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

Seventy-nine carefully screened volunteers were compared with 46 clinically referred outpatient primary depressives to assess the validity of use of symptomatic volunteers in research on depression. Overall, symptomatic and clinical referral samples were similar on the majority of demographic and symptomatic variables, although volunteers were less likely to be single, had slightly lower Hamilton scores, less self-reported anxiety, and a longer index episode of depression. Symptomatic volunteer and clinical referral groups had a similar prevalence of endogenous depression by either RDC or DSM-III criteria. Results in 60 patients treated with amitriptyline indicated that both groups were comparable with respect to overall dropout rate, side-effect attrition, dosage of amitriptyline received, and clinical response. Only the proportion of patients who dropped out between completion of assessment and initiation of treatment significantly differed between groups (symptomatic volunteers = 19%; clinical referrals = 0%; p less than 0.05). These findings support use of rigorously screened symptomatic volunteers in outpatient depression research.
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PMID:Symptomatic volunteers in depression research: a closer look. 658 29

Four research diagnostic schemes are compared in one community sample. The prevalence of psychiatric disorder ranged from 8.7 per cent (ID-Catego, threshold and definite) through 13.7 per cent (RDC, probable and definite) to 20.3 per cent (Bedford, borderline and definite). The main comparison made is between the PSE/ID/Catego and SADS/RDC systems. Sixty-one per cent of cases are identified as such by both these schemes. There is poor agreement about labelling; only 56 per cent of cases of depression and 16.7 per cent of cases of anxiety are so diagnosed by both systems. A post hoc check list was used to identify Bedford cases; all bar one were found to fulfil RDC and PSE case criteria. The results are compared with those from other centres which have used the same diagnostic criteria in community studies.
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PMID:Comparison of research diagnostic systems in an Edinburgh community sample. 686 Aug 77

Changes in symptomatology (Hopkins Symptom Checklist scales) during a three- to four-week period were observed in a group of subjects (symptomatic volunteers) who had specific psychiatric disorders (Research Diagnostic Criteria [RDC]) and who were not currently receiving or awaiting treatment. Four of the depressive disorder categories and two of the anxiety disorder categories showed a significant drop in the primary symptomatology. There was a differential effect of diagnosis on the amount of this "spontaneous" symptom reduction; for the HSCL scales depression and panic-phobic anxiety, the RDC disorders with the highest initial levels of those symptoms (major depressive disorder; panic anxiety disorder, combined panic-phobic anxiety disorder) showed the least reduction in that symptomatology.
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PMID:Short-term symptom change in outpatient psychiatric disorders. 716 84

The neuropsychological test performance of 76 hospitalized, depressed patients meeting RDC for the presence of affective disorder was assessed as part of a protocol involving amitryptyline (n = 53) or placebo (n = 23). Tests included the Trail-making Test (TMT), the Benton Visual Retention Test, and the Shipley-Hartford Scale. Clinical ratings and data concerning the characteristics of EEG sleep were also obtained. Analysis of data collected after a drug-free period of 2 weeks and again at the end of the protocol yielded the following conclusions. Base-line performance was inferior to norms for these tests, but for the TMT, scores were not as poor as that expected for brain-damaged patients. Poor performance was often associated with older age, the presence of psychotic features, and prolonged sleep latencies. Baseline Hamilton Rating Scale (HRS) was predicted best by TMT part B. However, this association was not as strong as that between HRS and poor sleep efficiency. Treatment with drug or placebo had little differential effect upon test performance over the course of the protocol. It is suggested that further research should utilize tests which have specificity in localizing cerebral lesions, so that any focal deficits in brain function in depression might be identified.
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PMID:Neuropsychological assessment and EEG sleep in affective disorders. 730 13

Thirty newly hospitalized patients with RDC major or minor depressive disorder were randomly assigned to open treatment according to fixed dosage steps with 1) amitriptyline alone, up to a maximum dose of 300 mg/day; 2) tranylcypromine alone, up to a maximum dose of 40 mg/day; or 3) the combination of amitriptyline, up to 150 mg/day, and tranylcypromine, up to 20 mg/day. For 28 patients this protocol continued for 4 weeks or until discharge. As measured by the Hamilton and Zung depression scales, patients in all three treatment groups improved equally. The combination treatment produced a nonsignificantly higher frequency of minor side effects, none of which required discontinuation of treatment. The results indicate the feasibility and safety of further controlled clinical research with combined treatment, although caution is advised.
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PMID:Combined monoamine oxidase inhibitor-tricyclic antidepressant treatment: a pilot study. 743 77

Point prevalence rates of psychiatric disorders, risk factors, and treatment sought for the disorders are presented, based on a 1975--1976 follow-up of a community probability sample originally surveyed in 1967. These data, while preliminary because of the limitations of a follow-up study, demonstrate the first application to a community sample of new psychiatric diagnostic techniques (SADS-RDC), which are being used with increasing frequency in the United States. The forthcoming DSM-III will be based on these diagnostic techniques. These results, consistent with other reports, show that depression is the most common psychiatric disorder in the community; that schizophrenia and bipolar disorders both have low frequency; and that psychiatric disorders are heterogeneous by age, sex, race, social class, marital status. While persons with a psychiatric disorder tend to use the health care system in the United States, they do not specifically seek help for emotional problems. Since the majority of psychiatric disorders are untreated in the mental health system, prevalence rates of psychiatric disorders based on cases receiving treatment in psychiatric facilities are a gross underestimate.
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PMID:Psychiatric disorders in a U.S. community. The application of research diagnostic criteria to a resurveyed community sample. 746 89

