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

Child victims of sexual abuse may present with physical findings that can include anogenital problems, enuresis or encopresis. Behavioral changes may involve sexual acting out, aggression, depression, eating disturbances and regression. Because the examination findings of most child victims of sexual abuse are within normal limits or are nonspecific, the child's statements are extremely important. The child's history as obtained by the physician may be admitted as evidence in court trials; therefore, complete documentation of questions and answers is critical. A careful history should be obtained and a thorough physical examination should be performed with documentation of all findings. When examining the child's genitalia, it is important that the physician be familiar with normal variants, non-specific changes and diagnostic signs of sexual abuse. Judicious use of laboratory tests, along with appropriate therapy, should be individually tailored. Forensic evidence collection is indicated in certain cases. Referral for psychologic services is important because victims of abuse are more likely to have depression, anxiety disorders, behavioral problems and post-traumatic stress disorder.
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PMID:Evaluating the child for sexual abuse. 1126 61

The urologic literature suggests that there is an association between a variety of psychiatric disorders and incontinence. Most notably, depression is found in a significant percentage of patients with urinary incontinence. Depression also occurs in other conditions associated with urinary urge incontinence, such as aging and dementia, and in neurologic disorders such as normal pressure hydrocephalus. Correction of some neurologic disorders eliminates both depression and urge incontinence. Although chronic medical disorders such as urge incontinence may lead to depression, an alternative hypothesis is that these two conditions share a common neurochemical pathogenesis. Lowering monoamines such as serotonin and noradrenaline in the central nervous system (CNS) leads to depression and urinary frequency and a hyperactive bladder in experimental animals. Thus, depression may not only be the result of persistent urinary incontinence, but individuals with altered CNS monoamines could manifest both depression and an overactive bladder. The latter condition may lead to urge incontinence, urinary frequency, urgency, or enuresis. Uncovering further evidence for such a linkage could serve as the basis for the development of genetic markers and novel therapeutic interventions for these two conditions.
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PMID:Depression and incontinence. 1176 Jul 84

Criminal statistics say that 300,000 children are sexually abused in the Federal Republic of Germany every year: 70-75% are abused by their own fathers or another psychological parent. Most victims are girls aged 7-12 years. Sexual abuse during childhood can lead to severe psychosomatic dysfunctions both in children and adults. Possible long-term results are depression, anxiety, emotional and cognitive problems, personal dysfunction, eating and sleeping disorders, alcohol or drug abuse, relationship problems, social maladaptation, and somatizations. Many urological dysfunctions without organic findings can be caused by sexual abuse. Among others, chronic pelvic pain (CPPS), enuresis, incontinence, and sexual dysfunction can occur. When children or adults see the urologist because of their symptoms there is always the danger of reproducing the abusive event by invasive diagnostic methods.Sometimes harming themselves the patients bring this situation about unconsciously. With the following article we want to heighten the awareness among urologists.
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PMID:[Urological dysfunction after sexual abuse and violence]. 1504 85

Considering the limits of the traditional EEG techniques the authors review the main methods and clinical importance of the event-related EEG investigations. According to methods, these can be classified into the spectral analysis of task-related, pre-task and post-task recordings as well as stimulus-controlled measurements based on evoked potential techniques. The main results of clinical studies on the event-related EEG methods are summarized according to chief disease groups (Alzheimer's disease, epilepsy, schizophrenia, Parkinson's disease, dyslexia, depression). The authors discuss the stimulus-dependent EEG discharges (P300, cognitive potential) in detail. They present the meta-analysis of 224 recent publications on human application of these methods. They analyze the involved scientific areas and the frequency by which these methods were applied in each. Following this, the results of 83 selected clinical studies are summarized. The frequency of the application of the various event-related EEG methods and the tested wave components and other parameters are listed. Finally a summary of the main clinical results is presented again by groups of diseases (schizophrenia, behavioral disorders, traumatic lesions, enuresis nocturna, depression, memory disturbance and dementia, drug effect). Finally, the potential perspectives and the limitations of the event-related EEG methods are briefly discussed.
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PMID:[Event-related EEG and evoked potential investigations in clinical practice]. 1649 63

