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

Since 1987, psychosocial primary care (PPC) provided by General Practitioners, are reimbursed by German health insurances. The aim of the psychosocial primary care is to improve recognition and treatment of mental disorders in the primary care sector. As a part of a eight-center national demonstration program on quality management in the outpatient services, General Practitioners (n = 191) from 5 regions participated in the study. 1341 treatment episodes of patients with predominately psychosocial strain were documented. Differences between psychosocial strain, treatment and outcome were determined by analyses of variance. Men and patients beyond the age of 65 were underrepresented. Psychosocial treatments were offered more often to those patients, who had the highest level of anxiety and depression. Patients with physical illness, with pain and without psychological attribution to the illness belief were offered less psychosocial interventions and reached a worse outcome. The study outcome helps to improve training programs as to recognition and treatment of psychosocial problems in primary care. Male and generally elderly patients with somatic symptoms and lack of psychological attribution need a special psychosocial intervention to improve the outcome.
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PMID:[Psychotherapeutic and psychosocial therapy in general practice. Results of demonstration project on quality management in psychosocial primary care]. 1090 96

The purpose of the study was to investigate the natural history of insomnia and its association with depression and mortality. In 1983, 1,870 randomly selected subjects aged 45-65 years answered a questionnaire on sleep and health. Of the 1,604 survivors in 1995, 1,244 (77.6%) answered a new questionnaire with almost identical questions. Mortality data were collected for the 266 subjects that had died during the follow-up period. Chronic insomnia was reported by 36.0% of women and 25.4% of men (chi2 = 9.7; p < .01). About 75% of subjects with insomnia at baseline continued to have insomnia at follow-up. Insomnia in women predicted subsequent depression (odds ratio [OR] = 4.1; 95% confidence interval [CI] 2.1-7.2) but was not related to mortality. In men, insomnia predicted mortality (OR = 1.7; 95% CI 1.2-2.3), but after adjustment for an array of possible risk factors, this association was no longer significant. Men with depression at baseline had an adjusted total death rate that was 1.9 times higher than in the nondepressed men (95% CI: 1.2-3.0).
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PMID:Relationship between insomnia, depression, and mortality: a 12-year follow-up of older adults in the community. 1108 51

The authors compared characteristics of 27 older men who perpetrated a spousal homicide-suicide and 36 age-matched married men who committed suicide in west central Florida between 1988 and 1994. Data were collected as part of an ongoing retrospective study of homicide and suicide among older adults in Florida. Men who committed suicide had significantly more disease conditions than homicide-suicide perpetrators (P<0.0001). Half of the latter were in caregiving roles, vs. 17% of the suicides (chi(2)=5.40; P=0.027). Depression was a prominent premorbid feature of both groups, but none of the perpetrators tested positive for antidepressants postmortem.
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PMID:A comparison of antecedents of homicide-suicide and suicide in older married men. 1115 52

The aim in this study was to assess the frequency and type of self-reported side-effects among hypertensives in a general population, and to estimate the relationship between drug use and side-effects and health utility using the Rating Scale (RS) method. The study is based on a postal questionnaire that was sent to a random sample of 8000 inhabitants aged 20-84 years (response rate 68%) in Uppsala County, Sweden, in 1995. The results showed that nearly 20% of the users of antihypertensive drugs reported side-effects. Men and women reported side-effects to nearly the same extent. In the linear regression analyses, those with hypertension, with or without medication, rated lower health utilities (-6.0 and -7.1 respectively) than did normotensives after controlling for age and sex. The lowest value, -8.7, was found among drug users who experienced side-effects. Side-effects causing impotence and emotional distress, i.e. insomnia, tiredness and depression had the strongest negative impact on health utility. To conclude, the study showed that side-effects among hypertensives are common. Both the disease and the drug treatment adversely affect the patient's well-being. However, drug treatment was of less importance than that found in prior studies. The findings here stress that side-effects should be taken into greater consideration when evaluating drug treatment.
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PMID:Self-reported side-effects of antihypertensive drugs: an epidemiological study on prevalence and impact on health-state utility. 1121 61

The reasons for a greater prevalence of psychological distress among women than men remain unknown. We sought to test two hypotheses that gender operates either as (1) a moderator or (2) a mediator between psychosocial risk factors and experienced distress. A cross-sectional community survey of 1,062 adult Russian-born Jewish immigrants to Israel was conducted. The Demographic Psychosocial Inventory (DPSI) and the Talbieh Brief Distress Inventory (TBDI) were used to measure the parameters of interest. Univariate and multivariate analyses were used to test the moderation versus mediational hypotheses of gender in the stress-distress relationship. The aggregate levels of psychological distress and depression, anxiety, and obsessive symptoms were significantly higher for women than for men. Five sources of distress were more likely to be reported by women: family problems, inappropriate climatic conditions, anxiety about the future, poor health status, and uncertainty in the present life situation. Men scored higher on three stress-protective factors: the number of reasons for immigration, commitment to the host country, and job adequacy. Results of multiple regression and multivariate analysis of variance (MANOVA) supported the mediation hypothesis that gender differences in psychological distress stem from women's greater exposure to specific psychosocial stressors. Our findings demonstrate the validity of gender as an important mediating mechanism underlying the differential perception of risk factors for the development of psychological distress.
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PMID:Gender differences in psychosocial risk factors for psychological distress among immigrants. 1124 52

