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

Work should respect the worker's life and health, leave him free time for rest and leisure, and enable him to serve society and achieve self-fulfillment by developing his personal capacities. This is not what work looks like to hundreds of millions of workers all over the world. Occupational stress arises where discrepancies exist between occupational demands and opportunities on the one hand and the worker's capacities, needs and expectations on the other. Ill effects are mediated by three classes of mechanisms: (1) feelings of distress (e.g., anxiety, depression, alienation, etc); (2) behaviors (e.g., increase in alcohol and tobacco consumption, risk taking, self-destructive behavior, etc.); and (3) hyper-, hypo- and dysfunction in various organs and organ systems (e.g., physiological stress reactions as described by Selye; specific changes in endocrine and immunological function, etc.). These effects are common and they are a challenge to occupational medicine. Work environments are man-made and can be adapted by man for man. Local, national and international monitoring of occupational health should be aimed at making work man's servant and not his master.
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PMID:Occupational mental health: its monitoring, protection and promotion. 75 93

Self-destructive behavior in the adolescent is a continuum that ranges from drug intoxications to gestures of low lethality to suicide attempts with high lethality of intent. Such behavior should be treated as a signal of long-term stress and strife. A "Psychological biopsy" is outlined for evaluation of the severity and type of perturbation. This focuses on 9 areas of inquiry: the circumstantial lethality of the event; prior self-destructive behavior; depression; hostility; stress; reaction of the parent or parent surrogate; loss of communication; lack of resources; and extremes of parental expectations and control. Adolescents under severe familial and socioeconomic stress, and with a history of acting-out behavior, often respond well to transfer to a more favorable home situation. In cases where there is no apparent familial perturbation, the physician should be alert to the possibility of severe psychiatric disorder. In either case, initial definition of the problem opens the way to a plan for management and support.
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PMID:Evaluation of suicide risk in adolescents. 120 61

The single most important risk factor for adolescent suicide is a previous attempt. It is unclear if physicians can identify adolescents who have attempted suicide. Our objectives were to determine the prevalence of previous attempts in an adolescent clinic population, if physicians identify attempters, and if attempters demonstrate persistent distress. Of 332 patients aged 12-19 years attending a medical clinic, 48 (14.5%) reported a previous attempt. The physician's visit note documented that only 8 (16.7%) of the 48 attempters were asked about suicidal behavior. Attempters were more likely than nonattempters (p less than 0.05) to be female; to come to clinic without a guardian; to give a chief complaint pertaining to sexually transmitted disease, obstetrics-gynecology, or mental health; and to report previous mental health care. Attempters had poorer mean scores (p less than 0.05) on validated subscales for family relationships, social competence, depression, unpopularity, somatic complaints, thought disorders, delinquency, aggression, and identity. We conclude that suicide attempts are common among adolescent clinic patients, that physicians may not recognize attempters, and that attempters remain distressed and in need of care. Physicians who see adolescents for routine medical problems must consider the potential for self-destructive behavior, regardless of the presenting complaint.
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PMID:Adolescent suicide attempters: do physicians recognize them? 161 Aug 44

The sexual addiction model enables physicians to understand the self-destructive behavior of patients whose actions may otherwise appear inexplicable. When a person is preoccupied with sex and continues to engage in compulsive sexual activity despite adverse consequences (eg, loss of marriage, job, health, freedom), he or she is a sex addict. Treatment allows sex addicts to stop their compulsive behavior and improve their relationships. Preferred treatment includes professional counseling and attendance at self-help programs based on the Alcoholics Anonymous model. Partners of sex addicts, whose coaddiction may manifest itself through various physical symptoms, depression, or compulsions, can benefit from the same treatment approach.
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PMID:How to recognize the signs of sexual addiction. Asking the right questions may uncover serious problems. 194 10

Self-injurious ideation or behavior appeared de novo or intensified during fluoxetine treatment of obsessive-compulsive disorder in six patients, age 10 to 17 years old, who were among 42 young patients receiving fluoxetine for obsessive-compulsive disorder at a university clinical research center. These symptoms required the hospitalization of four patients. Before receiving fluoxetine, four patients had major risk factors for self-destructive behavior including depression or prior suicidal ideation or self-injury. Three hypotheses concerning the apparent association between fluoxetine and these self-injurious phenomena are discussed: (1) coincidence; (2) disorganization of vulnerable individuals secondary to drug-induced activation; and (3) a specific serotonergic-mediated effect on the regulation of aggression.
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PMID:Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment. 193 9

