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Query: UMLS:C0011570 (depression)
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Two cases of suicide of patients with renal insufficiency and haemodyalisis commited by liquidation of the shunt are reported. Authors stress the importance of prevention and psychotherapy among haemodyalized patients having depression and neurotic complications.
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PMID:[Suicide of patients with chronic kidney failure by disconnecting their shunt]. 50 95

A random sample of 3,935 adults from a general population were interviewed and asked to report how often they had thoughts of suicide as well as their opinion on the frequency of suicide ideation in others. Depression was found to be related to the respondent's reports of his/her own suicidal thoughts and to reports of frequent suicide ideation in others. A total of 5.4 percent of the respondents reported some degree of suicide ideation in the previous month and 9.1 percent reported that others think about suicide once a month or more. When the demographic characteristics of those who report suicide ideation in themselves or others were compared to those of suicide attempters and committers, some consistencies were found, suggesting that such questions may be useful in identifying those "at risk." Nevertheless, sufficient discrepancies were found which suggest that there may be a number of factors which increase or decrease the likelihood that someone with thoughts of suicide will attempt or commit suicide. Follow-up studies are necessary to uncover such factors and the degrees to which they influence the occurrence of suicide.
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PMID:Suicide ideation: its relation to depression, suicide and suicide attempt. 51 26

Of 14 medical and surgical patients who committed suicide in a general hospital, there were ten men and four women, ranging in age from 19 to 82. The patients had not made statements of suicidal intent; however, their hospital records showed there had been symptoms of depression and contained indirect references to a preoccupation with suicide. Most of the patients had been depressed because of their illnesses or distressing symptoms. It is important to keep in mind that there are clues that help anticipate suicide. Awareness by hospital staffs of symptoms and subtle signs of depression and of suicidal thoughts in patients is important in reducing the number of suicides in general hospitals. Of preventive and treatment measures, warmth, compassion and commitment to the care of patients by hospital staffs are most important.
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PMID:Suicide in general hospitals. 51 65

Mood disorders, particularly depression, now represent a major world health problem which will most likely continue increasing. From a clinical standpoint, the synthesis of new antidepressant agents of various chemical structures and the advent of the thymoregulators (lithium salts) has allowed a more flexible, better individualized, therapeutic approach to the affective disorders. However, the widespread use by general practitioners of the antidepressants, alone or in combination with other psychotropic drugs, often with mitigated success, brings to psychiatric consultation patients whose symptomatology has become less characteristics, is more difficult to identify rapidly, requiring thus greater diagnositc refinement. Moreover, greater attention is currently given to depressive affects that can occur during organic illnesses or at various periods of life, particularly at senescence. Besides sustained concerns concerning suicide, the attitude of man confronted with his death arouses great interest and a depressive phase constitutes one of the steps towards this ending. Finally, during the last two decades, some psychoanalysts have reexamined the psychodynamic concepts of mood disorders, whereas from behavioral and cognitive theories new techniques of treatment of depression have emerged. In brief, if no revolution has occurred, there has been evolution. Mood disorders and their approach have known modifications and some concepts pertinent to this are considered here from various angles, particularly from the clinical (association with organic illnesses, with respect to death), therapeutic (psychopharmacological, behavioral and cognitive therapies), sociological (including suicide) and psychoanalytic viewpoints.
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PMID:[Modern aspects of mood disorders]. 54 66

Given the high incidence of depression, it is necessary and desirable that as many cases as possible should be treated by general practitioners. However, general practitioners are on the whole ill-prepared to meet the needs of depressed patients. In the last few years a big effort has been made in certain countries to improve the psychiatric training of general practitioner and to enable him the better to detect and treat depression. Communication between psychiatrists and general practitioners is made difficult by the lack of a common language and terms used should be defined clearly. Some of the problems in practice are diagnostic in nature: detect of the depressive syndrome, of the minor or masked forms; differential diagnosis of depression and anxiety. The commonest problems in treatment are: selection of drug, monitoring of side-effects, duration of treatment. The general practitioner needs information also on such questions as: how to evaluate the risk of suicide; when to call in the specialist; how far to use supportive psychotherapy. Some types of depression are particularly likely to come to the general practitioner: depression masked by physical symptoms, depression associated with or secondary to physical disease, depression in the elderly.
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PMID:[The problems posed to the general practitioner by depression (author's transl)]. 54 71

