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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the development and evaluation of a multi-ethnic inventory (the BSI) of somatic symptoms associated with anxiety and depression, symptoms were derived from psychiatric case notes of Pakistani and indigenous British patients with a clinical diagnosis of anxiety, depression, hysteria or hypochondriasis. The inventory was constructed simultaneously in Urdu and English. A pilot version of the BSI was checked against psychiatric case notes in north and south India, and Nepal. The revised BSI achieved over 90% coverage of all somatic symptoms recorded in each centre. The linguistic equivalence of the Urdu and the English versions was established in a bilingual student population in Pakistan. Conceptual equivalence of the BSI was explored using factor analysis of responses by functional patients presenting to medical clinics in Britain and Pakistan. Four principal factors (head, chest, abdomen, fatigue) were similar in both populations.
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PMID:The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. 203 38

A clinical study was made on depressive state following stroke using stroke patients in the chronic stage. There were 118 stroke patients in the present study and 25 patients (21.2%) satisfied the diagnostic criteria for major depressive syndrome of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (DSM-III-R). As for dispositional, social, and somatic factors, a tendency was observed for depressive state to develop at a high frequency among patients with a past history of mental disorder prior to development of stroke, patients residing in suburban area, patients engaged in domestic and agricultural work, and patients with a frequent history of physical disorders. A tendency was observed for depressive state to develop at a high frequency among patients showing B type in YG test and patients presenting laterality in electroencephalography. Among the 49 right stroke patients, depressive state was observed in 10 cases (20.4%), while among the 43 left stroke patients, depressive state was seen in 10 cases (23.2%) with the incidence of depressive state showing no difference by hemisphere stroke. Study of the clinical characteristics of depressive state by hemisphere stroke with the use of symptom items of Zung scale and Hamilton scale showed that patients in depressive state with right hemisphere stroke had high values in symptom items considered close to the essence of endogenous depression such as depressed mood, suicide, diurnal variation, loss of weight, and paranoid symptoms, while patients in depressive state with left hemisphere stroke had high values in symptom items having a nuance of so-called neurotic depression such as psychic anxiety, hypochondriasis, and fatigue. Comparison with endogenous depression patients indicated that right stroke patients rather than left stroke patients showed a clinical picture suggestive of endogenous depression. Antidepressant was effective in 71.4% of the cases, but no difference in effectiveness could be observed by hemisphere stroke. In stroke patients in the chronic stage the incidence of clinical depressive state was higher than 20%, and involved in its onset were not only brain organ lesions but also dispositional, social, and somatic factors and integration dysfunction in the emotional activity of the left and right hemisphere functions. As for the clinical picture, a picture considered close to endogenous depression was observed in right stroke patients, while that considered close to so-called neurotic depression was seen in left stroke patients. The therapeutic effect of antidepressant was almost equivalent to that for endogenous depression.
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PMID:[Clinical study on depressive state following stroke]. 223 45

The overall effect of zotepine was a "slightly improved" or better response in 20 patients (64.5%), "unchanged" in 10 (32.3%) and "worsened" in 1 (3.2%). Zotepine exhibited some degree of improvement in 54.5% of patients unresponsive to prior drugs. The onset of effect of zotepine was within one month in 19 patients. The improvement rate in the hebephrenic type (66.7%) was almost the same as in the paranoid type. The improvement rate classified by psychopathology was highest for hypobulia, followed by restlessness-excitement and hallucination, depressive mood, hypochondria and delusion. The side-effects were subjective complaints, such as general fatigue, dryness of mouth, sleepiness or fainting in a small number of cases. There was a slight increase in S-GPT in one patient and a slightly increased blood platelet count, also in one patient. Serial EEG changes associated with zotepine studied in another 17 chronic schizophrenics could be classified into three groups: those with increased slow waves, those with enhanced alpha waves and those with unchanged EEGs. There was a positive correlation between the incidence of slow waves and higher plasma levels of zotepine.
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PMID:Clinical and EEG studies of zotepine, a thiepine neuroleptic, on schizophrenic patients. 288 87

The Acquired Immune Deficiency Syndrome (AIDS) has become an increasingly common cause of severe morbidity and death among homosexual men. As such it has become a major source of concern to this group. In this paper I report the cases of two bisexual men who developed a severe illness characterized by fatigue, malaise and infirmity for which no physical etiology could be determined despite extensive and complete investigations. At psychiatric consultation it became apparent that each man had a mental disorder, one symptom of which was an excessive and groundless concern that he suffered from AIDS. These men both received appropriate psychiatric treatment consisting of psychotropic medication and short-term psychotherapy. This resulted in the remission of the mental disorder, resolution of the overconcern about AIDS and the return to good physical health. Also discussed is the connection between the symptom of overconcern about AIDS and the concept of hypochondriasis.
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PMID:Excessive concern about AIDS in two bisexual men. 394 8

Fatigue is usually stated as a major symptom of the depressive condition. Its diagnosis value seems higher in mild depressions, that in severe depressive syndromes. In this later case the symptom is overwhelmed by psychic pain. Contrary to the common viewpoint fatigue does not seem a consequence of sadness and lack of interest. It seems we have to make a distinction between the fatigue related to anxiety and hypochondria and an other kind of fatigue that is the subjective aspect of motor and mental retardation. Its relationships with circadian rhythms and nor-adrenergic transmission are probably the best ways to explore the biological mechanisms.
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PMID:[Fatigue and depression (author's transl)]. 627 8

