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

The importance of 'typical' diurnal variations in mood (depression worse in the morning) as a diagnostic criterion of endogenous depression has been challenged in previous investigations. Disturbance in time experience may contribute towards an understanding of diurnal variation in depressive symptomatology. To examine this hypothesis a series of time estimation experiments was conducted in the course of the day. Twenty-five endogenous depressive patients (according to ICD-9) and 12 healthy controls were asked to estimate prospectively a 30-s interval on two successive days at 7.30 a.m., 11.30 a.m., 3.30 p.m. and 7.30 p.m. Simultaneously the subjects assessed their state of well-being using a visual analogue mood scale. A circadian rhythm of time estimation errors could not be detected; even in daily courses with 'typical' diurnal variations an increasingly favourable self-assessment of well-being was not accompanied by a corresponding diurnal fluctuation of time estimation. These results cast additional doubts on the significance of 'typical' diurnal variations in depressive symptomatology.
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PMID:The daily course of the symptomatology and the impaired time estimation in endogenous depression (melancholia). 252 98

Brofaromine (CGP 11 305 A), a new reversible and selective MAO-A inhibitor, was studied in two multicentre, (Trial A and Trial B) double-blind, dose-finding trials in a total of 124 depressed in-patients. Doses of 25, 50 and 75 mg bid were compared, to determine which was the most effective. The duration of the trials was four weeks. The comparative drugs were nomifensine (100 mg/day) and tranylcypromine (20 mg/day). The majority of patients in the Trial A was classified as "endogenous" depression. Diagnosis of depression was based on DSM-III or ICD-9 criteria. Conversely, most of the patients in Trial B were "non-endogenous" depressives. In "endogenous" depression, a statistically significant linear dose-response relationship was found in all the efficacy variables assessed. The most effective dose was 150 mg/day. This dose gave a mean drop of 25.3 +/- 11.9 (S.D.) points in the total Hamilton Depression Rating Scale (HAMD) scores and provided successful treatment in 83% of the patients treated, success being defined as a drop of at least 50% in the initial HAMD score at the end of the trial period. In "non-endogenous" depression, no statistical difference was found between the four treatment groups in any of the efficacy variables assessed. Response rate in all brofaromine groups averaged 59% (tranylcypromine group 60%). Tolerability was good in 90% or more of the brofaromine patients in both trials, regardless of the dose administered. The side effects reported most frequently were sleep disturbances, nausea, and headaches.
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PMID:Therapeutic and side-effect profile of a selective and reversible MAO-A inhibitor, brofaromine. Results of dose-finding trials in depressed patients. 267 40

We examined covariations between results of the dexamethasone suppression test (DST) and suicidal behaviour for 44 patients who had attempted suicide at least once; the suicide methods, diagnoses and time factors were controlled for. The control groups comprised 82 psychiatric patients and a sample of 69 patients with endogenous depression. In spite of hypotheses suggesting the contrary, there was no significant relationship between DST results and acute suicide attempts. Although patients who had used "soft" methods were often suppressors, chi-square tests using the suicide classification of the ICD-9 as well as tests employing more precise subcategories failed to reveal any significant covariation. In groups of patients with an identical diagnosis of endogenous depression, the sensitivity of the DST with regard to suicide attempts was 52%. The difference between suppressors and nonsuppressors in previous suicide attempts was insignificant. Further, the Hamilton Rating Scale for Depression profiles of DST suppressors and nonsuppressors showed no significant differences with regard to either different symptoms or the evaluation of acute suicide risk.
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PMID:The dexamethasone suppression test and suicide attempts. 271 55

Illness behaviour patterns were evaluated in 31 psychiatric patients, who had predominant somatic complaints to which there were no organic basis, using the Illness Behaviour Assessment Schedule. Psychiatric examination was also done and diagnosis given according to ICD-9. The relationship between abnormal illness behaviour and certain socio-demographic variables was examined. Younger patients more often had disease phobia (p = 0.05) and pre-occupation with disease (p = 0.003). Interesting trends were observed in different religious groups, as regards their beliefs about the 'cause' of somatic symptoms. Patients diagnosed as neurotic (anxiety or depression) significantly more often (p = 0.024) regarded their illnesses to be somatic in origin. The relationship between somatisation and abnormal illness behaviour is found to be complex, and the cause-effect relationship is not fully understood.
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PMID:Somatisation and illness behaviour. 272 91

Neurasthenia is one of the commonest diagnostic terms in psychiatric practice in China, but it is employed less and less by psychiatrists in the Western world. In order to investigate what diagnoses would be given in terms of modern Western standard diagnostic systems, 40 patients who were diagnosed as suffering from neurasthenia by two Chinese psychiatrists were rediagnosed according to ICD-9 descriptive criteria, using the Catego computerized system based upon PSE findings and DSM-III criteria based on findings of the Diagnostic Interview Schedule (DIS). Furthermore a set of self-report or observer rating scales, including the SAS, SDS, HAMA, HAMD and BPRS, were administered to evaluate their psychopathological characteristics. The main findings are the following: (1) the distribution of the results of rediagnosis is widely dispersed from mild character disorder to severe affective disorder; (2) most of these patients are diagnosed as having an anxiety or depressive illness in different diagnostic systems; (3) the majority of diagnoses belong to the field of neurosis in all systems except DIS/DSM-III; (4) there is a group of patients who do not belong to any diagnostic entity in these systems; (5) the prominent psychopathological features are anxiety and depression and often a combination of both, which adds to the complexity of the clinical picture; and (6) these patients tend to over-report their suffering or symptoms, which results in a discrepancy of findings between objective assessment and self-reporting. The author suggests that the term neurasthenia represents a disease spectrum and should be refined in future study, but that it seems too early to discard it from psychiatric nosology.
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PMID:The diagnosis and phenomenology of neurasthenia. A Shanghai study. 276 91

