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

EMD 49980 is a dopamine agonist with selective affinity to dopamine autoreceptors. Following pharmacological findings in animal studies, it was postulated that a hyperactivity of dopaminergic neurons, which is possibly present in acute schizophrenia, may be reduced by autoreceptor stimulation. To investigate the antipsychotic efficacy of EMD 49980, 20 acutely ill schizophrenics (ICD No. 295.3) were treated over four weeks with dosage increasing up to 3 mg or 9 mg. According to previously defined criteria four patients were clear responders, but clinically none of them revealed a full remission. Ten patients were nonresponders, and three of these patients were drop-outs because of marked deterioration of schizophrenic symptoms. The explorative analysis of BPRS subscales shows a statistically significant reduction of anxiety/depression and anergia, but no clear influence on the subscales THOT, HOST, and ACTV, which are the more specific scales for acute schizophrenia. EMD 49980 was subjectively well tolerated and there was no case of drug-induced extrapyramidal side-effects. In view of the only moderate antipsychotic efficacy in acute schizophrenia and the fact that antidepressant and anxiolytic effects were also observed, a clinical investigation of EMD 49980 in affective disorders and in schizophrenia with depression or anergia should be performed.
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PMID:Antipsychotic efficacy of the dopaminergic autoreceptor agonist EMD 49980 (Roxindol). Results of an open clinical study. 168 39

A sample of 83 first-admitted patients with delusional depression were diagnosed according to DSM-III, ICD-9 and reactive and endogenous types. They were followed up twice after a mean of 10 and 18.5 years. As to background, course and outcome variables DSM-III schizoaffective patients were closely related to affective patients. A small difference between reactive and endogenous type was accounted for by the endogenous subgroup of DSM-III schizoaffective patients. The study provides evidence for dismissing the reactive-endogenous distinction in terms of psychotic depressive disorder, but in terms of schizodepressive disorder the issue is less clarified based on course and outcome.
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PMID:Unipolar delusional depression. Outcome in reactive versus endogenous types. 178

The efficacy of the S2-antagonist ritanserin has not yet been clarified satisfactorily. In an open indication finding study to generate new hypotheses concerning its possible therapeutic application carried out in the psychiatric university clinic 25 patients (10 patients with vitalized neurotic depression (ICD No. 296.1), 7 with florid depressively tinged schizophrenia (ICD No. 295.3)) were treated with an average of 15.5 mg/day of ritanserin for a period of 4 weeks. Alterations in the psychopathological findings were documented by means of the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA), and the psychopathological findings (page 4) of the AMDP system. The results suggest that ritanserin improves depressive rather than schizophrenic symptomatology. In 4 of the 7 schizophrenic patients of our study an intensification of the psychotic symptomatology could even be observed. On the basis of our open study findings ritanserin could be classified as a substance with antidepressive effects, with a low incidence of side-effects and a rapid onset of action. In placebo controlled clinical studies this indication should be examined in different patient groups.
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PMID:Psychotropic effects of ritanserin, a selective S2 antagonist: an open study. 182 98

The comparative validity of six operational diagnoses of major depression was evaluated in 600 psychiatric inpatients using the independently assessed clinical ICD-9 diagnoses as a yardstick. Agreement with, and positive predictive value for the ICD-9 categories of pure (endogenous and psychogenic) depression served as validation criteria; sensitivity of major depression diagnoses for detecting ICD-9 bipolar depressions was additionally used for examining the adequacy of width, time and exclusion criteria of the competing operational definitions. Three essential results were found. First, the "old" diagnostic definitions of RDC and FDC are superior to all newer definitions because they define the time criteria and the schizophrenic exclusion criteria more adequately than, for example, both DSM-III and DSM-III-R definition. Secondly, the current ICD-10 definition of 1989 ("mild", "moderate" or "severe" depression) comes closer to the concurrent validity of RDC and FDC than DSM-III, DSM-III-R and the previous ICD-10 definition of 1987. Thirdly, using the criterion of identifying a high proportion of ICD-9 bipolar depressions, all six competing diagnostic systems are too restrictive. Evaluations of predictive and criterion-related validity will be needed to substantiate these findings.
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PMID:The concept of major depression. III. Concurrent validity of six competing operational definitions for the clinical ICD-9 diagnosis. 182 2