The effectiveness and tolerance of Lofepramine was investigated in a neurological practice on 100 patients with predominantly slight and moderately severe depressive states. The treatment could be carried out according to the trial plan on 78 patients and the success of the therapy could be evaluated. 67 patients showed definite improvement (85.9%) and tolerance was good to very good in 96.2% of the cases. Although a tranquilizaer was also administered to 62 patients, the success of therapy was definitely accounted for by the antidepressant. This applies particularly to the symptoms of fear, tiredness and impairment of work capacity as well as "depressive mood", hypochondria, somatization and states of agitation. No serious side effects were observed in any patient. Insufficient success in therapy was observed most often when the minimal dose of 35 mg per day was administered, while convincing results were obtained by a dosage of 70 to 140 mg of Lofepramine daily. A large number of patients who were initially treated with higher doses of Lofepramine profited from a subsequent long-term therapy lasting several months during which 17.5 to 35 mg of Lofepramine were administered daily.
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PMID:[Results of treatment with the anti-depressive agent lofepramine in neurological practice]. 736 77

Symptoms of Human Immunodeficiency Virus (HIV) infection and somatic symptoms of depression overlap, confounding clinical assessments of persons with HIV infection. This research examined the extent of this confounding. In Study 1, 71 persons with HIV infection demonstrated high rates of depression on the Beck Depression Inventory (BDI). However, depression scores correlated with symptoms of HIV infection. In Study 2, 63 persons with HIV infection also demonstrated high rates of depression on the BDI, and depression was again related to symptoms of HIV disease; specifically, persistent fatigue, diarrhea, night sweats, and muscle aches. Principal component factor analyses demonstrated that somatic symptoms of depression were closely associated with number of Acquired Immunodeficiency Syndrome diagnoses, number of HIV-related symptoms, and inversely related to number of T-helper cells. In contrast, cognitive-affective depression was most closely related to anxiety, hypochondriasis, and number of months since tested HIV positive. Results support the conclusion that depression scores require differential interpretations at different stages of HIV disease and that persons who have experienced HIV-related symptoms only be assessed for depression using instruments void of somatic symptoms.
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PMID:Assessing persons with human immunodeficiency virus (HIV) infection using the Beck Depression Inventory: disease processes and other potential confounds. 787 94

Clonazepam was administered to 55 patients with depressive disorder (DSM-III-R) in average minimal and maximal doses of 2.40 and 6.54 mg/day for 21-28 days. Complete remission was achieved in 60% patients (Serejskij AB, drop of global HAMD and FKD score by more than 50%), in particular in case of concurrent anxiety. A marked antidepressive effectiveness of clonazepam was suggested also by a drop of the total HAMD and FKD score already after the first week of treatment. All items of the HAMD and FKD scale were significantly positively influenced with the exception of agitation, somatic anxiety, insight, paranoidity, obsession respectively hypochondriasis and paranoidity. No correlation was found between the effect of clonazepam and sex, the patients' age, duration of the depressive disorder, period of the index episode and severity of depression. As to undesirable effects, the authors recorded fatigue and sleepiness (40%) and hypotension (20% of the patients), in particular at the onset of treatment and after larger daily doses. In 3/10 bipolar patients a switch to hypomania was observed.
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PMID:[Effectiveness of clonazepam in depressive disorders]. 865 96

Fourteen common physical symptoms are responsible for almost half of all primary care visits. Only about 10% to 15% of these symptoms are found to be caused by an organic illness over a 1-year period. Patients with medically unexplained symptoms are frequently frustrating to primary care physicians and utilize medical visits and costs disproportionately. This paper will review the relationship between psychological distress and the decision to seek medical care for common physical symptoms such as fatigue and headache. Evidence will be presented demonstrating that an increasing number of medically unexplained symptoms over a patient's lifetime correlate linearly with the number of anxiety and depressive disorders experienced, the score on the personality dimension of neuroticism, and the degree of functional impairment. Several scales measuring somatization and hypochondriasis are recommended for primary care and medical specialty patients.
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PMID:Medically unexplained symptoms in primary care. 988 37

This article deals with the history of the terminological and nosological development of the concept neurasthenia introduced in 1869 by George Miller Beard and in particular with its reappearance in western medicine in the 1980 s. Beginning with its predecessors in antiquity and continuing with hypochondria, which became a fashionable disease in the 18 th century, the concept neurasthenia reached a high point and world-wide medical acceptance at the end of the 19 th/beginning of the 20 th century. However, between the 1930 s and 1960 s it declined in popularity and gradually disappeared until finally it only had a rudimentary nosological role in the term "pseudoneurasthenia". In the countries of the Far East, on the contrary, the concept of neurasthenia has been in continual use since its importation in the first decades of the last century. In the 1980 s, when an interest in the symptoms of chronic fatigue was reawakened in western medicine, the concept neurasthenia reappeared, this time to define the particular form of a neurotic disorder. Parallel to these developments increasing importance was attached to clinical descriptions of illnesses which on account of their similarity to the symptoms of neurasthenia could be termed modern variants of the concept neurasthenia. These are "Chronic-Fatigue-Syndrome", "Fibromyalgia" and "Multiple Chemical Sensitivities" which have more or less adopted the organic inheritance of Beard's former concept of neurasthenia, despite the fact that so far the question of organicity could not be decisively answered in a single case. In order to clarify possible influences on the development of the concept neurasthenia and its variants, the theories and ideas of E. Shorter, medical historian at the University of Toronto, are discussed in the final part of the article, whereby the particular cultural background in each case has a decisive influence on the manifestation of the psychosomatic symptoms.
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PMID:[On the history of the concept neurasthenia and its modern variants chronic-fatigue-syndrome, fibromyalgia and multiple chemical sensitivities]. 1241 Apr 27


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