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

We used transcutaneous electrotherapy to treat 27 patients with persistent tinnitus. Each patient was tested with the short form of the Minnesota Multiphasic Personality Index test (MMPI) prior to the commencement of treatment. The "unimproved" group of patients (n = 15) showed higher pretreatment scores for depression (P less than 0.05), psychasthenia (P less than 0.05) and schizophrenia (P less than 0.02). Our findings indicate that patients having significantly pathological scores on at least one of these three scales will fail to benefit from treatment. These findings also show that there appear to be psychological prognostic factors that can be used to evaluate patients receiving transcutaneous electrotherapy for persistent tinnitus.
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PMID:Psychological factors affecting outcome of treatment after transcutaneous electrotherapy for persistent tinnitus. 349 23

Despite the widespread use of non-steroidal anti-inflammatory drugs (NSAIDs), the current number of reported cases of poisoning is small. However, with the introduction of 'over-the-counter' preparations of NSAIDs in some countries (e.g. ibuprofen in the UK and USA) an increased incidence of acute poisoning from this group of drugs can be expected. Conventionally, NSAIDs are divided into the following groups based on their chemical structure: arylpropionic acids, indole and indene acetic acids, heteroarylacetic acids, fenamates, phenylacetic acids, pyrazolones and oxicams. Unless NSAIDs are ingested in substantial overdose, acute poisoning with these agents does not usually result in significant morbidity or mortality. In most cases the clinical features are mild and confined to the gastrointestinal and central nervous systems, though acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse and cardiac arrest may complicate severe poisoning. Arylpropionic acid derivatives were thought initially to have a low order of toxicity in overdose but, in addition to anticipated gastrointestinal symptoms, headache, tinnitus, hyperventilation, sinus tachycardia, hypoprothrombinaemia, haematuria, proteinuria and acute renal failure have been described. In addition, drowsiness, coma, nystagmus, diplopia, hypothermia, hypotension, respiratory depression and cardiac arrest have been reported in severe cases of poisoning. Oxyphenbutazone and phenylbutazone are considerably more toxic in overdose. Complications of severe poisoning include coma, convulsions, hepatic dysfunction, acute renal failure, sodium and water retention, haematuria, cardiovascular collapse, respiratory alkalosis, metabolic acidosis, hypoprothrombinaemia and thrombocytopenia. In contrast, indomethacin appears to be much less toxic. In addition to gastrointestinal symptoms, indomethacin taken in overdose induces headache, tinnitus, dizziness, lethargy, drowsiness, confusion, disorientation and restlessness. Only 1 case of acute sulindac poisoning has been reported in the literature. A 16-year-old boy was admitted with hypokalaemia (2.2 mmol/L), transient granulocytosis and 'scanty' haematemesis after ingesting 12 g sulindac. No case of acute tolmetin poisoning have been reported. The fenamates (flufenamic acid, meclofenamic acid, mefenamic acid, tolfenamic acid) are, with the exception of mefenamic acid, not as widely prescribed as other groups of NSAIDs. In overdose, mefenamic acid may result in nausea, vomiting, diarrhoea, muscle twitching, convulsions and coma.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acute poisoning due to non-steroidal anti-inflammatory drugs. Clinical features and management. 353 13

Twenty-four patients with moderately severe (grade 2) to severe (grade 3) subjective tinnitus participated in an experimental group study. The patients were randomly assigned to a treatment group and a waiting-list control group. Treatment was given with a coping technique and comprised 10 one-hour sessions. Following a corresponding period without treatment, the control group was treated similarly. Daily self-recording of the subjective tinnitus loudness, the discomfort from the tinnitus, depression and irritation was performed before and after treatment. In addition, psychoacoustic measurement was undertaken on three occasions. The treatment group improved significantly more than the waiting-list control group. After treatment of the latter group, combined data of both groups showed statistically significant improvements in all variables. The results show that tinnitus annoyance can be treated by psychological methods.
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PMID:Psychological treatment of tinnitus. An experimental group study. 391 55

