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

Pelvic pain was a prominent complaint among one third of 3,000 gynecology clinic patients. In 1.1% no causative disease could be found, and these patients failed to respond to routine therapy. Twenty of these patients who were studied minutely revealed some psychologic disorder including hysteria, passive-aggressive behavior, sociopathy, depression, and alcoholism. A strong tendency toward psychophysiologic disturbances in other systems was practically universal. Supportive psychotherapy, progressive relaxation training, and insight therapy were used. The greatest barrier to treatment success was refusal of patients to accept the psychologic factors in their total illness.
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PMID:Diagnosis and treatment of nonorganic pelvic pain. 47 38

Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather.
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PMID:Fibromyalgia syndrome. New associations. 146 72

Assessment of cases of chronic pelvic pain presents a challenging problem, and many physicians overlook the association of sleep disorders and depression with such pain. We examined these linkages in our chronic pelvic pain clinic, using a questionnaire that assists in diagnosis and management of these cases. To date, the cases of 72 patients (both physician- and self-referred) with pelvic pain have been evaluated. Of these patients, 51 of 71 (72%) reported sleep disorders, and 37 of 72 (51%) had clinical depression, as determined by the Beck Depression Inventory. After adjustment for a sleep-related item on the Beck scale, these two measures showed a positive correlation of .355 (P < .01). The scores of pain patients differed significantly from those of a control group of asymptomatic patients on the depression and sleep disorder measures. By being aware and using a simple questionnaire, the clinician may readily identify overlooked factors, such as sleep disorders and depression, when assessing cases of chronic pelvic pain.
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PMID:Unrecognized association of sleep disorders and depression with chronic pelvic pain. 147 Sep 59

During the past decade, the development of various gonadotrophin-releasing hormone (Gn-RH) agonists, which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis. In an open, multicentre phase III study, the efficacy, tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested. The preliminary results of 104 women treated in seven German centres are presented. Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system: 33% of patients had minimal, 22% mild, 28% moderate and 8% severe endometriosis and in 9% no pathological results were obtained. The patients' mean age was 30 +/- 6 years and 66 had infertility problems. Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg, repeated once monthly over 24 weeks. A follow-up period of 12 months after the last injection has been completed in 70 patients, including a second laparoscopy. At all visits, symptoms were evaluated, physical examinations performed, and blood samples collected for haematological screening, serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate. The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate. Of the total number of patients, 89% had improvements in their endometriosis, 8% a deterioration and 3% no change. Patients reported improvement in the following: dysmenorrhoea 93%, dyspareunia 62% and pelvic pain 70%. However, all women complained of at least one of the following symptoms: hot flushes 86%, sleep disturbance 62%, sweating 61%, headache 41%, nausea 32% and depression 20%. Fifty-five percent of patients reported additional side effects such as vaginal dryness, fatigue and lower abdominal pain. After the third injection, amenorrhoea persisted in 94% of the women. Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml, follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period. During the 6 months' treatment, laboratory parameters showed no significant deviations from normal; only total cholesterol, high-density lipoprotein cholesterol and alkaline phosphatase increased. Treatment results were judged as good and satisfactory in 82% and 11% of cases, respectively. On the basis of this study, it can be concluded that leuprorelin acetate treatment is safe, well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints.
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PMID:Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. 153 21

From August 1988-June 1989, 983 physicians participated in a phase IV trial by following 7759 women using the monophasic oral contraceptive (OC), Demulen 1/35 (1 mg ethynodiol diacetate and 35 ug ethinyl estradiol) to evaluate its efficacy and safety. The total number of cycles for the study stood at 21,440. In addition, the total woman-years stood at 1787. Only 6382 patients could be evaluated for safety. 4.4% of the patients had adverse reactions to the OC, but only 1.7% of all patients stopped taking it. The leading side effects included nausea (67 cases), headache (45), amenorrhea (42), emotional changes (30), breast pain (19), dysmenorrhea (12), and 11 cases of weight gain, abdominal/pelvic pain, and bloating. Of the 280 reported adverse reactions, only 87 (31%) were considered severe. The leading serious adverse reactions were depression (10) and hypertension (6). Only 5412 patients could be used to determine efficacy. The physicians initially reported 121 (2.2%) pregnancies during the study. The researchers learned that 33 of the 84 returned 2nd questionnaires (response rate, 70%) reported that the women conceived after enrollment but before taking the OC. 36 conceived while taking it, but 8 did not take it daily. Noncompliance may have contributed to pregnancy for the remaining 28 cases. Therefore the 36 confirmed pregnancies made for a failure rate of .7%. 85.7% of the pregnancies happened in the 1st 3 months of taking the OC. Either patient noncompliance or true medication failure accounted for treatment failure. Therefore it is important for physicians to instruct patients on how to take OCs correctly.
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PMID:Efficacy and safety of ethynodiol diacetate, 1 mg, with ethinyl estradiol, 35 micrograms, with an emphasis on contraceptive efficacy. A phase IV trial. 204 81

