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

To evaluate the clinical and virologic course of patients with chronic fatigue who had elevated Epstein-Barr virus (EBV) titers, we prospectively followed up 26 patients with serial cultures for EBV in blood and saliva and serial EBV serologic and clinical and psychiatric evaluations, and we compared these results with those for healthy controls. The frequency of isolating EBV in blood or demonstrating EBV infection by in situ hybridization in blood lymphocytes or in saliva was similar in patients and controls. The prevalence and titers of antibody to human herpesvirus type 6 were also similar in the two populations. Patients with chronic fatigue did demonstrate higher in vitro natural killer activity and lower in vitro interleukin 2 production than controls, and patients had a high frequency of DSM-III depressive illness. Over 50% of patients with chronic fatigue improved over the course of follow-up. Improvement was not associated with any discernible change in titers of EBV proteins. No evidence of ongoing EBV infection with either transforming or nontransforming strains was demonstrated in this population of patients with chronic fatigue. Clinically, most patients gradually improve over time.
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PMID:Chronic fatigue. A prospective clinical and virologic study. 184 16

The authors determined the prevalence of late luteal phase dysphoric disorder in 217 university women aged 17-29 years. Unaware of the focus on premenstrual syndrome (PMS), the participants rated DSM-III-R symptoms of late luteal phase dysphoric disorder over 90 days. Using a 30% or greater premenstrual change as an index of luteal variation, the authors found that 10 women (4.6%) met the symptom criteria during two menstrual cycles. Compared to 25 young women seeking treatment for PMS who met the same diagnostic criteria, the 10 women from the university sample reported significantly less fatigue and impaired concentration and somewhat less severe depression and overall symptoms.
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PMID:Late luteal phase dysphoric disorder in young women. 224 41

Among 49 consecutive patients with Parkinson's disease, 40% were depressed according to DSM-III; they had major depression or dysthymic disorder accompanied by sleep disturbance, fatigue, psychomotor retardation, loss of self-esteem, and excessive guilt. During a 10-day dopamine-free period, lumbar puncture was performed to measure the metabolites of dopamine, serotonin, and norepinephrine. Patients were given an overnight dexamethasone suppression test, and the effects of thyrotropin-releasing hormone and L-dopa on plasma growth hormone and prolactin were examined. Level of CSF 5-hydroxyindoleacetic acid was lowest in parkinsonian patients with major depression and was related to psychomotor retardation and loss of self-esteem.
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PMID:Clinical and biochemical features of depression in Parkinson's disease. 242 23

A structured interview covering the DSM-III criteria for major depression was adapted for separate use with Alzheimer's disease patients and with their families. Data from 36 patients yielded a depression rate of 13.9%, whereas information from their families indicated that the rate was 50.0%. This disagreement reflected greater family endorsement of patients' loss of interest or pleasure, irritability, fatigue, and feelings of worthlessness. Use of DSM-III-R criteria narrowed but did not eliminate the discrepancy between patients' and families' assessments of the patients' depression. Uniform procedures for gathering and integrating data from the family that are relevant to diagnosis in this group are indicated.
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PMID:Differences between patient and family assessments of depression in Alzheimer's disease. 230 71

Sixty (60) out-patients with DSM III generalized anxiety disorder were treated after a 1-week placebo washout in a 4-week double-blind study with buspirone, diazepam and placebo; after which they were withdrawn abruptly from medication or assigned to a 2-week period of placebo. The HAM-A score was significantly lower in the diazepam group at week 2 (p less than .02) and the buspirone group at week 3 (p less than .04) as compared to the placebo group. A similar pattern was evident in the female group, but not in the male group. Dizziness was the most prominent adverse effect in the buspirone group, whereas the diazepam group had more adverse effects including sedation, fatigue, dizziness and impaired concentration. Withdrawal symptoms were more evident in the diazepam group than the buspirone group.
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PMID:Buspirone: anxiolytic? 286 95

In this study we estimate the power of DSM-III Major Depression (MDD) symptoms to discriminate MDD from (1) Generalized Anxiety Disorder (GAD) and (2) no disorder. The NIMH-DIS was administered to 319 women exposed to chronic stress (all were mothers of disabled children). Two methods were used: (1) conditional probabilities, and (2) multiple regression analysis. Symptoms had greater utility in discriminating MDD from no disorder than from GAD. 'Gained weight' and 'thinking about death' had the least efficacy in either discrimination. 'Hypersomnia' and 'insomnia' contributed to the discrimination from no disorder, whereas 'fatigue' and 'sex disinterest' discriminated MDD from GAD. 'Guilt', 'trouble concentrating', 'lost appetite' and 'wanted to die' were important in both comparisons. Despite recent emphasis on observable behaviors and physiologic measures, guilt, a subjectively experienced inner state, was the most important symptom in MDD.
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PMID:Refining DSM-III criteria in Major Depression. An assessment of the descriptive validity of criterion symptoms. 293 53