The Crown-Crisp Experiential Index (CCEI) was administered to 472 patients complaining of tinnitus who took part in a multi-centre study on tinnitus masking (Hazell et al., 1985). This inventory includes scales of anxiety, phobic anxiety, obsessionality, somatic anxiety, depression and hysteria. The scores on the CCEI scales for patients with and without 'dizziness' as an additional symptom were compared. In the non-dizzy patients, scores on the anxiety and depression scales were consistently elevated compared with the published normative values. In the dizzy patients scores on all scales except Hysteria were elevated. The most pronounced and consistent difference between the dizzy and non-dizzy patients was in the Somatic Anxiety scale. The presence of dizziness also obscured the relationship between the CCEI scales and measures of tinnitus. In contrast, however, hearing disability did not appear to influence the results.
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PMID:The Crown-Crisp Experiential Index in patients complaining of tinnitus. 402 40

After setting up a catalogue of complaints and signs for the most frequent disturbances of feeling tone of the patients suffering from cerebral arteriosclerosis, consisting of somatically subjective head pain and mental disturbances, treatment was given to 33 patients with cerebrovascular disturbances and 7 patients with similar, although non-vascular, disturbances (4 patients with presenile dementia, 3 patients with tinnitus in otosclerosis), the treatment consisting of eutergin 3 X 1 tablets to 3 X 2 tablets daily, the concomitant cardio-internistic medication remaining the same throughout the treatment course. The type and severity of the symptoms prevailing in each case were determined at the beginning, after 3 weeks and after 6 weeks of the medication with eutergin. It was found that improvement of the somatic-subjective head pain was more pronounced than that of the mental disturbances. Generally speaking, the disturbing somatic or mental signs were those which could be influenced better than the others. As far as the head pain was concerned, the feeling of giddiness, congestion in the head, rapid exhaustion, above all, tinnitus, responded best to the medication (the improvement amounting to approximately 40%), whereas of the mental complaints, a feeling of being "lost" or "abandoned" and a morose mood were most amenable to improvement (degree of improvement approximately 30%). The prevention of the delirogenic effect of antidepressives in senile depression was a remarkable effect; this means that effective antidepressive medication is made possible with the help of eutergin, EEG controls did not reveal any significant effects. There were no side effects. Elevated blood pressure levels showed a tendency to become normal without any dramatic drops. Hence, eutergin is recommended in all kinds of chronic cerebrovascular lesions, provided it is associated with concomitant cardiac and internistic treatment.
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PMID:[Eutergin in the treatment of chronic cerebrovascular disturbance patterns (author's transl)]. 610 60

This paper describes a comprehensive program for behavioral management of complex tinnitus. The clinical characteristics and typical treatment of tinnitus are reviewed. Psychosocial sequelae are discussed in terms of their exacerbation of the symptom and their potential as foci of treatment. The management problems of tinnitus are considered analogous to those of chronic pain. A case illustration is provided with a description of the treatment process. The comprehensive behavioral program discussed in the present paper included biofeedback therapy, pain management training, social skills training, assertion training, in vivo exposure to being alone, cognitive treatment of depression, and marital therapy. Outcomes were monitored multidimensionally. Self-report of tinnitus severity decreased after the 6th treatment day and stabilized at a "mild" rating after the 9th day. Skin temperature readings at baseline increased and stabilized after the 8th day, and the patient was able to reliably increase skin temperature on request. Scores on the Beck Depression Inventory and the Willoughby Personality Schedule, and a self-rating of Fear of Being Alone dropped markedly by the end of treatment. Follow-up data at 3 months indicated maintenance of gains.
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PMID:Comprehensive behavioral management of complex tinnitus: a case illustration. 639 62

