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)

Drug-induced depression which is classified as DSM-III-R is difficult for clinicians to diagnose because the cause is not easily distinguishable from adjustment disorders or nonorganic mood disorders. This review summarizes the few articles published within 20 years as searched in the Index Medicus about the clinical manifestations of organic mood syndromes from oral contraceptives (OCs), beta blockers, alcohol and sedative-hypnotic drugs, and other medications. There was a noticeable lack of articles and specific clinical features which would help differentiate causes. Oral contraception may cause depression by inducing hepatic tryptophan oxidase, which may lead to a deficiency of vitamin B6. The most common reason for discontinuing OCs is depression, i.e., there are reports of a rate of 70/1000 woman years during the 1st year of OC use. However, the rate among females examined in a catchment study was similar at 6.6%. There is some indication that depression may be dose related, i.e., low dose is related to the same prevalence as in the control group. A basic requirement of DSM-III-R is severe and persistent depression; OC-related depression does not exhibit sleep or appetite disturbances. The relationship between beta blockers and depression indicates that the prevalence and the nature of the relationship are not consistently confirmed. Depressive episodes (14) reported in 8 studies showed major depression and suicidal thoughts or attempts just after initiation of propranolol and resolution when the drug was discontinued; timing of the symptoms may be the best basis upon which to make a clinical judgement. Alcohol use is usually seen as associated with depression, but the extent to which alcohol induces depression is unknown. Symptoms are transitory and appear during bouts of heavy drinking. Studies on benzodiazepine use and depression are reported to be confounded by other factors. Other depression-causing agents for which information was unavailable are identified as psychostimulants, metoclopramide, H-2 blockers, methyldopa, and steroids.
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PMID:Can drug-induced depressions be identified by their clinical features? 135 May 3

Considerable evidence exists that the limbic system and the hypothalamus play an important role in the HPA axis disturbances found in depressive disorders. Evidence also exists that the limbic system plays a role in the modulation of aggressive behavior. Yet the HPA function of individuals with a disordered regulation of aggression has received little scrutiny. Because aggressive behavior has been observed to be extensively correlated with heavy alcohol use, we explored the HPA function of alcoholics who had had a life-long history of violence. Basal 0700h cortisol was measured in 4 consecutive wk following cessation of drinking in 19 alcoholics with a history of depression, and 17 alcoholics with a history of violent behavior, eight of whom had been incarcerated because of the severity of their violent acts. When compared with alcoholics with no problem in mood or aggression regulation, significant cortisol increases were found in the group of patients who had been incarcerated for violent acts and not in any other group. This increase persisted for 4 wk after cessation of drinking. A variety of variables, including several measures of alcohol consumption, amounts of benzodiazepines used for detoxification, and liver function tests, failed to show significant associations with cortisol. Data are interpreted as indicating that individuals displaying severe forms of violence could have a dysregulated HPA function revealed by exposure to excessive amounts of alcohol.
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PMID:Cortisol in alcoholics with a disordered aggression control. 160 16

The current study was undertaken primarily to identify whether psychiatric co-morbidity was associated with the rate and time of alcohol-related inpatient readmissions for a group of 255 patients discharged from alcoholism treatment at a midwestern rural medical center. A structured interview obtained information regarding psychiatric disorders, including depression, antisocial personality disorders and polysubstance abuse, as well as alcohol history and sociodemographics. Ninety-eight subjects (38.4% of sample) were readmitted for alcoholism-related diagnoses within 15 months of discharge. Patients with a long history of heavy drinking, high daily alcohol consumption and history of previous alcoholism treatment were most likely to be readmitted with an alcoholism-related primary diagnosis. Once these variables were controlled for, other major psychiatric disorders, polysubstances abuse and sociodemographic variables did not appear to predict time to readmission. However, other potentially more sensitive outcome measures such as return to drinking were not evaluated in the present study.
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PMID:Patient factors predicting early alcohol-related readmissions for alcoholics: role of alcoholism severity and psychiatric co-morbidity. 199 21

Follow-up interviews on a sample of 298 ex-heroin addicts 12 years after they entered treatment were used to examine alcohol use and substitution of alcohol for heroin. Almost one-fourth of the sample were classified as heavy drinkers in Year 12, and half had previously used alcohol in a substitution pattern. Classifications into one of three substitution groups (none, low and high) and multivariate analysis of variance were carried out to identify background and baseline factors related to substitution and long-term behavioral outcomes 12 years after entering treatment. Substitution was found to be related to higher levels of alcohol problems and treatment before addiction, parental alcohol problems, to vulnerability to peer influence in starting drug use and to feelings of rejection by peers during adolescence. In terms of 12-year outcomes, substitution was related to more use of nonopioid drugs, more heavy drinking and alcohol-related problems and more psychological dysfunction symptoms (such as depression). These results showed a strong relationship between substitution and preaddiction as well as postaddiction alcohol abuse. However, to delineate the effects of substitution apart from the effects of previous alcohol abuse, additional analyses were computed in which substitution was examined after controlling for previous alcohol abuse. The results confirmed the validity of substitution as a powerful construct in identifying behavioral differences before and after addition.
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PMID:Alcohol use by heroin addicts 12 years after drug abuse treatment. 234 63

