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

Patients diagnosed as suffering from manic-depressive psychosis-depressed (ICD 296.2) were retained and randomly assigned to two groups, one receiving mianserin, the other placebo. For the pre-trial period and throughout the trial, patients' sleep was estimated by themselves and by nurses. Patients rated themselves on the Beck Self-Rating Inventory (BSRI) before the trial and at weekly intervals thereafter. Nurses rated the patients twice daily on a seven-point global rating scale of depression. A blood sample for estimation of mianserin levels was taken on day 14. Eighteen patients received placebo and 21 mianserin. On the BSRI, the mianserin group improved significantly, whereas the placebo group showed no change. The mean daily nurse ratings showed some improvement in the placebo group, but a greater improvement in the mianserin group, particularly towards the end of the 14 days. Sleep (nurses' observations) improved significantly in the mianserin group from the first night of the trial and over the following 2 weeks. Sleep as assessed by the patients also improved significantly on mianserin. Blood levels of mianserin did not correlate significantly with changes in mood or sleep. This study confirms that mianserin is an antidepressant. The mianserin group showed an improvement in sleep which, since it started from the first night of the trial, was probably due to the hypnotic sedative properties of the drug.
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PMID:The antidepressant properties of mianserin and its effect on sleep. 37 85

All patients suffering from affective psychoses (ICD 296) who were admitted to the Psychiatric University Clinic of Zurich between 1959 and 1963 were studied in a follow-up investigation until 1975. Of 254 affective psychoses, 95 were bipolar patients (37.4%) and 159 were monopolar (62.6%). The sample of bipolar patients was complemented with all patients who had been admitted in the period 1959--1963 because of manic or mixed manic-depressive syndromes. This paper describes the change of diagnosis in the two diagnostic groups. In 10% (N = 20) of monopolar depression cases there was a change of diagnosis to bipolar affective illness. An analysis shows that the diagnosis of patients with three or more depressive episodes (unipolar depressives) was especially prone to change. A mathematical correction of some diagnostic errors leads to the conclusion that the ratio of unipolar depression to bipolar illness may be about 1:1. A major source of diagnostic error lies in the change of affective to schizo-affective illness. Up to now, no clinical criterion exists that would exclude this error, which was found in 6% (n=12) of the monopolar but also in 7.5% (n = 3) of the bipolar index patients. It is recommended that studies of affective disorders should be based on truly representative samples of the illness, including patients with one or two episodes, and that the term 'unipolar depression' be used synonymously with the term 'monopolar depression,' originally created by Kleist (1947) and Leonhard (1957).
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PMID:The course of affective disorders. I. Change of diagnosis of monopolar, unipolar, and bipolar illness. 70 27

Many surveys of general populations have suggested a high untreated psychiatric morbidity, vairously referred to as mental illness, pre-clinical neurosis, minor neurosis, untreated depression, etc. An Index of Definition psychiatric disorders is described which incorporates cut-off points on the basis of symptoms rated in the Present State Examination. Eight degrees of definition are specified. At the "borderline disorder" level and above, disorders are sufficiently well defined to apply the CATEGO program of clinical classification. This procedure enables in-patients, out-patients and samples of the general population to be compared. Data from surveys in south-east London are presented in order to illustrate the technique. The main conclusion at this stage is that it is possible to identify, by strictly defined and repeatable procedures, a substantial proportion of people in the general population who have "borderline disorders" that can be tentatively classified in terms of the ICD. Whether it is clinically useful to do so requires further investigation. It is also suggested that techniques of this kind can be scientifically useful in comparing the level of morbidity in various populations, both referred and non-referred, and in testing theories concerned with the causes and treatment of various types of psychiatric disorders.
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PMID:A technique for studying psychiatric morbidity in in-patient and out-patient series and in general population samples. 100 81

On the basis of criminal police files we studied 508 suicides which happened between 1970 up to 1981 in the Ravensburg area in southern Germany. The police files also included medical records about in- or outpatient psychiatric treatment and also data about former violent behaviour. Mental disease as follows were most frequent: Depression 66% (diagnoses were made according to IDC-0 by two doctors under supervision of two senior psychiatrists; ICD-9: 300.4, 309.0 and 309.1 22%, ICD-9 296.1, 296.3 7.1% of the entire suicide group); neuroses and personality disorders 19%, addition, especially alcoholism, 28%. No psychiatric diagnosis could be made retrospectively in 10.6% (54 suicides). Sign in the presuicidal development like depressive symptoms, hopelessness and feelings of having no future, sleeping disturbances, feelings of guilt and anxiety, inner restlessness, but also changes in the direction of serenity and relaxation, treats of suicidal behaviour and reactions of the family and environment were reported showing a broad span of reactions from lack of perception to wrong interpretation. 15% of the suicides had also criminal activities in their former history. From a psychiatric point of view, improved diagnostic and therapeutic procedures in the treatment of the mentally ill, especially in the field of outpatient medical care of depressive and addictive patients, and better information of the relatives is to be demanded in order to prevent suicides.
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PMID:[Suicide in the Ravensburg/Oberschwaben area. Results of a study of 508 suicides based on criminal police records]. 128 28

The Canberra Interview for the Elderly (CIE) has been developed as a field instrument for identifying cases of dementia and depression, doing so strictly according to the diagnostic criteria in both the draft ICD-10 and DSM-III-R. It has been designed to be administered by lay interviewers. Information is gathered from the subject and an informant, and is then processed by computer algorithm to generate diagnoses. In a sample of 76 elderly patients attending a hospital clinic, test-retest reliability was found to be high at the level of individual items. For the diagnoses made on two occasions, agreement was comparable with other standardized psychiatric interviews designed for lay administration in the community. Validity, other than content validity, remains to be assessed. The CIE and its diagnostic algorithms are an efficient tool for clinical and epidemiological research on dementia and depression among elderly people, where close adherence to international criteria is required.
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PMID:The Canberra Interview for the Elderly: a new field instrument for the diagnosis of dementia and depression by ICD-10 and DSM-III-R. 154 33

