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)

Fifty-two patients with depressive illness characterized by four symptoms (periodical course, psychomotor retardation, diurnal variation, unrealistic self-depreciation) and a score of at least 18 on the Hamilton Depression Scale 1-17 (HDS) were allocated to a double-blind randomized study with femoxetine and imipramine. Patients were diagnosed according to RDC and further classified according to the Newcastle-II index. During the six weeks of treatment, efficacy was evaluated by means of HDS and a global evaluation. Side-effect symptoms were recorded on a check-list by questioning. After six weeks of treatment with femoxetine or imipramine (recommended daily standard dosages are 600 mg femoxetine and 150 mg imipramine (b.i.d.); in the present study, dosages were flexible and could be adjusted according to effect/side-effects) evaluation of efficacy based on HDS, a six-item subscale, groups of HDS items as well as single items showed no statistically significant differences between the treatment groups except with regard to the factor for sleep disturbances in the HDS, where greatest reduction was seen in the femoxetine group. No statistically significant differences regarding side-effect profile were seen. However, in the imipramine group, higher frequencies of such moderate to severe symptoms as dry mouth, constipation and urination difficulties were observed (the greatest difference was seen for dry mouth, p 0.1, while p-values for the remaining two symptoms were greater than 0.1). Moreover, based on the patients' own opinion on side-effects, femoxetine seemed to be better tolerated. One patient took an overdosage of approx. 26 g femoxetine; half of the intake was removed by gastric emptying at the hospital.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy and tolerance of femoxetine and imipramine in the treatment of depressive states. A randomized, double-blind study. 306 46

TRH tests were performed on 131 patients with RDC diagnoses of major depressive disorders to study altered endocrine control mechanisms in subtypes of depression. The TSH response to TRH was measured in all patients. In more than a third of the sample the prolactin (PRL) and growth hormone (GH) responses were also analysed. There were no differences between bipolar, primary unipolar and secondary unipolar patients in means of any endocrine variable. However, the expected positive correlation between baseline TSH and delta TSH was absent in the secondary unipolar group, indicating a dysregulation of pituitary TRH receptor sensitivity in this depressive subtype. Only delta TSH was dependent on depressive state, being lower in currently ill primary unipolar patients only. Patients with melancholic features (endogeneity scores high) had blunted TSH responses. Weight loss was connected with TSH blunting in all depressive subtypes. Among patients with blunted delta TSH (less than 5 mU/l) there was no relationship between degree of weight loss and delta TSH. Further, examination of partial correlation coefficients suggests weight loss of affect delta TSH by virtue of its being part of the melancholic syndrome. A significant correlation between blunted delta TSH and nonsuppression of cortisol in the DST was found only among primary unipolar patients, arguing for some independence of the TRH test and the DST in mirroring disturbed endocrine controls in depression.
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PMID:TRH tests with analyses of TSH, prolactin, and GH responses in subtypes of patients with major depressive disorders. 309 81

Masked depression refers to a concept of a phenomenological state, either endogenous or psychogenic where somatic symptoms replace sadness: Thirty patients were evaluated by RDC (22 endogenous and 8 masked depressions) wherein in the latter dysphoria was replaced by a nonreactive persistent somatic complaint. They were rated on Beck and Hamilton Depression Scales, on Hamilton and Trait-State Anxiety Scales and the NOSIE. All patients presented with insomnia, anorexia, loss of weight, diminished libido and anhedonia. Initial ratings were similar for both diagnostic groups except for a significantly higher agitation factor and lower retardation in masked depression. Although 59.9 percent of the subjects are positive on the dexamethasone test, only 1 masked depression did not suppress secretion of cortisol. After a randomized 30-day drug trial where patients were assigned to Clomipramine or Desipramine, patients in both groups show significant improvement on rating scales but diagnostic group drug treatment interaction exists on anxiety and agitation criteria.
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PMID:[Comparison of masked and endogenous depression using psychometric scales, endocrinological markers and pharmacological responses. Masked depression versus endogenous depression]. 309 93

A group of 27 patients with definite (n = 20) or probable (n = 7) RDC major depressive disorder underwent 2 sleep EEGs and 1 TRH test while in a drug-free depressive phase. A short mean REM latency (less than 60 min) identified 55.5% of major depressives while added use of blunted TSH responses (delta max. less than 5 microU/ml) increased that percentage by 11%. When patients were subdivided into RDC endogenous and nonendogenous, mean REM latency and global depression scores distinguished the 2 groups, while delta TSH did not. A short mean REM latency identified endogenous depression with 80% specificity and 76% sensitivity. The combination of REM latency and delta TSH reduced the specificity to 60%, and therefore cannot be recommended for differentiating endogenous from nonendogenous depression.
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PMID:Biological heterogeneity of major depressive disorder: indications by sleep EEG and TRH stimulation test findings. 312 30

