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

Although there has been concern about the use of psychoactive drugs in children, evidence is accumulating that these drugs are beneficial. The various groups of currently available drugs are reviewed with their pharmacological characteristics, adverse effects, dosages, and uses in children. Benzodiazepines, both widely used and severely criticized, are effective when used correctly, in particular for the shortest possible length of time. Antidepressants are indicated in many conditions including depression, obsessive-compulsive disorders, and anxiety; some of their indications are specific to children, such as separation anxiety, enuresis, and school phobia. Neuroleptics have a less well defined role and are usually given as symptomatic treatment, although their use is limited by their side effects. This is also true of lithium, despite fairly good tolerability in children. Carbamazepine was introduced in psychiatry too recently to allow valid evaluation. Psychostimulants are viewed with fear in France despite their documented efficacy in hyperkinetic children. A few other drugs used in other fields of medicine are currently being investigated in psychiatry (beta-blockers, clonidine, naloxone). A debate on drugs used in child psychiatry is much needed in particular to overcome the methodological and ethical problems raised by controlled trials of which few have been conducted to date. Drug therapy should be combined with psychotherapy to place the target symptoms in perspective with regard to the child's overall make-up.
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PMID:[Psychotropic drugs in child and adolescent psychiatry]. 827 3

The importance of the psychological aspects in treating the enuretic patient is often underestimated. The author reports 13 patients with functional enuresis, whose emotional implications of the symptom are very clear. In 7 patients a psychodiagnostic evaluation, with colloquia, tests, play and drawing, was carried out: the personality and family features of the children resulted similar to those described in literature (a too close mother-child relationship preventing child's separation, with both aggressiveness against mother and regression; depression; a difficult sexual identification). In 3 patients a psychotherapy lasting more than 6 months was undertaken. Psychologic care and short psychotherapy were always useful to relieve the neurotic symptoms connected with enuresis and to better child's personality; in some patients, they were not completely successful on the symptom, because this persisted although the number of episodes was reduced. The clinical approach depends on the type of enuresis. A psychologic care of the patients with secondary enuresis and of children with neurotic personality is necessary; in the other cases it is advisable to set up a therapeutic alliance with the child against his symptom, and to deal with the depressive traits related to it. We have to think of enuresis not as a border between organic and psychological, but as a problem in which the two aspects are closely linked together without excluding each other. The author believes that psychotherapy with enuretic patients is frequently lasting.
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PMID:[Functional enuresis. Which is the border between the organic and the pathological?]. 892 65

There is a general tendency to restrict the notion of sleep disorders to insomnia and consequently to limit treatment to the prescription of hypnotics. However, it is very often of benefit to prescribe psychotropic agents, in particular antidepressants, not only in insomnia but also in certain cases of hypersomnia, parasomnia and dysomnia associated with organic diseases. In some conditions, however, antidepressants may either induce or aggravate sleep disorders. This is the case with a number of psychostimulants that occasionally induce insomnia. It is also true of the tricyclic antidepressants, which may worsen or even induce a restlessleg syndrome that is often associated with periodic movement syndrome. On the other hand, the antidepressants may play a therapeutic role in certain sleep disorders : - depression-related insomnia is of course the << primary >> indication for antidepressants. Furthermore, certain antidepressants exhibit a sedative action resulting in a hypnogenic-type effect which appears well before the antidepressant effect; - the other types of insomnia may also often be treated with antidepressants : not acute reactional insomnia, against which hypnotics are remarkably effective, but chronic insomnia. In addition, all antidepressants may eventually correct depressive hypersomnia, but in these cases, it is evidently preferable to prescribe non-sedative drugs. Although some tricyclic antidepressants have been proposed for use in hypersomnia due to sleep apnea, their therapeutic interest is minor compared with mechanical and surgical treatment. In contrast, antidepressants play an important role in the treatment of narcolepsy, particularly for the correction of attacks of cataplexy. Antidepressants have also been used for some time in the treatment of parasomnia related to slow deep sleep (night terrors and sleepwalking), but the antidepressants may also be used in enuresis and in parasomnia related to REM sleep : nightmares, sleep paralysis, behavioral problems associated with REM sleep. Antidepressant (mainly serotoninergic drugs) are often used in the treatment of fibrolitis syndrome. Finally, antidepressants (particularly the serotoninergic antidepressants) play an important role in the drug treatment of fibromyalgia.
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PMID:[Use of antidepressants in sleep disorders: practical considerations]. 892 78

