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

Five-hundred consecutive referrals to the psychiatric consultation service at the University of Padua School of Medicine have been reviewed. In 69% of cases concurrent physical and psychiatric disorders were reported. There was a prevalence of females, working class patients, and individuals with limited schooling. Depression was the most common psychiatric disorder in all classes of organic disease and accounted for 37% of all psychiatric diagnoses, followed by anxiety neurosis (18.6%) and drug dependence (13.8%). In 10.8% of cases no psychiatric diagnosis was made.
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PMID:Consultation psychiatry in an Italian general hospital: a report on 500 referrals. 738 Feb 47

Some delinquents who were unreachable and failed to respond to juvenile interventions may at age 17 or 18 become depressed and then be accessible and motivated for treatment and rehabilitation. If their needs and potentials remain unrecognized, they may act out their depression with continued offenses, alcoholism, drug dependence, and social maladaptations. Untreated, such depressions are long-lasting and have far-reaching influences upon family.
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PMID:Juvenile delinquency and the quality of life: the 17-year depression. 743 Oct

The clinical experience of a psychiatrist working in a pain clinic is described. One hundred and seventy two patients were assessed over a 4-year period. The modal age was 45-54 years with a male : female ratio of 7 : 10. The model duration of pain was 1-5 years, the back being the commonest site. Depression was diagnosed in 30% of cases. PErsonality disorder, traumatic neurosis, anxiety, hysteria and drug dependence were the next most common diagnoses. Treatment was instituted in half of the patients seen and half of the treated patients improved or recovered. Drug withdrawal, EMG feedback and brief psychotherapy were associated with more improvement than pharmacotherapy or treatment at a psychiatric unit. The response to antidepressant medication was particularly disappointing and possible reasons for this are discussed.
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PMID:The psychiatrist and the chronic pain patient: 172 anecdotes. 745 87

Psychiatric morbidity was studied in a sample of 176 opioid-dependent men recruited from prison and treatment services. The Diagnostic Interview Schedule (DIS) was used for psychiatric assessment. Lifetime and current prevalence of any mental disorder, excluding substance use disorders, reached 90.3% and 66.1%, respectively. The most prominent lifetime DSM-III axis I disorders were anxiety (31.8% lifetime and 16.5% last month) and affective (25% lifetime and 19.9% last month) disorders. Antisocial personality disorder (ASP) had a lifetime prevalence of 69.3%. Higher rates of affective and anxiety disorders were diagnosed in the treatment sample than in the imprisoned sample, whereas the inverse was observed for ASP. Results from the psychiatric interview showing a strong association between drug--opiate--dependence and DSM-III mental disorders are further supported by findings of high levels of depressive symptoms on the Center for Epidemiological Studies-Depression (CES-D) scale (71.5%) and increased rates of self-reported suicide attempts (27.4%) and psychiatric hospitalizations (26.8%). Psychiatric disorders seem to precede drug dependence in the majority of cases. Results from this study are compared and discussed with those from similar North American Studies.
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PMID:Drug abuse and psychiatric comorbidity. 749 6

Exploration of the neurochemistry of psychiatric and substance use disorders in dual diagnosis patients may help explain the greater than chance comorbidity of these disorders and lead to advances in treatment. This paper will focus on the hypothesized neurochemical changes associated with primary substance use disorders which might lead to secondary psychiatric disorders by mimicking the hypothesized neurochemical changes of primary psychiatric disorders. For example, hypothesized serotonergic deficits in alcoholism, endorphin deficits in opioid dependence, and dopamine depletion in cocaine dependence all might predispose to depression. A vicious cycle of cocaine dependence and depression and a vicious cycle of alcohol and drug dependence and panic anxiety are reviewed as models for hypothesized alcohol or drug withdrawal related neurochemical changes predisposing to continued chemical dependency. Exploration of the neurochemistry of dual diagnosis patients reinforces the need for treatment approaches that take into account both aspects of illness.
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PMID:Hypothesized neurochemical models for psychiatric syndromes in alcohol and drug dependence. 750 27