Chronic pelvic pain has rarely been discussed in the pain management literature, although it is extremely common in general gynecological practice and often refractory to traditional medical and surgical therapy. A chronic pelvic pain program was developed to offer an alternative treatment approach for women for whom standard gynecological procedures were inappropriate or unsuccessful. Sixteen subjects completed the full 6-8 week interdisciplinary program, which included both somatic and behavioral therapies. Compared to a waiting list control the results showed a dramatic decrease in reported levels of pain following treatment. Anxiety and depression also decreased and psychosocial functioning improved, including return to work, increased social activities, and improved sexual activity. The outcome suggests that the interdisciplinary pain management approach is effective for the treatment of chronic pelvic pain.
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PMID:Effectiveness of an interdisciplinary pain management program for the treatment of chronic pelvic pain. 235 65

Episodic and chronic idiopathic pelvic pain is enigmatic for both physician and patient. Antidepressant drug therapy combined with behavior modification techniques is beneficial in improving the functional status of some patients. Whether the decrease in frequency, intensity, and duration of pelvic pain complaints results from treatment of underlying depression or analgesic effects of the antidepressant drugs is difficult to determine. Addressing the psychological component of idiopathic pelvic pain through education and counseling is essential to long-term resolution of symptoms.
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PMID:Idiopathic pelvic pain. The relationship to depression. 252 23

The authors matched gynecologic patients with the abdominal pelvic pain syndrome (N = 41) with other gynecologic patients. They administered to both groups self-rating scales of anxiety, depression, anger-hostility, and somatization of the Hopkins Symptom Checklist and of the Symptom Questionnaire, a questionnaire about disruptions in early home life, and a questionnaire of recent stressful events. Patients with pain rated themselves on the average significantly more anxious, depressed, and hostile, and had more somatic symptoms than other patients; 56% of the patients with pain rated themselves within the normal ranges on all scales. There were no significant differences between the two groups in reports of disruptions of early home life and recent losses. The findings are consistent with the view that patients with the abdominal pelvic pain syndrome are psychologically a heterogeneous group; in many patients, depression and anxiety may be consequences of persistent pain.
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PMID:Anxiety and depression in patients with the abdominal pelvic pain syndrome. 291 19

Using the Middlesex Hospital Questionnaire (MHQ) and the Zung Self-Rating Depression Scale (SDS) psychological distress was measured in 30 women who underwent laparoscopy for chronic pelvic pain and in 30 matched controls. Both organic pelvic pain patients (OPPs) and idiopathic pelvic pain patients (IPPs) reported higher scores for somatisation than controls. IPPs scored higher than OPPs and controls on the Zung SDS, while no difference emerged in this scale between OPPs and controls. No correlations were found between age or duration of symptoms and somatisation and depression scores. On the basis of the above reported results the authors suggest that some forms of idiopathic chronic pelvic pain might represent an expression of a depressive disorder.
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PMID:Psychological profile of women with chronic pelvic pain. 395 51

The psychological and clinical characteristics of 29 women who underwent laparoscopy for chronic pelvic pain (CPP) have been studied. Patients (n = 11) with CPP without obvious organic pathology showed a significantly higher mean score at the Zung Self-Rating Depression Scale and more somatic symptoms which usually accompany depression than patients (n = 18) with CPP in whom pathology was found; they also showed higher frequencies for depressive disorders in personal anamnesis and for 'depression spectrum disorders' in family history. No differences between the two groups emerged for anxiety, somatization and inadequacy as measured by the Kellner-Sheffield Symptom Rating Test. Through a comparison with a group of women affected with another type of idiopathic chronic pain, and on the basis of the above reported results, the authors suggest that CPP without obvious organic pathology might be an expression of a depressive disorder.
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PMID:Chronic pelvic pain and depression. 647 75


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