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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For the treatment of phobia and obsessive-compulsive disorder (OCD), we developed a method of exposure (in vivo or in imagination) and response prevention by transcutaneous electrical stimulation (TES), in which weak electrical stimuli (3-4V, about 5Hz) are applied to the palm ("Rokyu" in acupuncture treatment) or vertex ("Hyakue") of a patient tolerating dysphoria induced in a state of imagination or in real life. TES was very effective in about 80% of 32 patients treated (Seishin Igaku, 1989). Through the treatment of severe cases with TES, several new findings regarding the psychopathology and etiologic mechanism of phobia or OCD were recently obtained. 1) In relatively simple cases treated with TES, anxiety and fear were extinguished within a few minutes by simultaneous close-up normal thoughts. Antagonism may thus possibly be present between a self integration mechanism and pathological mental structure, and TES may discontinuously dysfunctions this antagonism in the manner of a changeover switch. In severe cases, anxiety and fear were not immediately abolished by TES, but strong resistance and fear appeared with increase in TES. Thus, multilevel pathological mental structure are possibly present in severe cases. Moreover, one obsessive-compulsive patient suddenly restored totally free senses after 10 months of TES treatment and stated that he had been found for 10 years by a rule demanding obsessive checking. A certain more decisive principle may then have been present in his pathological mental structure. Based on the above, the pathological mental structure in these phobia and OCD may be concluded to have been dissociated from the self integration mechanism, intensified as the mechanism dealing specifically with anxiety, and finally became resistant to self integration due to the simultaneous close-up of a decisive principle. As for the mechanism of TES action, the following change provides some indication: that is, when TES was applied to the patient under exposure in a state of imagination, strong anxiety was initially induced, and then disappeared after several minutes. This may indicate that TES activates not only a pathological mental structure but also normal mental structure. Thus, while TES may be elevating the energy of anxiety, filling the pathological mental structure, by exposure and response prevention, it is efficiently inducing this anxiety towards the self integration mechanism. 2) On the basis of the above concept, an attempt was made to explain the etiologic mechanism of phobia or OCD. In many cases, the disease is evoked by a trivial provoking trigger after persistent conflict and psychic fatigue.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A study of psychopathology in phobia and obsessive-compulsive disorder: through the treatment of exposure and response prevention by transcutaneous electrical stimulation]. 195 65

Depressed patients and suicidal patients are common Emergency Department patrons with the potential for serious morbidity or death. Dysphoric mood, vegetative symptoms, and negative perceptions of oneself, the environment, and the future are characteristic of depression. Often, the patient is unaware of the depression and presents with a variety of somatic complaints, chronic fatigue, or pain syndromes. In these instances, the physician must consider the diagnosis of depression and ask the patient about any history of depressive symptoms. In all depressed patients, a careful history and physical examination are needed to identify any drugs or concurrent medical illnesses which might cause or exacerbate the depression. If depression is suspected or if the patient presents after a suicide attempt, then a thorough evaluation of suicide potential is mandatory. Several risk factors for completed suicide exist. Male sex, age under 19 or over 45, few social supports, and a history of previous suicide attempts are all factors associated with increased suicide rates. Concurrent chronic or severe medical illnesses and certain psychiatric illnesses, notably depression, schizophrenia, and substance abuse, also increase an individual's risk for suicide. The method of suicide attempt and the chance for rescue must also be considered when determining risk as well as the presence of an organized plan. Acute psychosis in the suicidal patient is an ominous finding and these patients should be admitted to the hospital. The physician must adopt an empathetic and nonjudgmental attitude when caring for potentially suicidal patients. Disposition can be determined after careful evaluation of risk factors, circumstances surrounding the attempt, and the patient's current feelings. Consultation with a psychiatrist or another mental health professional is desirable for any potentially suicidal patient. Many such patients can be safely treated as outpatients with proper referral; certain high-risk individuals will need to be admitted to the hospital. The decision to either hospitalize or discharge can be difficult and the emergency physician should admit the patient if doubt exists.
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PMID:Depression and suicide assessment. 200 61

A retrospective study of the clinical features in 39 children who were investigated for evidence of Coxsackie B virus (CBV) infection is reported. Eighteen children were found to have serological evidence of infection. An extensive range of features was elicited in both seropositive and seronegative patients, most children complaining of abnormalities referable to muscle and, in particular, of weakness and easy fatiguability. Children with evidence of CBV infection were significantly more likely to belong to social classes I and II, to have relatives with serological evidence of CBV infection, and to show certain dysphoric features as well as to complain of sore throats. The relationship between CBV infection and 'myalgic encephalomyelitis' or 'post-viral syndrome' is discussed, and it is suggested that these descriptions are inappropriate given our current knowledge, and inadequately describe the clinical features seen in the children under study. An alternative description, 'fatigue-dysphoria syndrome' is proposed.
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PMID:Features of Coxsackie B virus (CBV) infection in children with prolonged physical and psychological morbidity. 253 17