We used the PCR amplification technique in an attempt to characterize further the dopamine D2L receptor expressed in the prolactin-secreting pituitary MMQ cell clone, derived from the prolactin- and ACTH-secreting Buffalo rat 7315 alpha pituitary tumour. By semiquantitative PCR amplification we were unable to detect the mRNA encoding the D2S receptor isoform, which derives from the well-known process of alternative splicing, producing two D2 receptor subtypes (D2L and D2S) in such tissues as the anterior pituitary and the corpus striatum. Although the pharmacology of the D2 receptor has been established in many studies on both native receptors and transfected receptor isoforms, because of the lack of tissues naturally expressing only one receptor isoform, MMQ cells represent the first example of cells uniquely or prevalently expressing only the D2L receptor, conceivably coupled to its native transduction mechanisms. These considerations prompted us to evaluate the pharmacology and the second messenger systems known to be modulated by dopamine. Scatchard analysis of [3H]spiperone binding resulted in a linear plot, consistent with the existence of a single class of binding sites, with a Kd of 0.055 +/- 0.002 nM and a Bmax of 27 +/- 3.5 fmol/mg protein. Competition experiments confirmed the GTP-dependence and the order of potency for agonist and antagonist ligands consistent with binding to a D2 receptor. The inhibitory effects of dopamine on adenylyl cyclase activity, inositol phosphate production and intracellular free calcium concentrations, the latter presumably via the opening of K+ channels, and prolactin secretion, as well as the reversal of the effect by the D2-selective antagonist (-)sulpiride and pretreatment with pertussis toxin, are consistent with the known biological actions of dopamine at D2 receptors. Based on our observations, the MMQ cell line can be considered a useful tool for investigating ligand-receptor interactions to develop new selective dopaminergic D2L ligands for the therapy of dopamine-related disorders such as schizophrenia, depression, Parkinson's disease and drug addiction.
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PMID:Absence of D2S dopamine receptor in the prolactin-secreting MMQ pituitary clone: characterization of a wild D2L receptor coupled to native transduction mechanisms. 766 27

Twenty-nine cocaine-dependent male veterans without other drug dependence completed a double-blind controlled, randomly-assigned study examining the efficacy of bromocriptine versus placebo in the management of cocaine abstinence symptomatology. Serum prolactin (PL) and growth hormone (GH) levels were obtained prior to and after the study was completed. Patients were seen daily and completed several self-report questionnaires, including the Symptom Checklist-90-Revised, the Beck Depression Inventory, and a Cocaine Craving Report. The patients were also asked to rate a variety of cocaine withdrawal symptoms. Overall, there did not appear to be any advantage to receiving bromocriptine versus placebo during the first 3 weeks following cocaine use cessation with the possible exception of changes in activity and appetite level. The placebo group showed a statistically significant increase in activity level during the first week in treatment and a significant increase in appetite throughout the study. Patients in both groups showed significant improvement in the other areas assessed, with improvement appearing to progress according to length of treatment. Hyperprolactinemia or abnormal GH levels were not found in this patient sample as a group. Thirty-four of the original 63 patients dropped out of the study. Seventeen received bromocriptine, and 17 received placebo. There was no significant difference between drug groups in incidence of retaining patients in treatment. The high dropout rate may reflect the difficulty incurred in retaining cocaine-dependent patients in treatment.
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PMID:Double-blind comparison of bromocriptine and placebo in cocaine withdrawal. 776 45

Optimal pain control in the dying child often requires aggressive opioid therapy that exceeds recommended parameters and may hasten death caused by respiratory depression. For pediatric nurses caring for the dying child, the administration of potentially life-shortening analgesia gives rise to a number of ethical issues. Pediatric nurses often express concern that aggressive pain control is a form of euthanasia or fear the child will develop a drug dependence. Lack of clarity about the ethical obligations and professional responsibilities of nurses who administer potentially life-shortening analgesia may also contribute to the dilemmas surrounding such situations. If left unresolved, these issues can interfere with the nurse's ability to implement an appropriate pain regimen. To provide adequate pain control, pediatric nurses who care for dying children must accomplish the following: critically examine ethical issues and underlying principles; understand the phenomena of addiction, tolerance, and physical dependence; and identify the boundaries of acceptable nursing practice when administering potentially life-shortening analgesia to terminally ill children.
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PMID:Pain management and potentially life-shortening analgesia in the terminally ill child: the ethical implications for pediatric nurses. 781 90

This study compared perceived marital quality among couples in which neither, one, or both spouses met criteria for an anxiety disorder. Phobic husbands and their wives reported poorer marital quality than did other spouses. Husbands' panic disorders had similar but weaker effects on perceived marital quality, and wives' panic disorders predicted poor perceived marital quality by by husbands. Wives with generalized anxiety disorder perceived their marriages to be less satisfying than did other wives. The effects of husbands' generalized anxiety disorders were strongest in the presence of comorbid depression or alcohol or drug dependence but the effects of husbands' phobias and of panic disorders did not vary with comorbidity. Spouse concordance for phobias was related to more favorable marital reports, but concordance for other anxiety disorders was unrelated to marital quality.
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PMID:Anxiety disorders and marital quality. 782 79

74 male alcoholics participated in a three year prospective study. Data were collected four times: at admission (for the detoxification) and 1, 2 and 3 years after discharge. Patients were divided into groups according to drinking behaviour. Abstainers and relapsers who had been followed up for three years were compared with treatment variables in an attempt to separate those factors which would be predictors of outcome type. Our results indicate that for alcoholics, having an additional diagnosis of antisocial personality or drug dependence was associated with poor outcome. We failed to find a relationship between the history of alcohol dependence (manner of drinking, age of onset etc.) and clinical course. Our results suggest that symptoms of depression and anxiety, observed during a period of detoxification were gradually lowered according to the time of abstinence. Abstinence-status at a 3 year follow-up was associated with regular out-patients treatment especially during the first year after discharge.
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PMID:[Analysis of clinical data on alcoholics: a 3-year follow-up study]. 787 48


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