Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hormonal preparations have become one of the most popular methods used for controlling fertility. The literature over the last 40 years continues to reveal how their numerous side effects negatively impact many users and even society at large. Three large cohort trials were the first to demonstrate, on a grand scale, certain emotional and behavioral associations with contraceptive use. Current contraceptive use was associated with an increase rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths. Despite the advent of more "user friendly" contraceptives, the discontinuation rate secondary to side effects has changed little through the years. While in rare cases hormonal preparations can be deadly to the user, there is substantial evidence that their negative effect issues more from their emotional and behavioral properties. This paper reviews the results of over seven studies which further characterize these prominent associations, particularly with hormonal contraception, in an attempt to demonstrate their association with the intrinsic pharmacologic properties of hormonal preparations. Hormonal contraceptive users, in contrast with non users, were found to have higher rates of depression, anxiety, fatigue, neurotic symptoms, sexual disturbances, compulsion, anger, and negative menstrual effects. The question of whether the association of these maladies is directly due to the effect of taking exogenous hormones versus the psychological impact of the contraceptive behavior itself had yet to be studied. Seven small randomized-controlled trials were found in a review of the literature which studied this hypothesis in a direct way. They do not support the origination of these side effects being from the pharmacological properties of hormones. No association was found between hormone levels and emotional functioning in females. Psychiatric evaluations among IUD and oral contraceptive pill (OCP) users reveal no significant differences. Women who were given an OCP placebo experienced a similar side effect profile of OCP users. Different hormonal concentrations and combinations made no significant difference in the side effect profile. A study of women who were given either "weak female hormones" or a placebo failed to duplicate the side effect profile found in all of the other studies where the hormones were labeled as contraceptives. The evidence suggests that most of the side effects of hormonal contraception are a result of a psychological response to the practice of contraception. More study is warranted to further understand this psychological phenomenon, especially now that an effective non-contraceptive method of fertility regulation and more reliable psychological instruments are available. Furthermore, it is reasonable to hypothesize, given the present data, that contraceptive activity itself is inherently damaging to women.
 ...
PMID:Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms? 1523 88

Fibromyalgia is a painful syndrome frequently leading to a rheumatological expertise. Between January 1998 and August 2003, 260 medical appraisals were carried out in the department. Forty-three people matched the fibromyalgia classification criteria proposed by the American College of Rheumatology. This number represents a twofold increase compared to the period ranging from 1968 to 1997. One quarter were men. The group of people with fibromyalgia (Exp. FM+) was compared with a group of patients undergoing a similar evaluation without fibromyalgia (Exp. FM-), matched for age and sex. There were no differences concerning the demographic characteristics nor increase in obesity, heart rate or decreased blood pressure in the Exp. FM+ group. In people mentioning back pain, Waddell tests for a non organic origin of the pain tended to be more present in this group. There were no more triggering events, heavy labor workers or a decreased education level in the Exp. FM+ group. Fatigue, sadness, irritability and evocation of suicide were more frequently noted in the fibromyalgia group. People with work disablement higher than 50% were no more numerous in the Exp. FM+ group. Similarly, the working ability level in the last job or in an appropriated job was not decreased in the Exp. FM+ group. In this study, comparison between people with and without fibromyalgia yielded no great differences and working ability was regarded to be equivalent.
 ...
PMID:[Fibromyalgia and working ability--experience of a rheumatological appreciation center]. 1545 45

Several studies have reported high rates of depression in multiple sclerosis (MS) with a lifetime prevalence of approximately 50% and an annual prevalence of 20% not uncommon. Concern about the potential of new drug treatments to exacerbate or precipitate depression in MS has led to increased interest in the relation between MS and depression. This review on MS and depression identifies the following key issues: How common is depression in people with MS? Is depression in MS associated with lesions in specific regions of the central nervous system? Is there an increased risk of suicide in MS? Is there a higher than expected incidence of anxiety disorders in MS? Are fatigue and depressed mood related in MS? Is there a relation between depression and cognitive impairment in MS? Which psychosocial variables affect the development of depression in MS? Does treatment with interferon increase the risk of depression? How effective are treatments for MS patients with depression? Each of these issues is briefly reviewed with critical commentary, and some priorities for future research are suggested.
 ...
PMID:Depression in multiple sclerosis: a review. 1577 30