Sleep apnea is highly prevalent in subjects after age 60, and affects older men and women similarly. Central apneas are often observed in addition to obstructive and mixed events. Pathogenesis of obstructive and central events during sleep in the elderly can be attributed to an amplification of well-established causes of sleep-disordered breathing (SDB) in younger adults. As in middle-aged adults, sleep-related complaints, cardiovascular diseases, depression and traffic accidents should prompt an evaluation by a sleep specialist. However, secondary enuresis and nocturia, cognitive impairment, ophthalmic conditions and repeated falls may be the main complaint in elderly subjects. Sleep studies in the elderly should systematically include reliable means to detect central apneas and periodic leg movements. Untreated SDB in the elderly appears to have a lesser impact on mortality than in middle-aged adults. However, the typical morbidity associated with the disorder in younger adults is observed in the elderly. Elderly symptomatic SDB patients tolerate CPAP no differently than younger patients and should be effectively treated. In conclusion, whether sleep apnea in the elderly represents a specific entity or the same disease as in younger subjects, with some distinctive features, is still unclear. Further research, in particular focusing on the impact of age on SDB outcomes, is needed.
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PMID:Sleep apnea in the elderly: a specific entity? 1731 40

We have made a questionnaire survey on an enuresis rate among old males living in Vilnus. Using questionnaires on enuresis, MMSE-30 test and GDS-15, we have examined a random sample of 294 males aged 75 to 95 years and older from January 2003 to December 2004. Enuresis was diagnosed in 26.5% of them. In age groups 75-79, 80-84, 85-89, 90-94, 95 years and older enuresis symptoms occurred in 32.8, 24.0, 12.2, 36.4, 9.1% males, respectively. Only 58.4% males with enuresis sought medical advice. Most of the patients suffered from enuresis for 1 to 5 years. The type of incontinence was stated according to international criteria of ICS (2002). The incontinence was urgent in 66.2% and stress in 3.9%. Only 13.0% males used hygienic protectors. The following risk factors were revealed: intake of alpha-adrenoblockers (OR = 3.89, 95% CI = 1.98-7.67), depression (OR = 2.51, 95% CI = 1.13-5.55). The risk to develop continuous incontinence grows in the presence of Parkinson's disease (OR = 3.50; 95% CI = 1.01-12.23), prostatic adenoma (OR = 5.29; 95% CL = 2.91-9.65). The responders believe that their incontinence is due to combination of factors: 2-3 factors were pointed by 36.4%, 4-5 factors--20.8%, 6 and more--by 22.0%.
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PMID:[Prevalence of enuresis in old males according to questionnaire data]. 1757 96

(1) Narcolepsy is characterised by sudden, overwhelming daytime drowsiness, sometimes associated with cataplexy (more or less complete loss of muscle tone during an emotional reaction). (2) Modafinil moderately reduces daytime drowsiness but has no effect on cataplexy. Methylphenidate, an amphetamine psychostimulant, seems to act on both drowsiness and cataplexy, although its clinical evaluation is limited to observational series. (3) Oxybic acid, long used in general anaesthesia, but also misused for recreational and criminal purposes (chemical or drug-induced submission), has been approved to treat adults with both narcolepsy and cataplexy, in the form of an oral solution of sodium oxybate. (4) The rationale behind the use of sodium oxybate is to re-establish a near-normal pattern of the different phases of sleep. Because of its short-lasting action, sodium oxybate has to be taken once at bedtime and then again 2.5 to 4 hours later. (5) Clinical evaluation mainly consists of 4 double-blind placebo-controlled trials of sodium oxybate. Three short-term trials, involving 136 patients treated for 4 weeks and 228 and 270 patients treated for 8 weeks, showed that sodium oxybate at a dose of 4.5 g to 9 g a day reduced the number of cataplexy attacks but that a dose of at least 6 g was needed to reduce daytime drowsiness. A trial involving 56 patients who had been taking sodium oxybate for nearly 2 years, assessed the effects of stopping versus continuing treatment. The results suggest that sodium oxybate is effective in the long term. (6) During clinical trials, 61% of patients had adverse effects attributed to sodium oxybate. These included gastrointestinal disorders (nausea (18%)), neurological disorders (dizziness (15%), headache (6%)), confusion (3%), and enuresis (7%). (7) Altered consciousness and respiratory depression occurred after a single intake of a dose two or three times higher than the recommended dose. (8) Misuse, especially to obtain chemical or drug-induced submission (i.e. as a 'date rape' drug), is facilitated by the odourless and colourless nature of the oral solution. (9) In practice, for some patients who are seriously affected by persistent episodes of cataplexy or drowsiness, despite treatment of narcolepsy, sodium oxybate is preferable to methylphenidate, which has been less thoroughly evaluated. However, the risks of misuse and overdose mean that this drug should only be proposed to patients in whom the benefits are likely to outweigh the risks.
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PMID:Sodium oxybate: new drug. Fewer attacks of cataplexy in some patients. 1758 23