Two hundred fifty four adolescents with psychiatric illnesses were evaluated in relation to alcoholism in their parents. All cases concerned underwent evaluation in Kurihama National Hospital by a psychiatrist. Those evaluated ranged from 11 to 25 years of age. The characteristic symptoms were as follows. 1. Thirty one had alcoholic parents, 48% of them came from broken families before reaching the age of 15, and 19% had mothers suffering from psychiatric illness. Many had serious family problems besides their father's alcoholism. In many cases, the psychotic symptoms started in early adolescence. 2. In an examination of psychiatric illnesses in adolescents with alcoholic parents, 36% were found to have borderline personality disorders, and 19% violence in the family. 3. Significant symptoms of psychiatric illness in adolescents with alcoholic parents were signs of aggression, violence, troubles in school, regression and convulsions. The average number of symptoms per patient was higher than in cases with non-alcoholic families. Other symptoms prevalent in adolescents with alcoholic parents were depression, anxiety, fear, delinquency and self-destructive behavior. It was apparent that severe symptoms were diverse in such adolescents. 4. Based on the above results, alcoholism in the family and borderline personality disorders in adolescents were discussed.
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PMID:[Psychiatric illnesses in adolescents of alcoholic parents]. 235 74

Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.
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PMID:Suicidal adolescents: factors in evaluation. 408 35

Suicidal and other self-destructive behavior was correlated with self-report (Buss-Durkee) and observer rated (Lion Scale) measures of hostility and violence in 45 male inpatients with major depressive episodes by DSM III criteria (296.2, 296.3, 296.5). Self-destructive acts were significantly correlated with a Buss-Durkee Indirect Hostility factor. Measures of directly expressed hostility and violence correlated with seclusion and restraint for self-protection. None of the Lion or Buss-Durkee measures correlated with depression measures, nor did self-destructive acts correlate with degree of depression in these severe patients. Thus our data indicate that, in patients with moderate to severe depression, self-destructive acts in hospital may be better correlated with feelings of anger and hostility than with depression itself.
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PMID:Direct and indirect hostility and self-destructive behavior by hospitalized depressives. 665 Feb 12

This paper presents the results of a survey of Washington, DC, area physicians who confront the diagnosis and treatment of childhood depression and potential suicide. Questions addressed included the prevalence of childhood depression and self-destructive behavior, beliefs about such phenomena, criteria used in the diagnosis of depression, and treatment preferences for both childhood depression and self-destructive behavior. Nearly half of respondent physicians reported knowing of suicide attempts among patients under 14 years old; almost two thirds currently had a patient in treatment for depression with a mental health professional. Physicians subscribed to a number of traditional but false beliefs about young children's capacity for intentional self-destruction and the incidence of such acts being disguised as "accidents." Wide variation was observed in the symptoms physicians used to diagnose depression. In general, physicians attended most to overt behavior and family history, followed by psychological problems. Physicians need to be alert to the diagnostic significance of "masked" symptoms of depression, such as somatic complaints and acting-out, antisocial behaviors.
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PMID:Diagnosis and treatment of childhood depression and self-destructive behavior. 741 Oct 42

This paper summarizes the experiences with suicidal and parasuicidal behavior of the psychotherapy research project on borderline patients in progress at the Westchester Division of the New York Hospital-Cornell Medical Center. In the diagnostic evaluation of these patients, it is important to differentiate acute and chronic suicidal behavior with the presence or absence of depression. The dominant psychodynamic features of chronic characterological suicidal behavior are reviewed, with a particular emphasis on the psychopathology of self-directed and projected primitive hatred, and the defenses against its conscious awareness on the part of the patient. A general psychotherapeutic strategy to deal with suicidal and self-destructive behavior is mapped out, centered upon the transformation of self-destructiveness into specific transference constellations that must be diagnosed, interpreted, and gradually worked through in the transference in the course of the treatment. The treatment of chronic, characterologically anchored suicidal behavior without depression requires the setting up of specific structuring of the psychotherapy from the very beginning of treatment, embodied in the establishment of a treatment contract that contributes to the organizing frame for the entire psychotherapy. The precondition for this psychotherapeutic work and limiting factors affecting its effectiveness are spelled out.
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PMID:Suicidal behavior in borderline patients: diagnosis and psychotherapeutic considerations. 851 72


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