Every year, many women all over the world will undergo a hysterectomy, the removal of their uterus. The majority of hysterectomies are performed to treat conditions such as fibroids, heavy bleeding, endometriosis, adenomyosis and prolapse. A hysterectomy is not often a procedure that needs to be performed urgently, except in the case of cancer. Therefore, a woman considering the procedure should take time to investigate all her options, including other possible treatments. Deciding whether to have a hysterectomy can be a difficult and emotional process. Signs of depression may include severe and prolonged feelings of sadness and hopelessness; diminished interest in activities; significant weight loss or gain; insomnia; fatigue; and thoughts of death or suicide. Every person reacts differently, and reactions are a combination of emotional and physical responses. We still have much to learn about the effects of hysterectomy on sexual function. We investigated many studies published in different journals relative to this subject and we compare their results. Women are more likely to report improved sexual functioning after the surgery when their symptoms have been alleviated. A new hysterectomy procedure that 'spares' abdominal ligaments and nerves is quicker and results in less blood loss and shorter hospital stays and seems to respect the tissues more, without affecting the sexuality of the women.
 ...
PMID:The effect of hysterectomy on sexuality and psychological changes. 1654 13

This study addressed the issue of a possible link between single-car accident drivers and suicidal intent. In the international literature this topic has generated both positive and negative results. Some authors have stressed unconscious suicidal motivations in various single accidents. Nevertheless, refutation of such theory was demonstrated through experimental studies. We selected 30 single-car accident drivers who had been admitted to emergency departments and then hospitalized for an average period of 10 days. We administered the Reason for Living Inventory (RFL) and investigated their attitudes toward suicide. We also matched these patients with a control group of drivers who had never had a car accident. Results showed that single-car accident drivers were not exposed to a higher overall suicidal risk, though they reported a higher risk on the RFL Survival and Coping Beliefs subscale and often expressed tiredness of being alive. These patients had experienced more life events than controls. We conclude that, although suicide risk was low in our patients, they were engaged in looking for a solution to their problems in which the accident played a role in such a process. This behavior has some characteristics of the logic of suicidal individuals.
 ...
PMID:Suicidal intent in single-car accident drivers: Review and new preliminary findings. 1691 32

Due to its chronic and fluctuating time course, multiple sclerosis (MS), thus far, has not been regarded as a focus of palliative care. However, sometimes we are confronted with severely affected MS patients, who suffer from complex medical, physical and psychosocial problems, which are not fully covered by the current health care services. We present two cases of severely affected MS patients we saw in our outpatient MS clinic, and who, we believe, are candidates for palliative care. The first patient, with primary chronic progressive (pcP) MS for many years (Expanded Disability Status Scale (EDSS): 8.0) presented with complex painful dysaesthesias and a depressive syndrome. He refused any treatment, and finally committed suicide with the help of a euthanasia group in Switzerland. The second patient was also severely affected by a secondary chronic progressive (scP) MS (EDSS: 9.0) and was finally admitted to our palliative care unit due to a complex pain syndrome associated with panic attacks and anxiety. She spent three weeks on the palliative care unit and her symptoms improved gradually after changing and optimising her pain medication. The patient was discharged with home care and is seen regularly on the palliative care unit. Additionally, as a first step, a questionnaire was sent to 53 German MS specialists regarding their general view on the needs for palliative care in MS. Our two cases and the results of the questionnaire demonstrated that MS patients and their caregivers are confronted with a variety of symptoms which are difficult to treat, and are a cause of great suffering for the patients, including ataxia, depression and fatigue. The data of the questionnaire also showed that neurologists usually do not deal with end-of-life care issues in MS.More research is needed to define the role of palliative care in MS and establish appropriate interventions to improve the quality of life in advanced stage MS patients and their relatives.
 ...
PMID:Palliative care in patients with severe multiple sclerosis: two case reports and a survey among German MS neurologists. 1734 59

The use of cardiovascular medications can have a variety of neuropsychiatric consequences. Many cardiovascular agents cause higher rates of fatigue and sedation than placebo, and case reports of medication-induced mood syndromes, psychosis, and cognitive disturbances exist for many cardiovascular drugs. Depression has been associated with P3-blockers, methyldopa, and reserpine, but more recent syntheses of the data have suggested that these associations are much weaker than originally believed. Though low cholesterol levels have been associated with depression and suicide, lipid-lowering agents have not been associated with these adverse effects. Finally, cardiovascular medications may have beneficial neuropsychiatric consequences; for example, the use of clonidine in patients with attention deficit-hyperactivity disorder, the use of prazosin for patients with post-traumatic stress disorder; and the use of propranolol for performance anxiety and akathisia.
 ...
PMID:Neuropsychiatric consequences of cardiovascular medications. 1750 24

