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

In dealing with college age (18-22) males, clinical observations have shown a fairly common inability to successfully form intimate relationships with same-age females. This problem often appears to be due to an inability to bond and trust that is rooted in the formative years in the nuclear home. When this happens, the young male frequently develops a fear of being sexually abnormal, perhaps even homosexual. This manifests itself in shame, anxiety, depression, denial, reaction formation, performance anxiety, concern about being found out, isolation, substance abuse and, occasionally, acting out. Getting such persons to admit these fears is generally extremely difficult, requiring gentle and empathetic, but persistent, probing on the part of the therapist. Therapy consists of understanding and acceptance by the client that these fears are most often reactive, that they are commonly held, and that when they are seen in proper perspective, they often diminish. The present paper reviews some of the literature on sexual developmental issues of the adolescent male as a backdrop for this problem. The specific difficulties related to reactive homophobia are explored, and some therapeutic approaches suggested.
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PMID:Sexual confusion among certain college males. 226 10

Expressed emotion (EE) refers to a set of emotional aspects of speech for which ratings have been derived. Seven independent studies have established that higher EE ratings in the relatives of patients with schizophrenia predict higher rates of relapse in these patients and two studies have established an association of higher EE in spouses with relapse of depression in their mate. There are no previous studies of parental EE as a predictor of childhood affective disorder or other disorders not in the schizophrenia spectrum. In this study we investigated the relationship between the level of maternal EE and the incidence of DSM-III affective disorder (major depression or mania or dysthymia), substance abuse, or conduct disorder in 273 children. We found that a higher degree of maternal expressed emotion was associated with a three-fold increase in a child's risk (odds multiplier) for having at least one of the following diagnoses: depressive disorder (major depression or dysthymia), substance abuse, or conduct disorder. This increased risk acts in addition to the increased risk of child diagnosis associated with parental affective illness. Research and clinical implications are discussed.
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PMID:Maternal expressed emotion and parental affective disorder: risk for childhood depressive disorder, substance abuse, or conduct disorder. 226 12

Interviewers questioned 496 low-income black and Hispanic women postpartum in New York City on attitudinal, motivational and financial barriers to prenatal care. Women who had little or no prenatal care were oversampled, so this study is not representative of the New York City population. Oversampling also fixes the distribution of the dependent variable which can bias the regression coefficients unless logistic regression is used. In this study, 54% of the women had received timely prenatal care, while 46% received late or no care. A questionnaire was used with both open-ended and closed questions to determine which barriers to prenatal care were most important. Age was a categorical variable for the descriptive analysis, and a continuous variable for the regression analyses. Health insurance was used as a series of dummy variables. The timely care group ranked depression, lack of energy, travel distance, and transportation problems among the top barriers to prenatal care. The late or no care group ranked lack of energy, depression, cost of care, travel distance, transportation problems, and lack of child care among the top barriers. Those who were most likely to receive timely care were those women with health insurance. Those women with regular doctors were also more likely to receive good prenatal care. Logistic regression according to 2 models showed that late or no prenatal care could be predicted. Lack of health insurance is a major predictor of timely prenatal care. Substance abuse also played an important role in the timeliness of prenatal care. Recommendations are made to reform maternity service financing, and to alleviate substance abuse among pregnant women.
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PMID:Barriers to prenatal care among low-income women in New York City. 227 80

There has been a dramatic increase in attention to comorbidity between psychiatric disorders and substance abuse in both clinical and research settings. Patients with major psychiatric conditions and substance abuse often fall between the cracks in clinical settings because of administrative distinctions between substance abuse and mental health. This article reviews the evidence regarding an association between alcoholism and depression in clinical and epidemiologic studies. Longitudinal and family-genetic studies are also reviewed to address possible mechanisms for the association between alcoholism and depression.
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PMID:Comorbidity for alcoholism and depression. 228 Oct 9

To identify similarities and differences between AIDS patients and non-AIDS patients, all psychiatric consultations done in one year in a large voluntary general hospital were reviewed. A total of 93 consultations were done on 67 AIDS patients and 138 consultations were done on 121 comparably aged patients without AIDS. The most common AIDS risk factor was intravenous drug use. The AIDS patients were more likely to be Hispanic and male than were the non-AIDS patients. The AIDS group was also more likely to have a diagnosis of organic mental disorder, particularly dementia. There were no other differences in Axis I diagnoses, including depression, substance abuse, and adjustment disorder. Suicidal risk was no greater in the AIDS patients than in the non-AIDS patients. Axis II diagnoses were made more often in the non-AIDS patients, who also required more one-to-one nursing supervision. Consultation in AIDS patients took more staff time, and AIDS patients were more likely to have required one or more repeat consultations within the period of the study, thus creating a heavier burden on consultation staff. Although these predominantly heterosexual, Hispanic, and drug-using hospitalized AIDS patients do not show significantly higher rates of psychiatric morbidity than other, non-AIDS patients, except for more organic mental disorders, AIDS seems to create a much higher demand for psychiatric consultation services.
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PMID:AIDS patients compared with others seen in psychiatric consultation. 229 36

