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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study examined the prevalence of major and minor depression in patients with acute coronary syndrome and their relation with heart rate and heart-rate variability, and clinical characteristics. The study group included 297 patients, 200 men and 97 women, between ages of 21 and 70 years (M age = 57.5 +/- 9.6), who were admitted to a coronary care unit with acute coronary syndrome and survived to discharge from the hospital. Major and minor depression were diagnosed using DSM-IV. There were 44.1% patients with acute coronary syndrome without depression, 29.3% with minor depression, and 26.6% with major depression. The prevalence of minor and major depression was more elevated in patients with non-ST-segment elevation myocardial infarction and unstable angina than in patients with ST-segment elevation myocardial infarction. Ventricular fibrillation and atrial fibrillation were more common in patients with major and minor depression than in patients without depression. The 24-hr. duration of heart-beat intervals and heart-rate variability were significantly lower in patients with major and minor depression than in patients without depression. This study implies that clinical depression was significantly comorbid with the acute coronary syndrome and was related to hypertension, diabetes mellitus, age, sex, type of acute coronary syndrome, left ventricular failure, higher heart rate, and lower heart-rate variability.
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PMID:Relation between major and minor depression and heart rate, heart-rate variability, and clinical characteristics of patients with acute coronary syndrome. 1788 12

This study investigated the prevalence of mothers' anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms triggered by their child's type 1 diabetes and identified individual diabetes-related traumatic stressors. Sixty mothers of children who had been diagnosed with diabetes within the past 5 years were interviewed using the Structured Clinical Interview (SCID) DSM-IV-PTSD module, and completed the Posttraumatic Stress Diagnostic Scale (PDS) and the Hospital Anxiety and Depression Scale (HADS). Fifteen percent of participants met criteria for partial and 10% for full PTSD. Fifty-five percent of participants identified hearing about their child's diagnosis as the traumatic stressor. Forty percent of participants reported moderate to severe symptoms of state-anxiety and 17% moderate to severe symptoms of depression. This study highlights the significant emotional impact this diagnosis in children can have on mothers, and identifies a population with clinical needs.
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PMID:Anxiety, depressive, and posttraumatic stress symptoms in mothers of children with type 1 diabetes. 1795 36

The relationship between mental disorders and chronic physical conditions is well established, but the possibility of ethnic group differences in mental-physical associations has seldom been investigated. This study investigated ethnic differences in associations between four physical conditions (chronic pain, cardiovascular disease, diabetes, and respiratory disease) and 12-month mood and anxiety disorders. A nationally representative face-to-face household survey was carried out in New Zealand from 2003 to 2004 with 12,992 participants aged 16 and older, achieving a response rate of 73.3%. The current study is of the subsample of 7,435 participants who were assessed for chronic physical conditions (via a standard checklist), and compares Maori, Pacific and Other New Zealanders. DSM-IV mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). The ethnic groups differed significantly in prevalences of both physical and mental disorders, but almost no ethnic differences in mental-physical associations were found. Independent of ethnicity, associations were observed between chronic pain and mood and anxiety disorders, cardiovascular disease and anxiety disorders, respiratory disease and mood and anxiety disorders. Despite differences in mental and physical health status between ethnic groups in New Zealand, mental-physical disorder associations occur with considerable consistency across the groups. These results suggest that whatever factors are conducive to the development of a mental disorder from a physical disorder (or vice versa), they are either unaffected by the cultural differences manifest in these ethnic groups, or, any cultural factors operating serve to both increase and decrease comorbidity such that they cancel each other out.
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PMID:Mental-physical comorbidity in an ethnically diverse population. 1815 19

An innovative nursing service to Maori communities was initiated in 2000, based on continuing disparities between health status of Maori and non-Maori peoples in New Zealand and a recognition that much Maori morbidity and early mortality is accounted for by three disease states, diabetes, heart disease and airways disease. The paper describes the project based on Kaupapa Maori heath providers employing registered nurses who completed an advanced post-graduate diploma programme specialising in disease state management. The first nurses to be employed as Maori mobile DSM nurses who lacked models and mentors needed to develop their professional practice and document outcomes for clients. Using case notes and drawing from community health theory, the paper describes the scope and strategy of practice in client's home settings that these nurses developed. Although it is too early to demonstrate statistically that the initiative is improving health outcomes for Maori, anecdotally the service is succeeding where mainstream services have had limited effect.
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PMID:Innovations in service delivery to improve Maori health outcomes: a mobile disease state management nursing service. 1818 30

Dependence is an unusual, but potentially serious complication of corticosteroid use. Two cases of prednisone dependence are reviewed; the first involving a patient with inflammatory orbital pseudotumor who developed a dependent pattern of prednisone use that persisted years after the resolution of the acute episode. The second case involves a patient with factitious disorder who attempted to obtain corticosteroids from multiple clinicians, despite the absence of any clinical indication for them, manipulating elements of her medical history to influence the prescription of corticosteroids. Both patients exhibited tolerance and withdrawal symptoms, and both developed serious systemic effects from the corticosteroids, including cataracts, diabetes mellitus, and cushingoid signs. Both patients also exhibited dependence upon other substances. A MEDLINE search was conducted, and the case literature regarding corticosteroid dependence was reviewed. Twenty-six cases of potential corticosteroid dependence were identified, and 22/26 (85%), retrospectively, met criteria for DSM-IV substance dependence involving corticosteroids. Prednisone was the most frequently implicated corticosteroid, but cases involving ACTH, cortisone, and high-dose inhaled dexamethasone and beclomethasone were also identified. Asthma was the most common underlying medical condition for which the corticosteroids were prescribed, but a variety of allergic and inflammatory conditions were also reported. Corticosteroids may induce dependence based on their propensity to induce euphoria as well as a characteristic withdrawal syndrome, in addition to directly influencing reward circuitry. Clinicians should be aware of the possibility of prednisone dependence when confronted with patients who exhibit vigorous insistence on corticosteroids out of proportion to objective signs and symptoms of inflammation.
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PMID:Drug dependence involving prednisone: two cases and a review of the literature. 1836 78