Ninety-seven members of a tinnitus self-help group were asked to list the difficulties that they had as a result of their tinnitus. Seventy-two replies were returned from 22 men and 48 women (sex not reported in two cases) whose average age was 61 years. Tinnitus was associated with hearing difficulties in 53%, effects on lifestyle in 93%, effects on general health in 56%, and emotional difficulties in 70% of the sample. Getting to sleep was the most frequently mentioned difficulty, and many respondents indicated that they experienced depression, annoyance, and insecurity. The clinical application of this open-ended questionnaire are discussed.
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PMID:Difficulties experienced by tinnitus sufferers. 662 Oct 6

Lidocaine, Mexiletine, Procainamide, and Phenytoin were administered intravenously to anaesthesized rabbits. BERA alterations showed two different patterns. If the intoxication dose was exceeded, amplitude depression, threshold elevation, desynchronization, and severe cumulative prolongation of all latencies and interpeak latencies appeared. Below this dose Lidocaine and Mexiletine induced a single, reversible, dose related, cumulative prolongation of all latencies and interpeak latencies. Procainamide induced counterrelated shiftings of interpeak latencies I-III and III-V, whereas Phenytoin showed no influence. One should, therefore, take into account these effects when BERA is used clinically, since otherwise serious errors can occur. On the other hand, there are diagnostic and therapeutic aspects for the tinnitus patient.
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PMID:[Effect of membrane-effective drugs (anti-arrhythmia agents) on acoustically evoked brain-stem potentials]. 670 Mar 43

Tinnitus is an otological symptom which is often encountered and is yet difficult to treat. If tinnitus is of cochlear origin then it seems reasonable to assume that a total depression of the cochlear function will abolish cochlear tinnitus. To achieve this depression, transtympanic injections of a local anesthetic (4% Lidocaine) to anesthetize the inner ear and of Decadoron were conducted in a patient suffering from tinnitus. One hundred and sixty-eight patients (220 ears) who had suffered from relatively long-term tinnitus were included in this study. In almost all of the cases the clinical symptoms and the otological findings (i.e., the audiogram and caloric test) indicated that the probable lesion underlying the tinnitus was located within the end organ. In some cases this injection brought a transient (for few days), slight, neurosensorial deafness in the low-frequency range. This auditory disorder, however, was completely restored without sequelae. Our results are summarized as follows: in 76 ears, tinnitus was abolished completely, in 109 ears, tinnitus was considerably ameliorated, in 35 ears, tinnitus was slightly ameliorated or no effect. One hundred and nine patients (138 ears) who had suffered from tinnitus were included in this study. Decadoron was applied to the middle ear cavity by transtympanic injection. Our results are summarized as follows: in 87 ears, tinnitus was abolished, in 39 ears, tinnitus was considerably ameliorated, in 14 ears, tinnitus was slightly ameliorated or no effect.
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PMID:[Therapy of tinnitus. Tympanic cavity infusion of lidocaine and steroid solution]. 673 47

Personality and coping mechanisms are related to patients' perceptions of their tinnitus. Although the occurrence of tinnitus is not unusual, its nature varies from infrequent, barely noticeable sound to an unrelenting, absorbing disturbance of critical significance. Tinnitus is a subjective complaint: the same level of tinnitus may be described by one patient as intolerable and by another as barely noticeable. Stress is intricately related to tinnitus: persons with severe tinnitus experience excessive stress. This has debilitating effects on their defences and coping can become very difficult. Patients may demonstrate a cluster of hysterical defences or a serious degree of depression. Many tinnitus patients focus on their problem, objectifying it and thus intensifying the disturbance. Most tinnitus patients can be helped by psychological intervention. A small percentage of tinnitus patients can be classified as disturbed, with borderline personalities. These patients are usually not suitable for therapy or biofeedback training. Tinnitus can be stress-related disorder. As a person is faced with conflict, physiological changes occur as a result of the "fight or flight" reaction. This state of stress can be responsible for the onset or exacerbation of a tinnitus episode. Treatment by management of stress can be successful, promoting relief through a shift of focus, repose from a state of tension, and support of constructive defences.
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PMID:Personality of the tinnitus patient. 703 99


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