Four hundred seventy-nine drug abusing adolescent patients enrolled in seven Straight, Inc. Adolescent Drug-Abuse Treatment Programs in five geographic regions across the United States were studied to determine the severity and patterns of cocaine abuse. Of these, 341 admitted to cocaine use and became part of this survey. Cocaine use was categorized as heavy, intermediate, or light. Areas examined were the addictive spectrum, psychosocial dysfunction, and psychiatric symptoms. Intermediate and heavy users of cocaine abused significantly less marijuana and inhalants than light cocaine abusers. Heavy and intermediate users were more likely to use cocaine intravenously and to use crack. They developed tachyphylaxis more frequently, progressed to weekly use in less than 3 months more frequently, and became preoccupied with obtaining and using cocaine significantly more frequently. They used more sedative hypnotics to calm themselves and engaged in more criminal behavior, such as stealing from parents and stores and passing bad checks. They had more arrests for possession of drugs, stole more cars, sold more drugs, and were more likely to trade sexual favors to obtain the drug. Heavy and intermediate users were significantly more psychiatrically disturbed than light users, becoming more suspicious, nervous, aggressive, and demonstrating increased symptoms of fatigue, sleeplessness, decreased appetite, and increasing cocaine dysphoria. All of these symptoms could be mistaken for psychiatric disorders. This study suggests that cocaine is as addictive in adolescents as in adults; possibly more so. It also causes psychosocial dysfunction and psychiatric symptoms. Further research into cocaine addiction among adolescents is indicated.
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PMID:Adolescent cocaine abuse. Addictive potential, behavioral and psychiatric effects. 258 95

Depression in the elderly should be viewed as a biological disorder, with multifactorial etiology, and not as a consequence of increasing social, physical, and material losses. Diagnosis is made basically on somatic symptoms, the most important ones being chronic fatigue, chronic pain, chronic sleep disorder, chronic gastrointestinal disturbance, and dysphoria. Other illnesses that might be present instead of or in addition to depression should be sought, both before depression therapy is started and also in the face of persistent symptoms after treatment is started. Basic treatment is with antidepressant medications, with careful attention to selection of drug and dosage, and careful monitoring for adverse effects. Antidepressant therapy and any other applicable forms of therapy are not mutually exclusive, and any other means of improving the patient's overall situation should be vigorously sought.
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PMID:Geriatric depression: avoiding the pitfalls of primary care. 355 33

Within the general population people destined for myocardial infarction are found to be more obsessional and greater worriers than others. Moreover, in the year before their infarction they display high levels of sadness, anxiety-related symptoms, loss of libido, and fatigue, unrelated to angina and other physical discomforts. They also claim, more so than others, to have no fear of having an incurable illness. Derived optimum weightings to responses to items in the Crown-Crisp Experimental Index permit the development of a simple scoring system which in the present study allows a two-thirds correct identification of those due for imminent infarction and an overall 81.5% correct classification of infarct/non-infarct cases. This apparent capacity of the instrument now needs to be tested in a prospective study. In the year after infarction survivors in the present study show very high levels of dysphoria and social withdrawal.
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PMID:Myocardial infarction and the emotional climate. 614 17

1. Twelve healthy subjects received 10 mg morphine HCl delivered transdermally from an occlusive reservoir applied to a small area of skin, painlessly de-epithelialised by vacuum suction. On a separate occasion, 10 mg morphine HCl was given as an i.v. infusion over 20 min. 2. Venous blood samples were collected serially for 72 h and assayed for morphine, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) by h.p.l.c. Pupil size, salivation, and central nervous effects (nausea, fatigue, headache, feeling of heaviness and dysphoria/euphoria) were also measured. 3. After transdermal application morphine was absorbed by a first-order process to produce relatively constant plasma drug concentrations over 11 h. The absolute bioavailability of transdermal morphine was 75% (65-85%; 95% CI). The plasma concentrations of both M6G and M3G were lower after transdermal administration than after i.v. infusion, and a considerable delay (of up to 1 h) was observed before the metabolites were detectable. AUC ratios for M3G and M6G relative to morphine were similar after both modes of administration. 4. Non-analgesic effects were less pronounced at the lower plasma drug and metabolite concentrations observed after transdermal delivery than after the i.v. infusion of morphine. 5. Transdermal administration of morphine warrants investigation as an alternative route of morphine delivery.
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PMID:Transdermal administration of morphine to healthy subjects. 791 76

