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 effectiveness and safety of ECT in pharmacotherapy-refractory depression was examined in 11 hospitalized adolescents (ages 16.3 +/- 1.7 years, 10 females) with a primary DSM-III-R diagnosis of mood disorder, which had failed to respond to three or more adequate trials of antidepressant pharmacotherapy. After a thorough diagnostic evaluation, patients received a course of ECT involving 11.2 +/- 2.0 (range 8-15) administrations. ECT was commenced with bilateral treatment in 2 adolescents and nondominant right electrode placement in 9 patients; 5 of the 9 patients were subsequently changed to bilateral treatment. All 11 patients improved to a clinically significant degree. Significant improvements were noted in scores on the Children Depression Rating Scale-Revised (CDSR-R) and the Global Assessment of Functioning Scale (GAF) (p < 0.05). Euthymia, defined as CDRS-R score < or = 40, was achieved by 64% (7/11) of patients. The Mini-Mental State Examination showed no significant decline in cognitive functioning. Neuropsychological testing completed in 5 subjects both before ECT and 1-5 days after the last treatment, indicated a significant decline in attention, concentration, and long-term memory search. Minor side effects, experienced within the first 12 hours of treatment, were headache (80% of patients) and nausea/vomiting (64%). The potentially serious complication of tardive seizure (after full recovery of consciousness) occurred in 1 adolescent. Prolonged seizures (> 2.5 minutes) were noted in 7 of the 11 patients (9.6% of the 135 ECT administrations). Pending further research on ECT in youth, it is recommended that ECT should only be administered to youth in hospital settings, that all regularly administered psychotropic medications (including antidepressants) be discontinued before ECT and restarted after the final administration of ECT, and that physicians be aware that 12 treatments are usually sufficient, but that 15 treatments may occasionally be necessary for treating depressed adolescents. With the understanding that scientific evaluation of ECT in youth is lacking, it appears that ECT can be an effective and relatively safe treatment for depressed adolescents who have failed to respond to antidepressant pharmacotherapy.
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PMID:Electroconvulsive treatment in adolescents with pharmacotherapy-refractory depression. 923 19

Modifying intrusive memories and images is a powerful intervention in depression and anxiety disorders, but little is known about the presence of these intrusions in bipolar disorder. A semi-structured interview was administered to 29 euthymic patients with bipolar disorder, requiring them to report the intrusive memories and images recalled from their most recent episode of euthymia, depression and hypomania. Euthymia was characterised by intrusive memories of the past, which were less distressing than the memories experienced in depressed states. In addition to intrusive memories, depression was associated with vivid images focussed on death and suicide. Intrusive memories were rare in hypomanic states, which instead were characterised by vivid, enjoyable images of future events. Behaviours and emotions in different bipolar states may be amplified by characteristic intrusive memories and images, suggesting novel opportunities for therapeutic intervention. For example, intrusive images may be particularly important prodromal indicators and hence require greater emphasis in relapse-prevention programmes. Rescripting that incorporates negative elements into overly positive images may also be valuable in minimising the extent of hypomanic episodes.
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PMID:Intrusive memories and images in bipolar disorder. 2045 Nov 76

In this study, we aimed to extend the present knowledge regarding the relationship of personality traits, as specified by the five-factor model (FFM), with the affective morbidity of bipolar I disorder. The primary aim of this study is to investigate the association of personality traits with affective morbidity, particularly with hospitalization for depressive, manic, or mixed episodes, in patients with bipolar I disorder. The Revised NEO Personality Inventory was administered to 83 subjects who showed a euthymic mood state. Multivariate Poisson regression analysis was performed to identify associations between five domains of personality and the number of hospitalizations for affective episode(s) (manic, depressive, and mixed state). As a secondary research interest, we attempted to determine personality traits which would be significantly different between subjects with Affective Switch from mania into depression Without Euthymia (ASWE) and non-ASWE. The Neuroticism score was positively associated with the number of hospitalization for depression and the total number of hospitalizations Extraversion and Openness scores showed a negative relationship with the number of hospitalizations for depression and the total number of hospitalizations. We found that ASWE patients showed significantly higher Neuroticism scores than did the non-ASWE group. However, there was no significant association between the hospitalization for manic episode and any particular personality trait based on the FFM. This study reveals that personality traits based on the FFM may contribute to an increased likelihood of depressive morbidity and switch into depression.
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PMID:Personality traits and affective morbidity in patients with bipolar I disorder: the five-factor model perspective. 2056 18