psychiatric disorder may precipitate increased concern about bowel symptoms, and consequent attendance at the gastroenterology clinic, of those with chronic mild symptoms. In this case it is illness behaviour, rather than abdominal symptoms, that is caused by the anxiety/depression. (3) Those with chronic neurotic symptoms as part of their personality must be screened for organic disease if they have a fresh onset of bowel symptoms; but they are at high risk of becoming persistent clinic attenders. Further research is needed to clarify when psychological abnormalities play a role in the aetiology of IBS and when they are coincidental, but lead to illness behaviour. The role of psychological factors in the aetiology of the irritable bowel syndrome (IBS) is far from clear, but a review of the literature suggests that some consistent patterns are emerging in spite of methodological problems. There have been three major defects with studies that have linked IBS with neurotic symptomatology. First, the measurement of psychological factors has generally been imprecise. Second, most studies have considered IBS patients as a single group, without making allowance for differing symptom patterns. Third, conclusions have been drawn about hospital samples and extrapolated to all IBS subjects, without taking account of factors which affect consulting behaviour. Most studies have been concerned with psychological factors so these will be considered in most detail.
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PMID:Psychological factors in the irritable bowel syndrome. 331 78

Besides sleep apnea, the main disorders of excessive daytime sleepiness include narcolepsy and hypersomnia. Narcolepsy is characterized by periods of irresistible sleepiness and sleep attacks of brief duration and, most often, by one or more of the auxiliary symptoms: cataplexy, sleep paralysis, and hypnogogic hallucinations. Generally, sleepiness and sleep attacks in hypersomnia are of longer duration and are more resistible than in narcolepsy; also, the auxiliary symptoms are absent. There are three types of hypersomnia: idiopathic, secondary, and periodic. Nocturnal sleep is typically disrupted in narcolepsy, whereas in idiopathic hypersomnia it is prolonged and in secondary hypersomnia it is variable. The exact causes of narcolepsy and idiopathic hypersomnia are unknown; however, there is evidence for genetic predisposition for either disorder. In secondary hypersomnia causative factors include: neurologic, such as head injuries, cerebrovascular insufficiency, and brain tumors; general medical, such as metabolic disorders, various intoxications, and conditions leading to brain hypoxia; and psychiatric, most notably depression. Although the cause of periodic hypersomnia is unclear, most research supports the notion of underlying organic disease. Often, the evaluation of patients with excessive daytime sleepiness can be completed in the office setting, based on the sleep history and a thorough neurologic, general medical, and psychiatric assessment. Whenever indicated, ancillary laboratory studies, such as computed tomography and magnetic resonance scans, should be performed. Sleep laboratory recordings generally are not necessary unless there is suspicion of sleep apnea or narcolepsy in the absence of auxiliary symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disorders of excessive sleepiness: narcolepsy and hypersomnia. 333 60

Psychological distress was evaluated in two groups of medical in-patients, one composed of geriatric subjects (178), the other of adults (201). The instrument used for this purpose was the SCL-90. The predominant pattern of emotional response among the geriatric patients was depression; although this pattern was also present among the adult patients, reactions of an anxious type were more common in these subjects. Women of both groups of patients scored significantly higher than men on many of the subscales of the SCL-90. No significant differences emerged in relation to the type of organic disease among the adult patients, while among the geriatric patients, subjects with disorders of the CNS, muscular-skeletal system and blood scored significantly higher than those with other diseases.
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PMID:Psychological distress in geriatric and adult medical in-patients. 341 95

Organic illness in the elderly can often present with psychiatric signs and symptoms such as anxiety, agitation, depression, mania, paranoia, delusions, hallucinations, and changes in cognitive function. The prototypes of three such diseases--B12 deficiency, hypothyroidism, and normal pressure hydrocephalus are discussed. Specifically addressed are the neuropsychiatric manifestations of these diseases and the need for a thorough and continuing evaluation of patients presenting with mental dysfunction, in order to ensure an accurate and timely diagnosis. It is only through the recognition that these symptoms may represent non-psychiatric organic disease that early treatment can be implemented and symptoms potentially reversed.
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PMID:Mental dysfunction as a sign of organic illness in the elderly. 367 40


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