The aim of this study was to evaluate the impact of enuresis nocturna on quality of life of the mothers. Mothers who have a child with monosymptomatic nocturnal enuresis (n=28) and mothers who have a child without any health problems (n=38) were enrolled in the study. Groups were in balance for background variables (child's age, gender, and number of siblings; mother's age, marital status, highest year of education completed, and occupation; presence of health insurance; and type of residence). Short-Form Health Survey (SF-36) Questionnaire, the Beck Depression Inventory (BDI), and Spielberg's State-Trait Anxiety Inventory (STAI) were applied to all mothers. The mothers of children with enuresis had significantly lower quality-of-life scores in the SF-36 for the bodily pain (p=0.015) and role emotional (p=0.014) subscales. We observed significant difference between groups according to BDI; mean score was higher in mothers who have a child with enuresis nocturna (p=0.017). There was no significant difference between groups according to the STAI. Significant differences according to bodily pain and role emotional subscales of SF-36, and the BDI scores, show that the mothers were negatively affected by having a child with monosymptomatic nocturnal enuresis.
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PMID:An evaluation of quality of life of mothers of children with enuresis nocturna. 1789 6

Drug-induced immune thrombocytopenia (DITP), excluding heparin-induced thrombocytopenia, is relatively uncommon. It is characterized by drug-dependent antibodies that bind to the platelets and cause their destruction when the responsible drug is ingested or injected. Imipramine is a tricyclic antidepressant drug that is one of those used widely for primary enuresis nocturna, attention deficit hyperactivity disorder, depression, and anxiety disorder in children and adolescents. Imipramine rarely causes hematological abnormalities. A five-year-old boy with imipramine-associated antiglobulin-positive immune thrombocytopenia is reported herein, and we also discuss the possible pathogenesis of drug-associated thrombocytopenia.
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PMID:A case of imipramine-associated immune thrombocytopenia. 1981 72

Evidence has existed for many years that individuals with Tourette's syndrome (T.S.) have associated neurobehavioral comorbid disorders. Though these disorders are not necessary to give a definitive diagnosis for Tourette's syndrome, many patients present with clinical signs of additional problems. Many believe that Tourette's is a neuropsychiatric disorder with symptoms originating from the brain or basal ganglia. Some of these coexisting conditions include attention deficit hyperactive disorder (ADHD), obsessive compulsive disorder (OCD), depression, sleep disorders, and enuresis. We hypothesize that an intraoral device can be utilized to eliminate these associated comorbid neurobehavioral signs and symptoms. Use of this device, called a neurocranial vertical distractor (NCVD), results in the elimination of unwanted neurobehavioral disorders via normally existing trigeminoreticular fibers and tracts (Fig. 1).
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PMID:An intraoral neurocranial vertical distractor appliance provides unique treatment for Tourette's syndrome and resolves comorbid neurobehavioral problems of obsessive compulsive disorder. 2030 68


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