Using a two-stage screening procedure, ICD-9 diagnostic criteria, and the Hamilton Rating Scale for Depression, the authors diagnosed depressive disorders in 81 (9.2%) of 881 patients in a primary care setting in Kenya. All depressed patients had somatic symptoms, and all of the 27 depressed patients assessed with the Hamilton scale scored higher than 2 on the work and activities item. These findings contradict the earlier reports that Africans do not admit to being depressed. Nearly one-third of the depressed patients were moderately or severely ill and would have benefited from psychiatric assessment and treatment.
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PMID:Prevalence and presentation of depressive illness in a primary health care setting in Kenya. 278 47

In the Upper Bavarian Field Study a total of 1536 persons (15 years and older) were interviewed by research psychiatrists. The prevalence of diabetes (ICD 250) identified by the interviewer and/or the primary care physician was 4.0%. Since the number of diabetics among the younger age groups was relatively low (n = 7) and in order to obtain a more homogeneous study group, only those over the age of 55 were considered in further analysis. Diabetics were compared with a control group of persons with another chronic medical condition of similar clinical severity and a control group without a somatic disorder. The sex- and age-adjusted prevalence of psychiatric disorders identified with the aid of the Clinical Interview Schedule was significantly higher among diabetics (43.1%) and persons with other chronic medical conditions (50.7%) in comparison to the healthy control group (26.2%). The difference was mainly due to mild psychiatric disorders and those suffering from depression. No statistically significant association was found between diabetes and moderate to severe mental disorders, the use of psychotropic drugs and previous psychiatric treatment.
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PMID:Psychiatric disorders and diabetes--results from a community study. 279 35

A group of 89 patients admitted to the Psychiatric Unit of a General Hospital, with diagnosis of depression according to ICD-9 criteria and randomly chosen were studied. 26 of them (29.2%) were resistant depressions and 63 (7.82%) responded to treatment. Both groups were composed retrospectively in order to analyse resistance or lack of response to a first treatment with tricyclic or tetracyclic antidepressants in effective dosages. We considered: the personality type; the associated somatic pathology; prolonged social stress; period of evolution of the disorder; previous treatments; type of disorder uni or bipolar; familial morbidity; diagnosis reconsideration; analysis of therapeutic compliance; side effects and intolerance. We observed a statistically significant difference with regard to prophylactic treatment (38.4% resistant versus 98.3% non-resistant, p less than 0.0001); a greater suspicion of psycho-organicity in the resistant group (p less than 0.05); a longer interval of time for the resistant group between the beginning of the disorder and the beginning of treatment in our service (F: 1.45, t: 2.58, p less than 0.01). The alternatives used with our patients are analysed and we propose schedules for tackling this kind of problem.
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PMID:[Refractory depression: therapeutic alternatives]. 280 Dec 64

Tolerability of long term clozapine treatment (7-8 years) was investigated in 27 female patients (age 34-77 years). Diagnosis according to ICD 9 was schizophrenia in 21 patients, severe psychomotor agitation with mental deficiency in 4 patients and an "endogenous" depression in 2 patients. All patients had previously been treated with different neuroleptics but with inadequate response or distressing side effects. The duration of the disorder was 10-36 years, duration of hospitalisation 10-36 years. At the day of investigation the total dose of clozapine ranged from 52-826 g, the average total dose being 385 g. The daily dose of clozapine ranged from 75 to 600 mg, the average daily dose being 225 mg. Only 2 patients were treated exclusively with clozapine, the other 25 patients were also receiving other neuroleptics. Seventy eight per cent of the investigated patients complained about hypersalivation and 63% showed overweight. In 37% of the patients the EEG demonstrated abnormalities. Mild parkinsonism was reported in 15% and akathisia in 11% of the patients, all these patients being on combined treatment. Clozapine did not induce tardive dysakinesia (TD) in any of the patients within a treatment period of 7-8 years. It is concluded that a potential benefit of clozapine includes a low incidence of neurological side effects even after long term administration.
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PMID:Tolerability of long term clozapine treatment. 281 63

Concentrations of the amines and amine metabolites dopamine (DA), noradrenaline (NA), adrenaline (A), serotonin (5-HT), homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA) and of the peptides, vasopressin (AVP), vasoactive intestinal polypeptide (VIP), thyrotropin releasing hormone (TRH) and cholecystokinin (CCK) were measured in lumbar cerebrospinal fluid (CSF) in patients with depression and compared with that of controls. Diagnostic classifications were performed according to ICD-9 and the Newcastle Rating Scales for Depression. The severity of depression was measured by Bech-Rafaelsen melancholia scale. Significantly decreased concentrations of CSF-A and AVP were found in as well endogenous as in non-endogenous depression, whereas reduced levels of CSF-VIP were found only in the non-endogenous group. CSF-5-HT and DA were significantly increased in endogenously depressed patients. In these studies patients with non-endogenous depression were not included. No relationship between severity of depression and concentrations of neurotransmitters was found. For most of the neurotransmitters no correlation between concentrations measured at the lumbar and at the ventricular level seems to exist. This finding indicates that measurements on CSF collected from the lumbar sack not necessarily are indicative for concentrations measured at more central levels. Although several transmitter systems most likely are disturbed in depression, results from studies on lumbar CSF should be interpreted with precaution, until further information about origin and distribution of neurotransmitters in CSF has been obtained.
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PMID:Do concentrations of neurotransmitters in lumbar CSF reflect cerebral dysfunction in depression? 290 16


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