This study aimed to investigate the psychological characteristics of chronic fatigue syndrome (CFS: Holmes et al. 1988). A battery of psychometric instruments comprising the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), the Minnesota Multiphasic Personality Inventory (MMPI) and the Lazarus Ways of Coping (WoC) inventory, was administered to a sample of clinically-defined CFS sufferers (N = 58), to a comparison group of chronic pain (CP) patients (N = 81) and to a group of healthy controls matched for sex and age with the CFS sample (N = 104). Considerable overlap was found between CFS and CP patients at the level of both physical and psychological symptoms. This raises the possibility that CFS sufferers are a sub-population of CP patients. However, while there was some commonality between CFS and CP patients in terms of personality traits, particularly the MMPI 'neurotic triad' (hypochondriasis, depression and hysteria), CFS patients showed more deviant personality traits reflecting raised levels on the first MMPI factor, emotionality. Moreover, results were not consistent with the raised emotionality being a reaction to the illness, but rather were consistent with the hypothesis that emotionality is a predisposing factor for CFS. The majority of CFS patients fell within four personality types, each characterized by the two highest MMPI scale scores. One type (N = 20) reported a lack of psychological symptoms or emotional disturbance contrary to the overall trend for the CFS sample. This group conformed to the ICD-10 classification of neurasthenia.
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PMID:Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome. 187 40

In a double-blind study, 41 schizophrenic patients (ICD, 9th rev.) were divided into two groups. With a flexible dose, twenty patients were treated with haloperidol, twenty-one with amisulpride. With respect to relevant criteria such as age, sex, length and degree of illness, the two groups were comparable. The study was conducted over 42 days. As early as within the first 14 days, both groups showed significant improvement with respect to their psychotic symptoms. When the two groups were compared on the basis of the BPRS subscore for the anxiety-depression syndrome, and the AMDP system subscores for the somatic-depressive syndrome and the hypochondriac syndrome, the amisulpride group showed significantly better results than the haloperidol group. The ratings on the EPS scales of Webster and Simpson revealed significantly fewer extrapyramidal side-effects in the amisulpride group. Psychotic symptoms were improved after both types of treatment. Amisulpride treatment showed better results with regard to depressive symptoms, and less tendency to generate extrapyramidal side-effects.
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PMID:Amisulpride versus haloperidol in treatment of schizophrenic patients--results of a double-blind study. 197 43

Sixty-five inpatients of a psychosomatic hospital in the Federal Republic of Germany with the diagnosis of anxiety neurosis (n = 31) or neurotic depression (n = 34) as defined by the International Classification of Disease (ICD-9), were randomized to a 4-week course of ipsapirone at 7.5 mg t.i.d. or placebo in a prospective, double-blind clinical trial to assess safety, tolerability, and efficacy. This article reports the efficacy results for those patients with the diagnosis of neurotic depression. The primary efficacy variable for patients with neurotic depression was the change from baseline in the Hamilton Rating Scale for Depression (HAM-D) at 4 weeks of treatment. Considering all of the randomized patients with neurotic depression (n = 34, the intent-to-treat population), the mean change from baseline in the HAM-D at Week 4 (observed cases) was -13.13 +/- 6.06 (n = 16) for the ipsapirone group, and -3.19 +/- 5.99 (n = 16) for the placebo group (p less than .001). A parallel analysis of the change from baseline in the Core Depression score of the HAM-D (defined as the sum of items 1, 2, 3, 7, and 8) also showed a significant treatment difference (p less than .01). Results were similar for the intent-to-treat population, last observation carried forward. Safety and tolerability were evaluated for all study patients independent of diagnosis. Treatment-emergent events (n = 65) were reported by 76 percent of patients treated with ipsapirone (n = 33) and by 38 percent of patients treated with placebo (n = 32).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ipsapirone: evidence for efficacy in depression. 197 72