In this study we inquire whether children and adolescents with suicidal ideation can be differentiated from children who attempt suicide on the basis of clinical symptoms or social grounds. From a total of 2181 consecutive outpatient referrals to a child and adolescent psychiatry service, 258 young persons who exhibited suicidal ideation are compared with 82 who had actually attempted suicide. We were unable to differentiate children with suicidal thoughts from those who attempted suicide on the basis of clinical symptoms alone. Both groups had similar high levels of symptoms of depression, anxiety, sleep disorder, and irritability. Conduct disorders were less common in both groups but 22% of the attempters abused illicit drugs or alcohol. Suicide attempts were more likely to be associated with chronic family discord and substance abuse. For boys, the odds of suicidal attempts were substantially increased if the subject had experienced loss. Results are discussed with reference to antecedents that may increase the odds of suicidal attempt and suggestions for future research are outlined.
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PMID:Are children and adolescents who have suicidal thoughts different from those who attempt suicide? 229 87

Seventy-four male veterans entering an alcohol abuse treatment program were screened for additional psychiatric diagnoses using the Diagnostic Interview Schedule (DIS). Fifty-four of these also completed a questionnaire on personal and family drinking history. Over half (54.1%) had another diagnosis. The most common syndromes other than substance abuse were antisocial personality disorder, phobic disorder, and depression. In each of these cases, the presence of the additional disorder accelerated the course of the alcohol problem significantly. The difference in course between syndromes was dwarfed by the time of presentation by the difference between "pure" alcoholism and alcoholism with another diagnosis. The primary versus secondary distinction appeared to account for only a part of this effect.
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PMID:Additional psychiatric illness by Diagnostic Interview Schedule in male alcoholics. 229 86

A sample of 223 adolescents who sought services from runaway and homeless youth programs in New York State during 1986-1987 was identified as having a history of maltreatment. A demographic profile is presented and the nature of their maltreatment described. The majority of these youth were female and between 15-16 years of age. Less than 25% came from intact families and one-third were born to single mothers. Of the sample, 60% had allegedly experienced physical abuse, 42% emotional abuse, 48% neglect, and 21% sexual abuse. Over one-third were "pushed out" of their homes by their families. Biological mothers were the most frequently cited perpetrators of maltreatment (63%), followed by biological fathers (45%). The sample of maltreated runaways is compared to both statewide and national samples of runaway and homeless youth with regard to their demographic characteristics and the problems they present to staff at intake (e.g., depression, substance abuse, etc.). Youth in the maltreated sample were more likely to be female and were more likely to have engaged in suicidal behavior. Otherwise, the maltreated runaways were not readily distinguished from the runaway and homeless youth population at large.
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PMID:Maltreatment among runaway and homeless youth. 231 Sep 77

Fifty-three homeless mentally ill patients were studied by two psychiatrists in a treatment setting in which data could be gathered from family members and other third parties as well. All the patients were severely mentally ill when the homelessness immediately preceding the current admission began. For the study group, the disabling functional deficits of major mental illness appeared to be important contributing factors to homelessness. These deficits included disorganized thinking and actions, poor problem-solving skills, inability to mobilize oneself, depression, and paranoia that prevented acceptance of help. Other important factors contributing to homelessness were the lack of a comprehensive and effective system of mental health care, substance abuse combined with severe mental illness, and the tendency for chronically and severely mentally ill persons, especially during their youth, to pursue their life goals in an unrealistic or irrational way.
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PMID:Factors contributing to homelessness among the chronically and severely mentally ill. 231 76

Adolescents report important unmet health care needs. This study directly assesses pediatricians' current practices pertinent to the primary care of adolescents. An anonymous questionnaire survey of general pediatricians was conducted in two suburban counties in New York State. Of the 101 respondents, 51% were older than age 50 and 88% were in private practice. The "average" pediatrician saw 28 patients in a 7-hour office day. Approximately 1 in 10 regularly saw patients with a sexuality-related concern, substance abuse problem, or anorexia nervosa. Fewer than half provided anticipatory guidance regarding sexuality, and only 14% questioned teens about depression. Respondents perceived factors related to fees, lack of time, lack of knowledge, and their image as obstacles to an expanded care of adolescents. Those with some training in adolescent medicine during residency were significantly more likely to provide care and anticipatory guidance related to sexuality and substance abuse. Thirty percent reported an interest in increasing their involvement with adolescents. We conclude that most of these pediatricians played a small role in meeting the health needs of adolescents.
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PMID:Adolescent medicine in pediatric practice. 231 13


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