Though the concept of Major Depression was generated by clinicians using depressed inpatients as models, a polydiagnostic study in 600 psychiatric inpatients with heterogenous psychological disturbances revealed that all six competing operational definitions of Major Depression (including DSM-III-R and ICD-10) were too restrictive to serve as a general concept of depression. Another polydiagnostic study in 500 primary care outpatients showed that more than two-thirds of all non-chronic depressed cases were below the severity threshold of Major Depression: these patients are classified as Depression Not Otherwise Specified (NOS) by DSM-III-R. Loosening of the over-restrictive time criteria would broaden the concept of Major Depression so as to meet the requirements of a general concept of depression, while the definition of Minor Depression below the threshold of Major Depression would add to a reduction of cases of NOS Depression by more than 80%. For the evaluation of antidepressant drugs in outpatient samples, we propose that patients with these modified definitions of Major and Minor Depression be included, provided they meet a minimum severity criterion of 13 or more points on the Hamilton Depression Scale; four-fifths of the modified Major Depression group and one-third of the Minor Depression group do in fact meet this criterion.
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PMID:Differentiation between major and minor depression. 154 47

There has been considerable controversy regarding the relationship between depression and anxiety. We review briefly the descriptive, longitudinal, genetic, biological, and treatment response data indicating that there is overlap between depression and anxiety. Several possible models are explored that provide different conceptions of how this relationship may best be understood: (1) that there are a variety of more or less discrete, but sometimes coexisting, syndromes within the spectrum of anxiety and depression; (2) that symptoms of depression and anxiety represent different external manifestations of a more basic underlying cause; (3) that one condition may predispose to the other; (4) that the association may be due to artifactual definitional overlap, particularly since the instruments used to measure depression and anxiety share so many items. All these propositions are supported. An important, practical question is discussed--should the mixed anxiety/depressive disorder that has been suggested by ICD-10 be included in DSM-IV?
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PMID:Relationship of anxiety and depression. 154 49

The Lifetime and 6 month DSM-III prevalence rates of mental disorders from an adult general population sample of former West Germany are reported. The most frequent mental disorders (lifetime) from the Munich Follow-up Study were anxiety disorders (13.87%), followed by substance (13.51%) and affective (12.90%) disorders. Within anxiety disorders, simple and social phobia (8.01%) were the most common, followed by agoraphobia (5.47%) and panic disorder (2.39%). Females had about twice the rates of males for affective (18.68% versus 6.42%), anxiety (18.13% versus 9.07%), and somatization disorders (1.60% versus 0.00%); males had about three times the rates of substance disorders (21.23% versus 6.11%) of females. Being widowed and separated/divorced was associated with high rates of major depression. Most disordered subjects had at least two diagnoses (69%). The most frequent comorbidity pattern was anxiety and affective disorders. Simple and social phobia began mostly in childhood or early adolescence, whereas agoraphobia and panic disorder had a later average age of onset. The majority of the cases with both anxiety and depression had depression clearly after the occurrence of anxiety. The DIS-DSM-III findings of our study have been compared with both ICD-9 diagnoses assigned by clinicians independently as well as other epidemiological studies conducted with a comparable methodology.
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PMID:Lifetime and six-month prevalence of mental disorders in the Munich Follow-Up Study. 157 82

Recurrent brief depression is now recognised separately in the international classification of diseases (ICD 10). The disorder is characterised by short severe bouts of depression which recur frequently but erratically. In our series of patients the median duration of the depression is 3 days, with two thirds lasting between 2 and 4 days. The severity is often marked with a mean MADRS score of 30, and the episodes recurred 20 times a year. The disorder is easily separated from major depression which lasts 2 weeks or more, although, there is an unfortunate overlap group with major depression superimposed on the recurrent brief pattern. Those with "combined depression" have a higher suicide attempt rate. There should be little overlap with dysthymia since on average only 20% of the time is spent depressed, whereas dysthymia requires a minimum of 50%. However, in practice the qualification of the time spent depressed is imprecise in dysthymia so there is potential for misdiagnosis. There is little overlap with bipolar illness. In our series with follow up of up to 15 years, the conversion rate to bipolar illness is low at 3%. Almost all of these were found to have combined depression, which suggests that the rate for pure recurrent brief depression is very low. These data suggest that pure recurrent brief depression is a unipolar depressive illness.
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PMID:Brief unipolar depressions: is there a bipolar component? 160 Sep 3

The Hospital Discharge Survey of 1980 and 1985 was used to assess changes in diagnostic case mix of psychiatric inpatient care in short-term, nonfederal general hospitals. Information regarding presence of psychiatric and chemical dependency units was added to both surveys, and information regarding exemption from Medicare's PPS system was noted for 1985. The largest increase was in ICD-9 code 296 (affective disorder), which more than doubled in frequency, along with a similar decrease in Diagnosis-Related Group 426, depressive neurosis. One explanation for this sizable shift was "gaming the system." One cannot conclusively, however, distinguish between gaming the system and the effects of changing professional views of depression during this time period. Other variables potentially contributing to the effect are described as well.
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PMID:Changes in diagnostic case mix in psychiatric care in general hospitals, 1980-85. 160 Dec 90


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