The frequencies of 15 self-reported symptoms of cocaine withdrawal were compared in 75 subjects to the symptoms listed as criteria by DSM-III and DSM-III-R for either amphetamine or cocaine withdrawal. Three of the four most frequently reported symptoms, depression (75%), sleep disturbance (71%), and fatigue (69%), corresponded to DSM-III and DSM-III-R criteria. The only other DSM-III symptom, increased dreaming (33%), was infrequently reported, lending support to its deletion by DSM-III-R. Physical withdrawal symptoms, which are generally unappreciated in cocaine withdrawal, were reported by 64% of the sample. Neither the DSM-III criteria nor the new DSM-III-R criteria include other frequent symptoms which might contribute to relapse and impaired functioning, such as craving (69%), apathy/amotivation (67%), and restlessness (64%). Thus, these criteria may be too narrowly defined for treatment purposes.
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PMID:A comparison of self-reported symptoms and DSM-III-R criteria for cocaine withdrawal. 318 56

The frequency of symptoms of depression (Feighner criteria) was evaluated in subjects with dementia of the Alzheimer type (DAT) and matched controls enrolled in a longitudinal natural history study of DAT. Despite enrollment criteria which excluded subjects with affective disorders, the collateral sources of subjects with DAT described these subjects as having significantly more "depressive" symptoms than controls without dementia at entry, and at 15- and 34-month follow-up. The collateral sources of the subjects with DAT reported that these demented individuals experienced significantly greater loss of interest, decreased energy, difficulty in thinking and concentrating, and psychomotor agitation or retardation then did the control group. The subjects with DAT reported fewer symptoms than did their collateral sources, but like their collateral sources, they did not report a global elevation of all Feighner symptoms, but rather related significantly greater difficulty in thinking and concentrating than the controls and a tendency toward loss of interest and psychomotor changes. No subject became clinically depressed. The results suggest a significant overlap between the symptoms of dementia and depression. The frequency with which the above symptoms occur in DAT confounds the use of Feighner and, by extension, DSM-III criteria in diagnosing depression in cognitively impaired individuals with DAT.
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PMID:Symptoms of "depression" in dementia of the Alzheimer type. 319 69

The concept of 'quality of life' has had a paradigmatic effect in psychosomatic medicine by focussing on the measurements of psychological distress. This concept has been phenomenologically described under such names as discomfort and psychological boredom. Elements of fatigue, anxiety and depression seem to be core symptoms of dysfunctions in quality of life. An objective and nomothetic approach to quality of life has been demonstrated in this review when referring to the instrumental use of rating scales, e.g. the General Health Questionnaire. Furthermore, it has been recommended to follow the multiaxial approach of DSM-III including dimensions of personality, psychosocial stressors and social functioning.
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PMID:Quality of life in psychosomatic research. A psychometric model. 332 35

In a multicenter placebo-controlled study, the safety, side effects, and patient acceptance of alprazolam for the treatment of panic disorder and agoraphobia were examined. A total of 525 patients meeting DSM-III criteria for agoraphobia with panic attacks or panic disorder were randomly assigned to receive alprazolam or placebo, which they took for eight weeks. The mean daily dose at the end of the study was 5.7 mg of alprazolam or 7.5 capsules of placebo daily. Potentially serious reactions to alprazolam occurred in ten of 263 subjects who received the drug. These included acute intoxication (three), hepatitis (two), mania (two), amnesia (one), aggressive behavior (one), and depression (one). Treatment-related side effects that were worse in patients taking alprazolam than in those taking placebo included sedation, fatigue, ataxia, slurred speech, and amnesia. Sedation was the most frequent but tended to subside with dose reduction or continued administration of the drug. Patient acceptance of alprazolam, as measured by the rate of completion for study participants, was high. Eighty-four percent of patients receiving active drug completed the study compared with 50% receiving placebo.
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PMID:Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. II. Patient acceptance, side effects, and safety. 335 44


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