Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serotonin (5-HT) uptake into platelets is reduced in functionally depressed patients. Depression following stroke (cerebrovascular accident; CVA) is common and severe. Sixteen patients who had suffered a CVA within 6 to 12 months and who were medication-free had blood taken for measurement of platelet 5-HT uptake. Seven of these patients were depressed. These were compared with age- and sex-matched hospital controls. No difference in platelet 5-HT uptake was found across these groups.
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PMID:Platelet 5-HT uptake in post-stroke depression. 239 28

A 55-year-old male subject was treated with a two-tiered neurotherapy approach for a period of six months beginning approximately one year after a left-side CVA. Medical evaluation revealed left posterior temporal/parietal infarctions secondary to occlusion of the left internal carotid artery. The patient complained of hesitant speech with word finding difficulty and paraphasia, difficulty focusing his right eye, lack of balance and coordination, poor short-term memory, poor concentration, anxiety, depression, and tinnitus. A quantitative electroencephalograph (QEEG) analysis revealed increased left-side 4-7-Hz activity and alpha persistence on eye opening. Two neurotherapy approaches were used beginning with electroencephalographic entrainment feedback (EEF). This was followed by neurofeedback to inhibit 4-7 Hz and increase 15-21 Hz over sensorimotor and speech areas. At the conclusion of treatment there were significant reductions in slow-wave activity. Improvement was evident in speech fluency, word finding, balance and coordination, attention, and concentration. Depression, anxiety, and tinnitus were greatly reduced.
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PMID:Neurotherapy for stroke rehabilitation: a single case study. 749 16

Recently, the therapeutic benefit of lithium augmentation in old age has come into question. These data, in light of the documented high incidence of side effects after lithium use in elderly patients, resulted in the design of a prospective, placebo-controlled lithium augmentation withdrawal study in elderly patients with unipolar depression. Twelve eligible geriatric patients (10 women and 2 men; mean [+/-SD] age, 76.2 +/- 5.7 years) with DSM-III-R unipolar depression receiving adjunct lithium therapy were randomized to receive continued lithium augmentation or matching placebo (withdrawal rate 150 mg/day/wk). At each clinic visit, patients were assessed for depression (Montgomery-Asberg Depression Rating Scale and Geriatric Depression Rating Scale) and lithium-induced toxicities (a 21-item side-effect checklist, renal and thyroid biochemistry). Over the 2-year observation period, the placebo group reported a decrease in composite 21-item side-effect score and specific lithium toxicities (e.g., urinary urgency, hand tremor, and renal/thyroid abnormalities). Two patients in the lithium maintenance group had a recurrence of depression at 61 and 96 weeks, respectively, immediately after a stressful life event (cerebrovascular accident [CVA] or death of spouse), and two patients had a recurrence in the placebo group at 7 and 92 weeks, respectively, without any apparent changes in life stresses. No other prognostic risk factors for recurrence were identified. Depression that recurred in patients who were receiving placebo was relatively resistant to reinstitution of lithium augmentation therapy. In otherwise stable geriatric patients with unipolar depression, the documented benefits of reduced side effects should be weighed against the risk of recurrence and subsequent lithium resistance before withdrawal of lithium augmentation.
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PMID:Gradual discontinuation of lithium augmentation in elderly patients with unipolar depression. 900 53

This study aimed at a contrastive analysis of coping strategies and psychosocial alterations in patients with Parkinson's disease (PD) and stroke (CVA) and their relatives. Fifty-four PD and 50 CVA patients were investigated with a standardized semistructured interview to assess the severity of psychosocial changes following illness, the Freiburg Questionnaire on Coping with Illness, the Cornell Depression Scale and instruments to assess motor impairment. Psychosocial alterations were most prominent in the professional and emotional-cognitive domains. Degree of depression correlated with familial and emotional-cognitive alterations in both patient groups. Active problem-oriented coping and distraction predominated as coping styles. Religious relief and quest for sense were significantly more important for the PD patients. Coping styles did not correlate with degrees of depression, motor impairment or psychosocial alterations.
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PMID:Coping with chronic neurological impairment: a contrastive analysis of Parkinson's disease and stroke. 902 Dec 79

Post-cerebrovascular accident depression (PCVAD) affects 30 to 50% of hemiplegic patients in the first two years post-CVA, and has major physical and social repercussions. Particularly closely studied since the beginning of the eighties, PCVAD is considered a therapeutic entity in its own right by many authors. The clinical picture is one of melancholia in 5 to 25% of cases, and of minor or masked depression (with psychomotor retardation and somatic disorders predominating) in 75 to 95% of cases. Etiopathogenesis varies depending on post-CVA period: during the first few months, the depletion of intra-cerebral neurotransmitters is considered to play a dominant role; subsequently, difficulty in coping with the handicap would appear to be the main factor. The diagnostic scales which may be used are CIM 10 or DSM IV. For quantification, Hamilton's, the MADRS, Zung's or the CESD scales may be used. There is as yet no scale specific to PCVAD. The therapeutic approach still remains empirical, due to the rarity of published studies. Tricyclic antidepressants and inadvisable as first-line treatment due to their anticholinergic effects. Serotoninergic agents are well tolerated, but their efficacy is currently insufficiently documented, despite a recent study. Electroconvulsive therapy (ECT) has been tried, with a certain degree of success, by some authors, but no controlled study is currently available. Personal and familial psychological management would appear necessary but this has not yet been validated. In a preliminary, open-label study in 15 patients presenting with PCVAD, the authors obtained normalization of the MADRS in 10 cases following 6 weeks of treatment with fluoxetine (Prozac). No adverse effects were observed. A multicenter, controlled study is currently ongoing in Bordeaux, France.
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PMID:[Post-cerebrovascular stroke depression]. 933 62

