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

Many people with HIV suffer from depression, which responds to antidepressants, counseling, education, and cognitive strategies. Untreated depression hinders treatment compliance and increases risk of suicide. Management and complications of major depression are described. The evaluation of rational suicide is examined. Clinicians who treat this population need to respond therapeutically to patients with depression and suicidal ideas.
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PMID:Managing depression among people with HIV disease. 908 49

A stratified random sample of 750 males in Calgary, Canada, aged 18-27 years, were given questions on sexual activity and orientation. Mental health questions included a measure of suicidality and of acts of deliberate self-harm. A computerized response format, which has been established as a good method for eliciting sensitive personal data, ensured anonymity. Almost 13% of the males were classified as homosexual or bisexual on the basis of being currently homosexually active or by self-identification. Significantly higher rates of previous suicidal ideas and actions were reported by homosexually oriented males than by heterosexual males. Homosexually oriented males accounted for 62.5% of suicide attempters. These findings, which indicate that homosexual and bisexual males are 13.9 times more at risk for a serious suicide attempt, are consonant with previous findings. The predominant reason for the suicidality of these young males may be linked to the process of "coming out," especially for those who currently have high levels of depression. These results underscore the need for qualified services rarely available to homosexually oriented youth.
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PMID:Suicidal behaviors in homosexual and bisexual males. 914 76

The present study summarizes the authors' experience reached in the last four years with chronic heart failure patients', particularly referring to the psychological aspects. The 218 male patients (age 51.7 +/- 8.3) psychological profile (obtained by means of the CBA 2.0 Primary Scales) has shown higher scores in the anxiety, depression and psychophysiological disorders scales and lower scores in some of the fear scales, compared with the reference normative group. The CBA 2.0 Schedule 4 has enlightened suicidal ideas, eating and sleep disorders, economic and sexual problems. The comparison between the psychological and the many cardiological variables taken into account, has not allowed to highlight significant relationships on the whole. Our data support the necessity to introduce other--likely subjective--variables in the studies aimed at analyzing the relationships between psychological and cardiological factors in the chronic heart failure patients.
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PMID:[The psychological side of chronic heart failure. A pluriannual experience]. 924 26

The aims of our study were (1) to examine the socio-demographic, clinical characteristics, autopsy and toxicological findings in 392 youth suicides in Paris, between 1989 through 1996, and (2) to analyze the psychodynamic determinants leading up to the onset of the suicide. During the eight-year study period 392 suicides involving young people were investigated at the Institute of Forensic Medicine of Paris. Two hundred and sixty victims (66%) were males. The mean age was 22 years in both sexes. Fifteen percent of the victims were below 20 years. Ninety-two percent of the subjects were single. Forty percent of the victims were students, 35% were unemployed. One third of the victims had previously attempted suicide. Thirty-five percent of the subjects used to take psychoactive prescription drugs and some of them had been under the care of a mental health professional at the time of the suicide. In 40% of the cases a suicide note was found near the body. Depression (70% of victims), schizophrenia, (10%), affective disorders, parent-child relational problems, partner relational problems, adolescent antisocial behavior, and borderline personality were found to be the most frequent diseases and stressors involved in the suicides. The suicide was rarely an accidental reaction to stress. It was constantly preceded by situational distress, which led to suicidal ideas if the adolescent failed to cope with problems. Ten percent were known as heroin users. In more than 40% of the cases, the victim's parents were divorced or separated. The most frequent method of suicide was poisoning followed by jumping from a height, gunshot, subway death, and hanging/asphyxia. Among firearms, a handgun was more likely to be used than rifles (85/15%). Tranquilizers were the most frequent psychoactive drugs used for suicide followed by antipsychotic drugs, antidepressants, and barbiturates (10%).
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PMID:Suicide among youth and young adults, 15 through 24 years of age. A report of 392 cases from Paris, 1989-1996. 972 12

Childhood suicide is an increasing problem in Western society. Identification of those at risk of suicidal behaviour is of priority to identify children with consequent mental suffering, and prevent successful attempts. The study determined factors associated with suicidal ideas, attempts or threats in 5426 psychiatric outpatients aged between 8 and 17 years who attended a British teaching hospital. Multivariate logistic regression analyses were performed by sex on the data from the standard department questionnaire. Substance abuse, depression and disturbed relationships with adults were predictors of suicidal behaviour for both sexes. For female subjects, antisocial behaviour was also associated. In girls alone, depression had significant interaction effects with substance abuse and conduct disorder. Possible reasons for these differences are discussed.
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PMID:Gender differences in rates and correlates of suicidal behaviour amongst child psychiatric outpatients. 975 2

In the debate on euthanasia and physician-assisted suicide, we have to exclude terminally ill patients in whom the desire for death is caused by major depression. However, it is still not clear to what degree major depression can be treated by psychiatric intervention in this setting. We evaluated the effect of antidepressant treatment in terminally ill cancer patients. Six cancer patients with suicidal ideas thought to be due to major depression were treated with tricyclic antidepressants. Three had requested terminal sedation to relieve them from their suffering. The median survival of five of these patients was 4 weeks after diagnosis; one was lost to follow-up. The efficacy of the antidepressant treatment was assessed using the Hamilton Rating Scale for Depression (HRSD). One week after the start of treatment with antidepressants, five of the six patients showed a marked improvement in their mood and showed no further suicidal thoughts or requests for terminal sedation. The average reduction in the HRSD score was 23.4 points (14-38; SD = 9. 9). Antidepressant treatment can be effective in alleviating the desire for death due to major depression, even in terminally ill cancer patients.
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PMID:Successful antidepressant treatment for five terminally ill cancer patients with major depression, suicidal ideation and a desire for death. 1054 87