Narcoleptic patients suffer frequently from obesity and type II diabetes. Most patients show a deficit in the energy balance regulating orexinergic system. Nevertheless, it is not known, why narcoleptic patients tend to be obese. We examined 116 narcoleptic patients and 80 controls with the structured interview for anorectic and bulimic eating disorders (SIAB) to test the hypothesis that typical or atypical eating attacks or eating disorders may be more frequent in narcoleptic patients. No difference in the current prevalence of eating disorders bulimia nervosa, binge eating disorder, or anorexia nervosa was found, nor was the frequency of eating attacks higher in the narcolepsy group. We conclude that present eating disorders and eating attacks as defined in DSM IV are not the reason for the observed differences in body composition. Additional factors, such as basal metabolic rates and lifestyle factors need to be considered.
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PMID:Prevalence of eating disorders and eating attacks in narcolepsy. 1872 24

Hypothalamus-pituitary-thyroid (HPT) axis dysfunction has been associated with pathophysiology of major depression. The aim of the study was to determine serum levels of total 3,5,3'-triiodothyronine (T3), total thyroxine (T4) and thyroid-stimulating-hormone (TSH) in patients with major depression and healthy controls. The study included 53 medication-free patients with depression and 49 healthy controls. Exclusion criteria for patients was: other axis-I and axis-II diagnoses, intensive psychotherapy or electroconvulsive therapy, prior clinical and/or laboratory evidence of hypo- or hyperthyroidism, alcohol or nicotine dependence, pregnancy, hormone supplement therapy, somatic illnesses (diabetes, renal or hepatic disorders), infections or autoimmune diseases, recent surgical treatment or significantly changed body weight. For controls: the presence of psychiatric disorders and/or thyroid dysfunctions. The diagnosis of major depression was made using structured clinical interview based on DSM-IV criteria. The results showed significantly lower T3 and TSH levels in patients compared to controls. There was no significant difference in T4 values between patients with depression and control subjects. The results showing altered levels of thyroid hormones in depression indicate that further research on thyroid hormone activity can contribute to the better understanding of the biological basis of depression. Based on the high frequency of the subtle neuroendocrine disorders coexisting with depression, the association of thyroid abnormalities and depression should not be underestimated. Future research should identify different behavioral endophenotypes characteristic for depression, which would greatly facilitate delineating the biological phenomena associated with this psychiatric illness.
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PMID:Thyroid activity in patients with major depression. 1898 76

Olanzapine is a second-generation antipsychotic that may cause weight gain and metabolic syndrome in some cases. The peroxisome proliferator-activated receptor (PPAR)-gamma is an important gene in the progress of type II diabetes and metabolic syndrome. In recent studies the polymorphism of the PPAR-gamma has been studied in type II diabetes mellitus, polycystic ovary syndrome, and insulin resistance syndrome. It is aimed to evaluate the association between polymorphism of PPAR-gamma gene and olanzapine-induced weight gain. Our study comprised 95 unrelated subjects who strictly met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for schizophrenia, and all were of Turkish origin. All patients were evaluated with rating scales, and genetic analyses were performed. We found statistically significant differences between pretreatment and posttreatment body mass index and weight change in Pro12Ala polymorphism of PPAR-gamma2. Our results suggest that genetic polymorphism of PPAR might be important in olanzapine-induced weight gain and that genetic variance of people might be considered in antipsychotic medication selection.
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PMID:The association of olanzapine-induced weight gain with peroxisome proliferator-activated receptor-gamma2 Pro12Ala polymorphism in patients with schizophrenia. 1962 37

The Composite International Diagnostic Interview (CIDI) was used to assess the prevalence of psychiatric disorders in a French population of 46 inpatients with diabetes mellitus. According to DSM-III-R criteria, 52.2% of subjects presented at least one psychiatric diagnosis in their lifetime and 41.3% did so less than six months before the study. Affective and anxiety disorders represented at least 83% of the psychiatric diagnoses. The risk for those disorders seems to be restricted to a predisposed group as only one of the 16 subjects who had suffered from an anxiety or depressive episode within the previous six months had never experienced such an episode before.
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PMID:Six-month and lifetime prevalences of psychiatric disorders in inpatients with diabetes mellitus. 1969 47

The purpose of this study was to investigate the relationship of social anxiety and insulin-dependent diabetes mellitus (n = 40 girls between 13 and 19 years of age). Mean duration of diabetes was 7 years. We supposed that this chronic illness may provoke feelings of friendlessness and sadness, social withdrawal and fear of social situations because diabetes entails a series of demands which differentiate the diabetic child from healthy children. Our population was compared with 35 healthy young girls. All were administered the Schedule for Affective Disorders and Schizophrenia for School-Age-Children and completed the State Trait Anxiety Inventory for Children, the Self-Consciousness Scale and the Imaginary Audience Scale. Diagnoses of anxiety disorders across DSM-IIIR do not show significant differences between groups. In self-report inventories, our findings do not support the hypothesis that social anxiety is a pathological symptom in diabetic subjects. However, they were more depressed than the control group. Furthermore, social functioning of the diabetic group did not differ from that of the control group. They were more concerned with their illness than with social anxiety.
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PMID:Social anxiety in insulin-dependent diabetic girls. 1969 8


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