In a study of 170 junior house officers who were followed up from their fourth year in medical school mean levels of stress were higher than in other reported occupational groups, and the estimated prevalence of emotional disturbance was 50%, with 28% of the subjects showing evidence of depression. Nearly a fifth of the subjects reported occasional or frequent bouts of heavy drinking, a quarter took drugs for physical illness, and a few took drugs for recreation. Those who were emotionally distressed at the initial study and the follow up were more empathetic and more self critical than those who had low levels of stress on both occasions. Overwork was the most stressful aspect of their jobs, though the number of hours worked was not related to stress levels, unlike diet and sleep. The more stressed they were the more unfavourably they viewed aspects of their jobs. The incidence of distress is unacceptably high in junior house officers, and both they and the hospitals need to deal with the causes of the distress.
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PMID:Emotional distress in junior house officers. 311 13

These studies assessed the risk status of children of untreated alcoholics. In Study 1, a cross-sectional survey of 208 high school students identified 18% as having serious concern about their parents' drinking. In Study 2, 32 children of problem-drinking parents and 39 others who participated in self-help groups were surveyed. Children of problem-drinking parents were more at risk of depression, low self-esteem, and heavy drinking than their peers in the general high school population. Within self-help groups, however, children's symptomatology was not related to their parents' drinking status. The results support the need for preventive intervention for children of problem-drinking parents and for developing strategies for improving the participation rate of such children in the intervention programs that are available.
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PMID:Risk status of adolescent children of problem-drinking parents. 340 33

Retrospective data on drinking behavior and related life experiences have been a neglected resource in research on alcohol use in the general population. Data from a 1981 national survey of women's drinking indicate the potential value of retrospective data analysis. The 1981 data provide comparative ages of onset for drinking behavior, drinking consequences, and health problems, and allow comparisons among different cohorts of women. The data also show the variability in women's lifetime drinking patterns and the time-ordering of heavy drinking in relation to onset of depression and reproductive dysfunction.
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PMID:Retrospective analysis of lifetime changes in women's drinking behavior. 348 32

Plasma amino acid abnormalities are frequently reported in alcoholics, with the most common abnormalities being those of depressed branched chain amino acids (BCAA) and increased aromatic amino acids. The depression in branched chain amino acids is due to multiple factors including portal-systemic shunting, hyperinsulinemia, hyperglucagonemia (all due to advanced liver disease) as well as dietary deficiency. alpha-Amino-n-butyric acid is a nonessential amino acid derived primarily from the catabolism of methionine, threonine, and serine. Increased levels due to chronic alcohol consumption may reflect altered glutathione metabolism and lipid peroxidation due to alcohol and may be used empirically as a biochemical marker of heavy drinking. The high levels of aromatic amino acids such as tyrosine and tryptophan as well as their breakdown products may be due to impaired hepatic metabolism and appear to play a role in the pathogenesis of hepatic encephalopathy. The effects of high levels of aromatic amino acids may be potentiated by depressed BCAA; these normally compete with each other for CNS transport. Alterations in these amino acids may have implications for nutritional requirements for amino acids in these patients as well as therapeutic approaches.
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PMID:Plasma amino acids in the alcoholic: nutritional aspects. 634 43

The relationship between Affective Disorder and Alcoholism is complex and has been studied extensively. Increased rates of depression are reported in alcoholics and in families of alcoholics. Some studies report that drinking behaviour may be influenced by the coexistence of depressive disorder while others indicate that depressed mood has little impact on the course and treatment of alcoholism. Some people who are depressed turn to alcohol as a form of self-medication and many of these have positive results from it, both due to the pharmacological effects of the drug and the self-limiting nature of most depressive episodes. Those with more severe depression, however, are less likely to benefit in this way. Excessive alcohol taken under such circumstances results in diminishing returns; alcohol becomes more of a contributor to the problem than a solution to it. There is no convincing evidence that drugs including anti-depressants and lithium are effective in the treatment of depressed alcoholics, except for those minority of patients where the diagnosis of primary affective disorder can be established. In such cases the indications for lithium and anti-depressant usage are similar as for non alcoholics with affective disorder. Decisions about the choice of treatment to be offered the alcoholic must be made as quickly and as accurately as possible and can only be done after a careful assessment, which may include hospitalization. It is worth noting that the pharmacologically induced depression of heavy drinking and the depression associated with the withdrawal phase may be clinically similar to the depression of primary affective disorder.
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PMID:Depression and its treatment in alcoholics: a review. 643 75

A 1981 national survey of women's drinking interviewed 917 women in the general population, stratified on the basis of screening interviews to include 500 moderate-to-heavy drinkers. The survey found no evidence of any major recent increase in women's drinking, and no evidence of unusually heavy drinking among working wives. Adverse drinking consequences and episodes of extreme drinking were most common among women aged 21-34; women who were unmarried, divorced or separated, or cohabiting; and women with frequent drinkers as spouses or companions. Alcohol-related behavior problems and symptoms of alcohol dependence were closely related to levels of alcohol consumption. Among women averaging one ounce or more of ethanol per day, 45 per cent had driven while intoxicated in the past year, and 36 per cent reported memory lapses while drinking. Women at this consumption level were also more likely to report experiences with depression (61 per cent). Women with extremely high consumption levels were more likely to have histories of obstetrical and gynecological problems. Some women with alcohol-related problems reported periods of temporary abstention, a pattern not studied heretofore.
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PMID:Women's drinking and drinking problems: patterns from a 1981 national survey. 649 15


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