There have been repeated reports that Afro-Caribbean people living in the UK are more prone than white people to be diagnosed as having schizophrenia and mania, along with some evidence that they are less likely to receive a diagnosis of depression. We attempted to replicate these findings in a population of patients on lithium prophylaxis. We therefore assessed the clinical characteristics of people under the age of 55 from three ethnic groups attending a lithium clinic in south London, those of (1) white British (n = 88); (2) Afro-Caribbean (n = 31); and, (3) African (n = 15) origin. Nineteen of the white patients met DSM-IV criteria for unipolar depression (UP) and eight met the criteria for bipolar II disorder (BP II); in contrast, only two black patients met the criteria for unipolar depression and none met the criteria for BP II. Among patients diagnosed as BP I, Africans were significantly more likely than whites to show exclusively or mainly manic presentations while Afro-Caribbeans were more likely to have had mood-incongruent delusions. On the other hand, white patients were significantly more likely than Afro-Caribbeans to have had suicidal ideas or actions, and showed a similar but not significant excess when compared with Africans. Our findings could reflect either genuine ethnic differences in the presentation of severe affective disorder or be produced by the failure of British doctors to detect depression and deliver appropriate treatment to their black patients. The frequency with which Afro-Caribbean patients with mania present mood-incongruent delusions probably contributes to the high rates of diagnosed schizophrenia in this population.
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PMID:Ethnic differences in the presentation of bipolar affective disorder. 1057 48

Patients with stroke may have an increased risk of suicide. We sought to examine the frequency and clinical correlates of suicidal ideas 3 and 15 months after stroke. The study group comprised 286 of 486 consecutive patients aged 55-85 years who at 3 and 15 months after ischemic stroke completed a detailed medical, neurological and radiological stroke evaluation, structured measures of cognition (Mini Mental State Examination), emotion (Beck Depression Inventory, BDI), disability (Rankin scale), and assessment of dependent living. Suicidal ideas were present in 9.8% (n = 28) at 3 months' follow-up and in 14.0% (n = 40) at 15 months' follow-up. The patients with suicidal ideas were more depressed measured by BDI both at 3 (17.0 vs. 7.9, p < 0.001) and 15 months (20.5 vs. 8.5, p < 0.001) after stroke compared to the patients without suicidal ideas. Patients with suicidal ideas had more often a history of a stroke already before the index stroke (35 vs. 18.3%, p = 0.0154), right-sided stroke (60.0 vs. 41.9%, p = 0.0323), they were more disabled according to the Rankin scale (2.4 vs. 1.9; p = 0.0035) and more dependent in living (45.0 vs. 27.2%, p = 0.023) 15 months after stroke. An independent correlate of suicidal ideas 15 months after stroke was history of prior stroke (OR 2.4; 95% CI 1.14-4.97) in logistic regression analysis. The frequency of suicidal ideas increased with the time elapsed from stroke. Recurrent strokes, depressive symptoms, more disabling stroke and right-sided stroke correlated to suicidal ideas at 15 months after stroke. Early identification of these risk factors may lead to effective therapeutic intervention.
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PMID:Suicidal ideas in stroke patients 3 and 15 months after stroke. 1143 75

This study examined patterns of depressive symptoms experienced by acutely depressed inpatients, previously hospitalized depressed outpatients, and depressed outpatients who had never been hospitalized for depression. The groups' symptom profiles were compared to determine whether the 21 major depressive symptoms measured by the Beck Depression Inventory were similar or different for the three groups. The groups differed significantly on five depressive symptoms that are classified as affective/cognitive symptoms (sadness, guilt, self-blame, indecisiveness, suicidal ideas) and one that is considered a somatic/vegetative symptom of depression (anorexia). Thus, commonly used diagnostic criteria may not reflect the full range or temporal patterning of symptoms experienced by depressed persons at varying levels of acuity or severity and in different treatment settings.
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PMID:Patterns of depressive symptoms in three groups of depressed adults. 1185 46

The purposes of this study were to develop an effective manual for the early self detection of depression in the Thai elderly, to detect the comorbidity of depression (pattern of drug and alcohol abuse, suicidal idea) and to ascertain the quality of life. A quasi experimental field research methodology (Randomized Control Group Pretest-Posttest Design) was implemented. The sample consisted of 1,390 elderly people in 35 communities from 4 districts surrounding Siriraj Hospital-Bangkok Noi, Bangkok Yai, Taling Chan and Bang Phlat. These areas are the peripheral parts of Bangkok and most of them have extended families. The result showed that: 1. The internal consistency reliability of the nine criteria of the manual for the self detection of depression in the Thai elderly ranged from 0.84 to 0.94. The validity tested by epidemiological methods, disclosed that the sensitivity was 82.14 per cent and the specificity was 97.56 per cent. 2. There was a statistically significant difference in the incidence of depression between the study and the control group (p<0.000); self referred cases = 86.7 per cent and 9.8 per cent respectively. The study group was able to detect depression in 42 days, while the control group did so in 122 days. In addition, in the associated comorbidity, there were differences in the patterns of drug and alcohol abuse, suicidal ideas and quality of life after the experiment. These findings showed a decreasing pattern of self medication for depression, and suicidal ideas and an improvement in the quality of life in the study group.
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PMID:Research on development of the manual for self detection of depression in the Thai elderly. 1218 83


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