Hypothalamo-pituitary axis disturbances, such as plasma cortisol escape after dexamethasone (DXM) administration or blunted TSH response to TRH, and sleep architecture abnormalities such as shortened REM latency are frequently encountered in depressive disorders. These anomalies only occur in a subgroup of depressed patients and could thus identify a biological or endogenous component to depressive illness. Several definitions of this endogenous depression have been proposed. In this regard, using biological criteria, the Newcastle scale remains the strongest validated clinical definition. In this study, 93 patients (58 women and 35 men) aged 15-79 years (mean: 42) who complained about a depressed mood were admitted for biological investigations (DXM and TRH tests, sleep EEG recording) after a drug wash-out period of at least 10 days. Patients were assessed with the Newcastle scale and diagnosed with RDC using the SADS. After the effects of age, gender and severity of illness were controlled for, multiple regression analyses showed that depressive pychomotor activity and weight loss were the 2 items of the Newcastle scale most contributing to explain the variances of the neuroendocrine tests results. Moreover, when the sample was dichotomized according to the presence of these 2 items, the 2 groups had significantly different post DXM cortisol values, TSH levels after TRH and REM latency values. The 2 groups (biological and non-biological) were then characterized using 16 depressive symptoms more frequently cited in 15 operational definitions of endogenous depression. A logistic regression analysis showed that weight loss, anhedonia, early awakening, and morning worsening of mood were the 4 symptoms that best distinguished biological from non-biological patients group. These symptoms could reflect biological abnormalities in depression and form the core of the endogenous depression.
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PMID:[Quantitative psychopathology of depression: application of the Newcastle Scale]. 750 47

A cross-sectional evaluation of 243 unipolar, nonpsychotic outpatients with major depression was conducted. All subjects were diagnosed by RDC with SADS-L structured interviews. Diagnoses included RDC primary/secondary, RDC endogenous/nonendogenous and Winokur's family-history subtypes. Symptom severity was assessed by the 17-item Hamilton Rating Scale for Depression. Chronic depression was defined as the current episode of major depression lasting at least 2 years, corresponding to DSM-III-R and -IV criteria. Patients with chronic depression (n = 64) were compared with those with nonchronic depression (n = 179). Chronicity was not related to gender, symptom severity, prior length of illness, age at onset of illness, RDC endogenous/nonendogenous, RDC primary/secondary or Winokur's family-history subtypes. Those with chronic depression were older and had fewer major depressive episodes than the nonchronic group. That the chronic group had fewer total episodes of depression than the nonchronic group, but a similar age at onset, is consistent with the notion that patients in a current chronic episode have characteristically longer depressive episodes throughout the course of their illness. Those with chronic episodes may be subject to psychological, biological and/or sociocultural factors that preclude an earlier episode remission for these individuals.
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PMID:Clinical characteristics of outpatients with chronic major depression. 762 36

Twenty five women with normal-weight bulimia nervosa were compared with 25 age- and weight-matched women without bulimia nervosa on measures of parental psychiatric illness. Case and control probands, as well as their parents, completed the Family History Research Diagnostic Criteria (FH-RDC) interview and a battery of self-report instruments. Case probands and controls were divided into two groups based on evidence for parental psychiatric illness. The assignment of parental psychiatric illness was made by (a) a positive parental history of alcoholism or depression from the FH-RDC; or (b) evidence of parental major depression, alcoholism, or personality disorder from the self-report measures. Parental psychiatric illness occurred significantly more frequently for case probands compared to the control probands (64% vs. 24%, odds ratio = 5.6, 95% Cl = 1.7-19.2). Parental psychiatric illness was also associated with parental divorce (Fisher's exact p = .023) and a trend toward lower ratings of paternal but not maternal relationship by case probands. This study suggests parental psychiatric illness may be a risk factor for bulimia nervosa and may contribute to environmental effects through increased rates of divorce and impaired paternal relationships.
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PMID:Risk factors for bulimia nervosa: a controlled study of parental psychiatric illness and divorce. 770 77

The relation of sexual and physical abuse in childhood to subsequent depression and eating disorders was explored in a community sample of mothers and their teenage and young adult daughters respectively. It was hypothesized that age would be a moderating influence on diagnosis following abuse in that depression would be more common in the mothers and eating disorders more common in the daughters. Depression was more common in mothers than daughters, using Bedford College caseness criteria (Finlay-Jones, et al., 1980), but the difference decreased when Research Diagnostic Criteria (RDC: Spitzer, Endicott & Robbins, 1978) were used. Bulimia was more common in the daughters using DSM-III criteria. Both physical and sexual abuse were associated with chronic and recurrent depression but not with single short episodes of depression in the mothers. However, the relationship of depression to abuse showed only a weak trend in the daughter sample. Both physical and sexual abuse were related to bulimia in the daughters, but not in the mothers, as only one mother had such a disorder.
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PMID:Depression and eating disorders following abuse in childhood in two generations of women. 775 38


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