The Neuropsych Questionnaire (NPQ) addresses 2 important clinical issues: how to screen patients for a wide range of neuropsychiatric disorders quickly and efficiently, and how to acquire independent verification of a patient's complaints. The NPQ is available over the Internet in adult and pediatric versions. The adult version of the NPQ consists of 207 simple questions about common symptoms of neuropsychiatric disorders. The NPQ scores patient and/or observer responses in terms of 20 symptom clusters: inattention, hyperactivity-impulsivity, learning problems, memory, anxiety, panic, agoraphobia, obsessions and compulsions, social anxiety, depression, mood instability, mania, aggression, psychosis, somatization, fatigue, sleep, suicide, pain, and substance abuse. The NPQ is reliable (patients tested twice, patient-observer pairs, 2 observers) and discriminates patients with different diagnoses. Scores generated by the NPQ correlate reasonably well with commonly used rating scales, and the test is sensitive to the effects of treatment. The NPQ is suitable for initial patient evaluations, and a short form is appropriate for follow-up assessment. The availability of a comprehensive computerized symptom checklist can help to make the day-to-day practice of psychiatry, neurology, and neuropsychology more objective.
 ...
PMID:An Internet-based symptom questionnaire that is reliable, valid, and available to psychiatrists, neurologists, and psychologists. 1831 53

Blunted neurohormonal responses to serotonergic agents are found in major depression and suicidal behavior, but there have been no prospective studies of their relationship to later suicide attempt. In this study, healthy volunteers and depressed subjects were administered a fenfluramine (FEN) and placebo challenge test at baseline and then followed for 2 years. Seven subjects made suicide attempts within the follow-up period. Healthy volunteers, depressed non-attempters, depressed past suicide attempters, and depressed future attempters were compared on plasma prolactin and cortisol responses, as well as on mood (Profile of Mood States; POMS) and behavioral measures that were assessed at baseline and at the end of each challenge testing day. Both past and future attempters had lower total prolactin output (area under the curve) in response to FEN relative to non-patients. Future attempters had lower cortisol response relative to all other groups. All subject groups reported a decrease in POMS Fatigue subscale score and increase in finger tapping rate after receiving FEN. Depressed subjects reported a significant decline in POMS Total, Depression, and Tension/Anxiety scores, but future attempters' did not, showing a slight mean increase. Lower cortisol response correlated with greater suicidal ideation 3 months and 1 year post-study. Logistic regression revealed that blunting of cortisol response and worsening of mood after FEN, and younger age could be used to predict later suicide attempt in the majority of cases (4/7). Results suggest that blunted cortisol and unfavorable acute mood response to serotonergic challenge, in the context of the general activating effects of these drugs, may be a risk factor for later suicide attempt.
 ...
PMID:Future suicide attempt and responses to serotonergic challenge. 1835 92

Air pollution and its impact on human health are of growing concern throughout the world. Recent studies have mainly focussed on respiratory and vascular mortality. The existence of seasonality of ozone distribution and also of the occurrence of suicides as well as suicide attempts is generally accepted, though an interconnection of both phenomena has not yet been established. This hypothesis of an influence of ozone on the occurrence of suicidality was tested on preliminary data (1008 suicides and 917 suicide attempts from a larger epidemiological sample in Middle-Franconia from 2004 to 2007). A higher suicide rate than expected could be observed from July to September, whereas the rates of the suicide attempts did not show a seasonality in relation to ozone levels. To further strengthen the hypothesis, ozone levels differed significantly (T = -2.5; p = 0.014) between days where one or no suicide were observed (mean ozone: 79.8 microg/m(3); SD: 36.3) and days with two or more suicides (mean ozone: 86.4 microg/m(3); SD: 39.4). This phenomenon might be explained including sociological, biological as well as psychological effects. Sociologically, behaviour precipitating suicide might be influenced by climatic variables such as the weather or air pollution causing fatigue or cardio-respiratory symptoms influencing individual well-being in general thereby possibly leading to the decision to end one's life. Biologically, ozone is able to influence the immune system, is a strong trigeminal irritant and might influence neurotransmitter systems such as serotonin, which are known to vary with season and play a major role in impulsivity, aggression, depression and thereby suicidality. Putative psychological explanations for the suicide peak in summer include the influence of a higher ambient temperature leading individuals to a more disinhibited, aggressive and violent behaviour possibly resulting in an increased proneness for suicidal acts that is influenced by ozone. This might lead one to speculate whether ozone is able to account - at least amongst others - for the seasonal distribution of suicides or might even be a causative agent in the multifactorial genesis of a suicide. If this hypothesis is found to be true, further research should focus on the underlying mechanisms. Furthermore, this might be a strong argument to further encourage environment protection.
 ...
PMID:The hypothesis of an impact of ozone on the occurrence of completed and attempted suicides. 1902 46


<< Previous 1 2 3 4 5 6 7 8 Next >>