One hundred and seventeen elderly residents of seven geriatric health facilities located in Tokyo participated in this study. The Mini-Mental State, Metamemory in Adulthood, Geriatric Depression Health Scale and demographic questionnaires were used in face-to-face interviews. The subjects were 32 males and 85 females, with a mean age of 83.08 years. Depression was found to be a key factor for explaining metamemory. Depression accounted for 17% of the variance in capacity and 23% in change. There were no differences between the mild cognitive impairment group and the cognitively intact group on achievement, capacity, change, locus and strategy subscales. When depression was considered as a moderating factor, a difference arose between two cognitive levels. History of stroke was not related to metamemory in this study; however, future studies should emphasize memory awareness in brain injury residents since 41% of the sample had a history of CVA.
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PMID:Memory awareness among Japanese nursing facility residents. 1048 50

Depression is a common disorder in older people. It is usually undiagnosed in elder patients due to atypical symptoms, masked depressive state, mixed with agitation, psychotic delusions and worsening of physical symptoms already present or multiple pains in extremities. It is a very common associated comorbidity with patients of all disciplines--as in post CVA state or postmyocardial infarction, postoperative state, posthysterectomy or in recovery state of various medical disorders, even in a viral influenza, or in a metabolic medical disorder like diabetes mellitus. Author has studied and analysed 120 patients in different wards of Midnapore Medical College & Hospital and some others usually referred by other physicians at OPD and have found high incidence of depression and a marked improvement of symptoms after a short period of treatment.
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PMID:Depression in older people: a point to remember in all specialties. 1588 24

Dutch GP's (General Practitioners) take care of people living in homes for the elderly. The population of these homes is selected on the basis of poor functioning on ADL (activities of daily living). We expected to find a group of elderly people within these homes that need more complex primary care. We describe the characteristics of care for an institutionalized elderly population and compare these to the care provided to their independently living peers. The design of this study is a matched case-control study in a Dutch General Practice in the study period 1/1/1998 to 1/7/2004. Our main results show that the rate of cognitive problems is two times, the prevalence of depression even three times higher in older people living in a home for the elderly than in those who live independently. Locomotory problems are a frequent problem in homes for the elderly. Rates of chronic pulmonary problems, atherosclerosis-related diseases and urinary tract infection are higher, whereas no significant differences for CVA, diabetes and cancer were found. Institutionalized older patients use more different types of medication. GP's do not have more contacts with people living in a home for the elderly than with older people living independently. We conclude that people living in homes for the elderly have complex problems, and need special attention for their specific vulnerability. Differences in care are not primarily explained by chronic disease but by problems with mobility, confusion, depression and cognition.
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PMID:[Primary care in homes for the elderly]. 1863 98

Falls of patients represent the most frequent reported incidents in our 541-bed urban public hospital, reaching more than 200 occurrences per year.This prompted a fall-prevention program consisting of several steps: i) descriptive analysis of 295 consecutive falls in order to look at the factors commonly supposed to be associated with falls, among physical, psychic and pathological characteristics of patients, medication, circumstances or environmental hazards, ii) case-control study on 10 medicine and surgery wards of high risk (178 patients), designed to identify which factors are discriminant to predict the falls, iii) proposal of a fall-risk assessment score to be calculated at the admission of the patient, iv) if the risk is confirmed, implementation of general and specific actions identified by the components of the score. The score is based on a 15-point scale including age older than 65 years, history of previous falls, weakness or insufficient weight, impaired mobility or altered feet state, psychic disorders (depression-agitation-risky behavior), neuro-psychiatric diseases (CVA-confusion-dementia), fever or infection, polypharmacy. The mean scores of fallers and of control patients were 7.53 +/- 3.02 and 4.81 +/- 2.93 respectively (p < 0.000001). A score range between 5 and 11 was chosen to start the fall prevention program, which may predict a large proportion (about 80%) of valid patients prone to falls in the assessed medical and surgical wards (scores higher than 11 correspond to severely diseased, often bedridden invalid patients, not suspected to fall). However, these criteria are not suitable for nursing homes and for long-staying patients.
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PMID:[Putting into place devices for prevention of falls at the hospital center at Haguenau]. 2018 Mar 37

The patent foramen ovale (PFO) is a controversial risk factor for CVA or TIA. In our center, adult PFO patients diagnosed with post cryptogenic CVA/TIA undergo trans-catheter closure of the PFO to decrease the risk of recurrent stroke. The aim of the study was to compare levels of functioning, depression and anxiety in post PFO closure patients following cryptogenic CVA/TIA and in other patients post CVA/TIA without PFO. Eighty-nine patients who had undergone trans-catheter PFO closure and 56 non-PFO post-CVA patients completed demographic, functioning, anxiety and depression questionnaires. Additional medical data were recorded from the medical files. Patients who had undergone trans-catheter PFO closure post CVA or TIA reported better level of functioning and substantially lower levels of depression and anxiety. The 70% of depression and 55% of anxiety variances were explained by female gender, older age, lower education, lower functioning level and additional health problems. Functioning level was the strongest contributor to the explained variance of psychological symptoms. We conclude that patients who have undergone trans-catheter PFO closure following cryptogenic CVA/TIA, which may prevent stroke recurrence, show good functioning and low levels of psychological symptoms. The procedure helps to keep these patients in a good physical and psychological health.
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PMID:Comparison of psychological symptoms in post-cryptogenic cerebral-vascular accident (CVA) and/or transient ischemic attack (TIA) patients who have undergone foramen ovale closure, and in post-CVA patients. 2107 64


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