Ninety-five inpatient, RDC-diagnosed major depressives, 68 unipolar and 27 bipolar, underwent 72-hour urine collection for the measurement of 3-methoxy-4-hydroxyphenylglycol (MHPG). The average 24-hour urinary MHPG was compared by multivariate analysis of variance with the postdexamethasone cortisol (DST), the delta thyroid stimulating hormone (TRHST), six quantitative EEG (QEEG) measures of regional interhemispheric symmetry and six QEEG measures of focal frequency abnormalities. MHPG failed to discriminate between unipolar and bipolar II depression. It showed no significant correlations with postdexamethasone cortisol or delta TSH. It failed to correlate with QEEG regional coherence or with focal frequency abnormalities. MHPG covaries independently of other markers of depression.
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PMID:Limited clinical utility of urinary MHPG. 313 45

Patients who met provincial criteria for atypical depression were contrasted with a group of patients who met RDC criteria for endogenous depression and a group of normal controls on a standard series of sleep variables. Atypical depressives were differentiated from normal controls by a shortened REMP latency. They did not, however, appear to have the sleep continuity disturbance exhibited by endogenous depressives. This preliminary work suggests that atypical depressives may have a unique pattern of sleep variables consisting of REM abnormalities without continuity disturbance. If this pattern is observed in additional studies, it would add to the validity of considering atypical depression a subtype of unipolar depressive illness.
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PMID:Sleep of atypical depressives. 315 12

The dexamethasone suppression test (DST) was performed on 30 patients fulfilling RDC or Kendell criteria for schizo-affective depression. Symptoms characteristic of depression or schizophrenia were noted, and the severity of psychosis and the severity and endogenicity of depression were assessed. Ratings of severity were repeated at 2-month follow-up. Ten of the 30 subjects were DST non-suppressors, but no clear differences in symptoms, severity of illness or outcome between suppressors and non-suppressors emerged. Thus, although schizo-affective depression is associated with an increased frequency of HPA axis abnormality as assessed by the DST, this test does not clarify the status of schizo-affective depression in the classification of psychiatric illness.
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PMID:The dexamethasone suppression test in schizo-affective depression. 315 18

A community sample of forty subjects (of a total of 50) were followed up an average of two and one-half years after a SADS/RDC diagnosis of depression. The group was composed of twenty-one subjects whose depressions were judged to be associated with a medical illness or medication use and nineteen without this association. There was no difference in outcome as measured by persistence or recurrence of depression when groups were defined by associated medical illness. There was a significant difference when groups were defined by association with medication use. Of the nine subjects whose depressions were associated with medication, six were still depressed at follow-up; all six had continued to use implicated "depressogenic" medications. The three who were not depressed at follow-up were no longer using the originally implicated medications. The use of depressogenic medication appears to influence the course and/or duration of depression and must be accounted for in epidemiological studies and clinical practices.
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PMID:Medication-associated depression: a two and one-half year follow-up of a community sample. 321 17

Analysis of family history and family study diagnoses of major affective disorder in 4806 relatives of affectively ill probands from the NIMH Collaborative Study of the Psychobiology of Depression (Clinical) suggests that rates of disorder in uninterviewed relatives are greatly underestimated by family history. The implications of these underestimates for family and genetics analyses using the family history method are discussed, and other estimates are developed that have better statistical properties. Using the Model Based Direct Adjustment method, the rate of major affective disorder in all relatives (interviewed and uninterviewed) is estimated to be 32%, compared to 25% by the consensus (standard) method, which uses the Family History-RDC interview with one or more family members to make diagnoses on all uninterviewed relatives. This difference (over ten standard errors) is due to the much higher rate of illness estimated for the uninterviewed relatives (28% compared to 14%). Analysis of the sources of insensitivity of the FH-RDC is used to explain the difference between observed and imputed diagnosis rates.
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PMID:Improving the validity of FH-RDC diagnosis of major affective disorder in uninterviewed relatives in family studies: a model based approach. 321 43

On grounds of the literature about significant others of psychiatric patients it is to look for by what kind of characteristics different groups of significant others (mothers, spouses, others) may be differentiated and which variables characterize confident relationships and bonds. Significant others of psychiatric patients were investigated as well as the patients who belong to the diagnostic groups schizophrenia, depression or mania (RDC-criteria). They were investigated during and after an inpatient stay in one of the three psychiatric inpatient treatment centers in a large city of West Germany. For data analysis correspondence analysis was used, a method which is able to show correspondence between several characteristics by a computational as well as graphical way. Results show particularly two groups of significant others: burdened mothers and partners of depressed or manic patients. A confident relationship exists if daily contact was given as well as feeling attached to the patient and feeling burdened. Maintaining a confident relationship in spite of burden is explained by cognitive processes of attachment.
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PMID:[Trusting relations in family members of psychiatric patients]. 324 1


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