The purpose of this study was to prospectively examine the occurrence and severity of sexual dysfunction symptoms in depressed patients before and after 6 months of treatment with selective serotonin reuptake inhibitors. The study was part of a randomized, double-blind, controlled trial of sertraline or citalopram in patients with a DSM-III-R major depressive disorder treated by general practitioners. Three hundred eight patients (221 women and 87 men) were assessed at baseline and after 6 months of treatment by means of the Montgomery-Asberg Depression Rating Scale and five items from the Utvalg for Kliniske Undersogelser (UKU) Side Effect Scale covering different aspects of sexual functioning. As measured by the UKU Side Effect Scale, sexual desire and mean total score significantly improved in women, and sexual desire improved in men. Men reported no change in orgasmic dysfunction, erectile dysfunction, or mean total score, but there was a trend toward worsening of ejaculatory dysfunction. However, in the subgroup of women who reported no sexual problems at baseline, 11.8% reported decreased sexual desire, and 14.3% reported orgasmic dysfunction at week 24. The corresponding figures in the same subgroup of men were 16.7% and 18.9%, respectively, and as many as 25% experienced ejaculatory dysfunction after 24 weeks. There were no statistically significant differences between sertraline and citalopram in the magnitude or frequency of adverse sexual side effects.
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PMID:Effect on sexual function of long-term treatment with selective serotonin reuptake inhibitors in depressed patients treated in primary care. 1127 Sep 11

Psychoneuroimmunology (PNI), the study of the impact of psychological factors on immunological diseases, has been studied in relation to AIDS in a flurry of research over the past 10 years. PNI research has shown that some psychological states lead to AIDS progression, while others improve immunity and survival. Some factors that affect these states include the degree of fatalism regarding HIV; the degree and duration of stress, grief, or depression; awareness of life purpose and goals; and self-assertive ability. Certain immune-suppressing factors, such as fear and panic regarding death, result from living during a public health crisis. Researchers at the University of California, Los Angeles, report that fatalistic beliefs regarding HIV status are negatively associated with health outcome. Survival was shortest in study participants who were both fatalistic and recently bereaved. Further study found that fatalistic thinking and bereavement led to immune marker changes that are tied to AIDS progression. Researchers remain divided over whether PNI research findings should be applied to the treatment of HIV patients. HIV-related PNI programs have emerged in recent years at the University of Miami, the San Diego Lesbian and Gay Men's Community Center, and Harvard University.
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PMID:Psychoneuroimmunology: a basis for HIV treatment. 1136 57

The Obvious Depression Scale was administered to 739 community residents at ages 50, 60, and 80 years, with 151 present at all waves. Although selective attrition influenced the level of depressive symptoms in cross-sectional vs. longitudinal samples, both sets of analyses revealed higher scores in women than in men at ages 50 and 60, but not at age 80. Men showed increases in depressive symptoms from age 60 to 80, but women did not (interaction p < .002). This interaction was not present in somatic symptoms, which increased across time in both genders. Potential explanations include differential changes in social roles with aging.
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PMID:A longitudinal study of gender differences in depressive symptoms from age 50 to 80. 1140 20

Functional depression (i.e., depression without neuropathology) occurs approximately twice as often in women as in men. A review of the literature from the period 1966-1999 on the prevalence, clinical correlates, and treatment of depression in neurologic disease revealed a female preponderance of depression in diffuse neurologic disease, including Alzheimer's disease. In focal neurologic disease, the data were consistent for men and women, with a 1:1 ratio. Treatment data on depression in neurologic disease are scant, with the exception of poststroke depression. Although gender-based outcome data on the treatment of functional depression reveal better tolerability and response to serotonin reuptake inhibitors in women than in men, this phenomenon cannot be generalized to depression in neurologic disease. Men seem to consistently respond better than premenopausal women to tricyclic antidepressants in both functional and neurologic disease. Understanding how gender influences depression in neurologic illness and its response to treatment is a necessary step to improve the specificity of psychiatric treatment for depression.
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PMID:Gender differences in depression associated with neurologic illness: clinical correlates and pharmacologic response. 1148 Jan 3

This study determined the frequency of problematic substance use and of counseling about drug and alcohol use among 867 women and 320 men who reported symptoms of depression in managed primary care clinics. Seventy-two (8.3 percent) of the women and 61 (19 percent) of the men reported hazardous drinking; 228 (26.3 percent) of the women and 94 (29.4 percent) of the men reported problematic drug use, including use of illicit drugs and misuse of prescription drugs. Only 17 (13.9 percent) of the patients who reported hazardous drinking and 18 (6.6 percent) of those who reported problematic drug use received counseling about drug or alcohol use during their last primary care visit. Men were significantly more likely than women to have received counseling about drug or alcohol use from their primary care practitioner.
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PMID:Problematic substance use, depressive symptoms, and gender in primary care. 1153 3


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