The frequency of depressive illness was investigated in 195 patients who had been referred consecutively after attempted suicide during the period 15. February 1989-15, October 1989. A total of 130 of these patients were admitted to hospital while the remainder were treated in the psychiatric emergency room or admission department. Registration of depressive symptoms on admission revealed that 85% had depressed mood and other depressive symptoms. According to the criteria established by Feighner et al. 51% suffered from definite depressive disease on admission. According to Zung's Depression Scale, 60% were depressed. On the basis of observations during hospitalization, 25% suffered from depressive disease according to the criteria established by Feighner et al. 19% of these patients suffered from endogenic depression according to the Newcastle I scale which corresponds to 5% of all the hospitalized patients with attempted suicide. Approximately 10% were treated with antidepressives. Only 8% were discharged with the diagnoses of endogenic or reactive psychoses (ICD-8). It is concluded that depressive symptoms occur in the majority of patients with attempted suicide but that slight non-endogenic depressive states are most commonly concerned and that many of these improve rapidly during hospitalization without medicinal treatment. Restraint should be observed in prescription of antidepressive medicine to patients with attempted suicide until the diagnosis of depressive disease is verified.
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PMID:[Attempted suicide and depression]. 201 67

In this review the traditional concepts of endogenous depression and modern trials of classification in operationalized diagnostic systems, especially in DSM and ICD, are critically discussed. The psychopathological and other phenomenological symptomatologies of endogenous (cyclothymic) depression within monopolar and bipolar affective psychoses and the diagnosis and differential diagnosis above all against schizophrenia, organic brain diseases and psychoreactive disorders, are described. The possibilities and limitations of operationalized classifications with regard to diagnostic reliability and validity are presented. At present state of research homogeneous groups of patients with regard to affective and other idiopathic psychoses and here depressive syndromes and episodes cannot be defined, neither with the traditional concepts nor with the up to now available operationalized diagnostic classifications. In contemporary operationalized diagnostic systems among others the psychopathological and other phenomenological criteria are not sufficiently or too vaguely defined, the different significance of the requested inclusion-criteria and the intraindividual variability with regard to single episodes and subsequent phases of the depression are too little considered. Up to now all trials failed to validate different diagnostic concepts of depression by biological markers. Clinical psychopathological diagnosis of endogenous depression according to the traditional psychiatry criteria may reach a better validity under certain conditions than diagnoses according to DSM-III-R or ICD 10. To use exclusively operationalized diagnostic systems instead of clinical diagnosis in the diagnostic practice but also in research would be too early at present. Modern diagnostic systems can complete the clinical diagnosis but not replace it.
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PMID:Diagnostic aspects of depression. 204 60

To test the hypothesis that the antidepressant effects of total sleep deprivation (TSD) are linked to the serotonergic and/or noradrenergic system the authors carried out a double-blind study (fluvoxamine versus maprotiline) in 42 inpatients with endogenous depression (ICD). Patients were randomized to a four-week treatment with either fluvoxamine (100-300 mg/day) or maprotiline (100-300 mg/day). In addition, patients underwent a TSD procedure before and after one week of antidepressant medication. There was a statistically significant reduction of depression ratings (HDRS) in both the fluvoxamine and maprotiline group. The day-1 response to TSD before antidepressive medication was not associated with a clear relationship to the outcome after four weeks of treatment with either fluvoxamine or maprotiline. On the other hand, the day-2 response to TSD was significantly correlated with a good outcome to subchronic treatment with maprotiline. Furthermore, the results of the authors' data suggest that a favorable short-term outcome of TSD may be connected to antidepressants enhancing the serotonergic neurotransmission. The global comparison between fluvoxamine and maprotiline revealed that the group of patients treated with fluvoxamine had a significantly higher efficiency index (CGI) than the maprotiline group; fluvoxamine was rated to be tolerated excellently in 70% of the patients whereas this percentage was only 43% in the maprotiline group. There was also significantly more vertigo and dry mouth in the maprotiline group whereas the fluvoxamine group was rated to have significantly more sleep disturbances during the trial.
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PMID:Response to total sleep deprivation before and during treatment with fluvoxamine or maprotiline in patients with major depression--results of a double-blind study. 211 80


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