Samples of heroin-addicted veterans in treatment at a VA drug clinic, ex-addict and nonaddict Vietnam veterans followed-up after return to the United States, and male suicide attempters who were not drug abusers completed a very short (five item) form of the Beck Depression Inventory developed for screening and research purposes. Results confirmed prior findings of high rates of depression among narcotic addicts in treatment. Two samples of patients assessed at intake to treatment did not differ significantly from the suicide patients in BDI-5 scores. Methadone maintenance patients and ex-addicts scored below those groups, but higher than nonaddicts. Relief of inner tensions or worries was chosen most frequently as the reason for continuing use of narcotics by patients in treatment, suggesting that self-medication for psychiatric problems may be common. The BDI-5 proved to be an efficient method for screening for depression in these samples, and thus might be useful in clinical or research settings when a very brief method is needed.
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PMID:Depression in treated narcotic addicts, ex-addicts, nonaddicts, and suicide attempters: validation of a very Brief Depression Scale. 54 68

In a group of 191 women admitted to the University of Iowa Psychiatric Hospital for depression over a 45-year period and selected on the basis of alcoholism or antisocial personality, vs. depression, in a parent, 105 probands fit into the depression spectrum group (parental alcoholism or antisocial personality) and 86 into the pure depression group (parental depression). Few differences were found between the presenting clinical pictures (including precipitating factors) of the two groups; but depression spectrum patients and pure depressive patients showed study differences in the areas of personal problems and personality as well as course of illness. The depression spectrum patients were significantly less likely to have loss of interest in usual activities as a symptom at index admission. They were significantly more likely to have had a history of sexual problems, to have been divorced or separated before, to have been described as irritable, and to report having previously been depressed. They are nonetheless significantly more likely to recover completely and have no relapse of depression. The pure depression group were significantly more likely to have depressed sisters, and suicide was much more frequent in their ill parents. Thus, important personality and course differences separate depressive spectrum disease from pure depressive disease;
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PMID:Depression spectrum disease versus pure depressive disease. Clinical, personality, and course differences. 56 91

This paper addresses itself to the reasons why suicide tends to repeat in some families. Factors include entire family exposure to stresses, grief, and guilt induced by the suicide, the provision of a model by the original suicide, suicidogenic interpersonal styles in families, suicidogenic child-rearing practice, and innate predispositions to depression.
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PMID:Factors determining the incidence of suicide within families. 61 98

The purpose of the study was to elucidate the role played by the so-called masked or somatic depressions in suicide. The records of 28 suicide persons were analyzed concerning depressive symptoms at time of death. The suicide group was drawn from a prospective longitudinal cohort study of 3,563 persons which began in 1947 (the Lunbdy Project) and was followed up during 25 years. All persons had been examined once or twice before the suicide. 14 were considered to have suffered from depression. Irrespective of any reactive factor, most of the depressive persons had symptoms of endogenous type. In 19 out of the 14 persons with depression the clinical picture included also somatic symptoms. The persons with depression had often sought medical advice, though mostly not psychiatrists'. Many of them had been difficult to treat and had shown negativism to medical care. An important suicide prophylactic measure would be to enhance the awareness of hospital clinicians and practitioners of the existence, diagnosis and treatment of endogenous depression.
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PMID:Suicide and endogenous depression with somatic symptoms in the Lundby study. 62 17

The multiple manifestations of depression may mimic those associated with many physical illnesses, leading to delay in diagnosis. The consequences of depression are disability, suffering, and sometimes death by suicide. Antidepressant drugs have greatly improved the prognosis for the depressed patient. Tricyclics are the drugs of first choice, with monoamine oxidase inhibitors playing a secondary role except in special instances. Drugs can be used along with electroconvulsive therapy when treatment is urgent. Differences in the pharmacologic effects of tricyclics may affect their choice for individual patients. Monitoring of plasma concentrations of tricyclics may uncover some sources of drug failure, such as altered drug kinetics in an individual patient or noncompliance with treatment. Side-effects of antidepressant drugs are numerous; most represent extensions of known pharmacologic actions. Overdoses produce severe intoxications that require expert and assiduous management.
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PMID:Treatment of Depression with drugs. 66 96


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