Sixteen subjects consumed low-fat/high-carbohydrate (LFHC), medium-fat/ medium-carbohydrate (MFMC), high-fat/low-carbohydrate (HFLC) iso-energetic breakfasts and no breakfast in a counterbalanced order on four separate days. The LFHC breakfast was similar in macronutrient composition, though not in meal size (more kcal) and types of foods offered, to the habitual breakfast of the subjects. A battery of cognitive performance tasks together with mood and appetite ratings were completed before and during the 3 h following breakfast. Results showed no clear differences in performance between the four dietary conditions, but significant effects on mood were observed. Mood improved (a decline in fatigue/dysphoria) following the LFHC breakfast compared to the other meals. The findings show that the macronutrient content of breakfast, independent of energy value and oro-sensory qualities, can exert small but reliable effects on subsequent mood, and suggest that deviation from habitual meal composition can produce a relative decline in mood state. These conclusions are supported by results from a previous study of the effects of lunch which found very similar relationships between meal composition, habitual choices and postprandial mood changes.
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PMID:Acute effects on mood and cognitive performance of breakfasts differing in fat and carbohydrate content. 893 19

Butyrates have been studied as cancer differentiation agents in vitro and as a treatment for hemoglobinopathies. Tributyrin, a triglyceride with butyrate molecules esterified at the 1, 2, and 3 positions, induces differentiation and/or growth inhibition of a number of cell lines in vitro. When given p.o. to rodents, tributyrin produces substantial plasma butyrate concentrations. We treated 13 patients with escalating doses of tributyrin from 50 to 400 mg/kg/day. Doses were administered p.o. after an overnight fast, once daily for 3 weeks, followed by a 1-week rest. Intrapatient dose escalation occurred after two courses without toxicity greater than grade 2. The time course of butyrate in plasma was assessed on days 1 and 15 and after any dose escalation. Grade 3 toxicities consisted of nausea, vomiting, and myalgia. Grades 1 and 2 toxicities included diarrhea, headache, abdominal cramping, nausea, anemia, constipation, azotemia, lightheadedness, fatigue, rash, alopecia, odor, dysphoria, and clumsiness. There was no consistent increase in hemoglobin F with tributyrin treatment. Peak plasma butyrate concentrations occurred between 0.25 and 3 h after dose, increased with dose, and ranged from 0 to 0.45 mM. Peak concentrations did not increase in three patients who had dose escalation. Butyrate pharmacokinetics were not different on days 1 and 15. Because peak plasma concentrations near those effective in vitro (0.5-1 mM) were achieved, but butyrate disappeared from plasma by 5 h after dose, we are now pursuing dose escalation with dosing three times daily, beginning at a dose of 450 mg/kg/day.
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PMID:Phase I study of the orally administered butyrate prodrug, tributyrin, in patients with solid tumors. 953 30

(+/-)3,4-Methylene-dioxymethamphetamine (MDMA, or 'Ecstasy') effects on serotonin system function and behaviour in humans are unclear. Fifteen MDMA users, who did not have other drug dependencies or alcohol abuse, and had not used other drugs for prolonged periods, and 15 control individuals were included in a study to assess the biological and psychological changes after chronic use of MDMA. Prolactin and cortisol responses to D-fenfluramine challenge, clinical psychobehavioural changes, personality characteristics, including mood, aggressiveness and temperamental aspects, were evaluated 3 weeks after MDMA discontinuation. MDMA users had significantly reduced prolactin and cortisol responses in comparison with control individuals (p < 0.001 and p < 0.005, respectively). Dysphoria and mood changes were exhibited in seven individuals, tiredness in five and sensation-seeking behaviour in twelve at the clinical evaluation. Significantly higher scores were found in MDMA individuals than in control individuals for Minnesota Multiphasic Personality Inventory subscale for Depression, for Buss Durkee Hostility Inventory direct and guilt subscales, for Hamilton Depression Rating Scale and for novelty-seeking Tridimensional Personality Questionnaire subscale. Prolactin responses to D-fenfluramine stimulation area under the curve among MDMA users were negatively correlated with direct aggressiveness scores for Buss Durkee Hostility Inventory; a negative correlation between prolactin responses and novelty-seeking scores was also evidenced among MDMA users. These data suggest an association between serotonin system impairment and MDMA use in humans; in interpretation of these results, the possibility that serotonin deficit in MDMA individuals was partially related to a premorbid condition, in relationship with novelty-seeking behaviour and mood disorders, can not be excluded.
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PMID:Serotonergic function after (+/-)3,4-methylene-dioxymethamphetamine ('Ecstasy') in humans. 998 61


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