Sleep-disordered breathing occurs in approximately 2% to 4% of the adult population and includes conditions in which patients stop breathing completely (apnea) or have marked reductions in airflow (hypopnea) during sleep. Typical symptoms of sleep apnea include snoring, restless sleep, excessive daytime somnolence, nocturnal enuresis, irritability, depression, memory deficits, inability to concentrate, and decreased alertness. The clinically relevant outcomes of these symptoms include impairment in work efficiency, increased automobile accident rates, and decrements in quality of life. Treatment of sleep apnea, primarily with continuous positive airway pressure, reduces sleepiness and improves mood disturbances, neurocognition, and performance. Traditional measurements of sleep apnea severity do not correlate well with current tests and scales that are used to quantify alterations in alertness, performance, quality of life, or sleepiness. A disease-specific quality of life scale has been developed following patient and physician interviews and literature reviews. The Calgary Sleep Apnea Quality of Life Index is expected to capture aspects of quality of life important to sleep apnea patients, such as cognitive function, performance, and mood, that could be improved with appropriate treatment of sleep-disordered breathing.
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PMID:Quality of life consequences of sleep-disordered breathing. 904 67

Based on a representative sample of 1,312 students 13 to 19 years of age from Mallorca, Spain, we used 19 variables from an anonymous questionnaire to define three groups of problems frequently found in adolescents: depression, deviant behaviors, and the use of alcohol, tobacco, and illicit drugs. We have found a close relationship between drug use and deviant behaviors which shows no relationship with depressive symptoms. There is a small group which uses drugs with no relationship to deviant behaviors. There are also relationships between these problem behaviors and sleeping difficulties, enuresis, weight problems, family difficulties, etc., which leads us to think of a network of connections with other problems of the adolescent and his family.
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PMID:Drug use and its relationship to other behavior disorders and maladjustment signs among adolescents. 904 34

Autistic children undergoing therapeutic programs, which adopt in our service (USL 3 CT) different theoretical approaches, sometimes show a marked reduction in motor activities, a lowering of tone of voice, physical expression of sadness. We observe that animation is absent in the scene they may draw and colours are no longer used in their drawings. Sleep disturbance may appear or reappearance of enuresis. Many authors consider these symptoms as signs of depression. These changes, even though they create new problems in therapeutic management, are, in our opinion, a very important index of the unblocking of autistic withdrawal and beginning of development of those emotional, relational and cognitive components which seem to be frozen in autistic children and inhibit the birth of the mind, according to the U. Frith Theory. We report in this paper the psychoanalytic, cognitive, systemic, biological viewpoint on the occurrence of depression in infantile autism. We submit three cases of patients being treated in our service with the cognitive-behavioural oriented educational program and pharmacological therapy and discuss the multidimensional approach. The temporary occurrence of depression symptoms may be an index of a change within the resisting autistic balance, which may have a biological basis, but indicates the disorganization of the autistic child's mind in view of further development.
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PMID:Prognostic significance of depression occurrence in infantile autism. 906 96

To study the main predictors of childhood preschool headache, 1443 families expecting their first child were followed from the onset of pregnancy to the child's sixth year of life. Subject selection was based on stratified randomized cluster sampling. Of the children, 14.9% (144) suffered from headache disturbing daily activities at the age of 6 years. The mother's assessment of the infant's poor health (OR 2.5, 95% CI 1.1 to 5.8) and feeding problems (OR 1.9, 95% CI 1.1 to 3.2) at the age of 9 months predicted later occurrence of headache. At 3 years, depression and sleeping difficulties (according to Achenbach's psychological test) and recurrent difficulties in falling asleep (OR 3.2, 95% CI 1.5 to 7.2) were strong predictors. Headache in other family members (OR 3.5, 95% CI 2.0 to 5.9), especially in the mother (OR 1.7, 95% CI 1.2 to 2.4), predicted preschool headache in a child. At the age of 5 years, travel sickness (OR 2.8, 95% CI 1.5 to 5.1), nocturnal enuresis (OR 1.8, 95% CI 1.1 to 3.0), and the presence of long-term disease (OR 1.8, 95% CI 1.1 to 3.0) were strong predictors of later headache. At the same age, concentration difficulties (OR 2.3, 95% CI 1.3 to 4.2), behavioral problems (OR 2.7, 95% CI 1.1 to 6.4), unusual tiredness (OR 3.8, 95% CI 1.0 to 13.5), and, conversely, high sociability (OR 1.5, 95% CI 1.0 to 2.2) predicted headache. The three last-mentioned psychological factors seemed to be associated with concentration difficulties at the age of 5, which was found to be the strongest predictor. The parents of child headache sufferers often became aware of the child's problems long before the emergence of headache.
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PMID:Factors of early life as predictors of headache in children at school entry. 950 99

Using three questionnaires, the Rutter Parent Questionnaire (RA2), The Rutter Teacher Questionnaire (RB2) and the Children's Depression Inventory (CDI), we screened 8-9-year-old children representing a total annual birth cohort (N = 60007) in Finland. In a second stage we interviewed the parents of 119 screen negative, and 316 screen positive children by using a structured parent interview. At the population level the overall prevalence rate for psychiatric disturbance was 21.8%, higher among boys (29.8%) than among girls (12.8%). Nine percent of the children were in urgent need of treatment and, in addition, 25% were in need of assessment. The prevalence of different levels of disturbance was: reactive 9.5%; neurotic 18.4%; borderline 3.1%; and other severe disorders 2.3%. The prevalence of different diagnostic groups were: anxiety disorder 5.2%; depressive disorder 6.2%; specific fears 2.4%; defiant and conduct disorder 4.7%; and attention-deficit hyperactivity-disorder 7.1%. The prevalence for the most common single first Axis-I DSM-III-R diagnoses were: attention-deficit hyperactivity-disorder 7%; dysthymia 4.6%; adjustment disorder with mixed disturbance of emotion and conduct 3.4%; oppositional defiant disorder 2.7%; specific fear 1.7%; anxiety disorder 1.5%; enuresis nocturnal 1.5%; and depression 1.4%. Only 3.1% of the children had visited health professionals for psychiatric problems during the previous three months. Only a minority of the children with psychiatric disturbances had ever consulted health professionals for their problems. Of all the children, 7.5% had a severe psychiatric disturbance that had lasted for more than 3 years.
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PMID:Psychiatric disorders in 8-9-year-old children based on a diagnostic interview with the parents. 1065 30

32 formerly monosyndromatic enuretic patients who had been treated for this condition between 1980 and 1992 were compared with a matched control group from the general population in respect of sociobiography, psychopathological and dimensional factors (depressiveness, satisfaction with life, global functioning). Most of the former patients did not fulfil diagnostic criteria for an ICD-10 diagnosis at follow-up, although there was a 37% vs. 9% difference between former patients and controls in this respect--without a clear diagnostic pattern of such disorders. Furthermore, former patients had slightly higher depression scores and slightly lower global functioning than controls at follow-up. These results confirm that childhood enuresis has a low negative predictive value concerning the development of psychiatric disorders, although it may constitute a vulnerability factor.
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PMID:[Inpatient treated, mono-symptomatic childhood enuresis--results of follow-up in adulthood]. 1103 69

This is a review of pharmacotherapy in children and adolescents with mental retardation from the perspective of DSM and ICD disorders. The existing research is reviewed in young people with mental retardation but, when data are lacking, we examined the literature from adults with mental retardation and from typically-developing children. The literature is discussed for each of the following disorders: ADHD, anxiety disorders, bipolar disorder, conduct disorder, depression, enuresis, schizophrenia, self injury, and tics and movement disorders. With the possible exception of ADHD, there is a woeful lack of empirical data on most of these disorders in young people with mental retardation. Clinicians will often be forced to extrapolate from data on adults having mental retardation and from typically-developing children. The best policy is probably to treat such patients cautiously, while gathering data on the effects of such therapy in the hopes of beginning a data base.
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PMID:Pharmacotherapy of disorders in mental retardation. 1114 Jul 85


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