Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The morbidity of sleep problems has been well documented; however, they are frequently associated with and are symptomatic of several psychiatric disorders. It is unclear how much of the morbidity can be accounted for by the associated psychiatric and substance abuse disorders and medical problems, and how much by the sleep problems per se. Sleep problems may also be an early sign of a psychiatric problem. This paper reports data from an epidemiologic community survey of over 10,000 adults living in three U.S. communities. A structured diagnostic assessment of psychiatric disorders as well as assessment of the presence of insomnia not due to medical conditions, medication, drug or alcohol abuse, and a 1-year follow-up were completed. Persons with insomnia in the past year without any psychiatric disorders ever (uncomplicated insomnia); with a psychiatric disorder in the past year (complicated insomnia); and with neither insomnia nor psychiatric disorders ever were compared on treatment utilization and the first onset of a psychiatric disorder in the subsequent year. Eight percent of those with uncomplicated as compared with 14.9% with complicated insomnia and 2.5% with neither had sought treatment from the general medical sector for emotional problems in the 6 months prior to the interview. The rates of treatment sought from the psychiatric specialty sector were 3.8%, 9.4%, and 1.2%, respectively. These differences were significant after controlling for sociodemographic characteristics and were sustained when the persons were interviewed 1 year later. Uncomplicated insomnia was also associated with an increase in risk for first onset of major depression, panic disorder, and alcohol abuse over the following year. Insomnia, even in the absence of psychiatric disorders, is associated with increased use of general medical and mental health treatment for emotional problems and for the subsequent first onset in the following year of some psychiatric disorders. Early diagnosis and treatment of uncomplicated insomnia may be useful.
 ...
PMID:The morbidity of insomnia uncomplicated by psychiatric disorders. 932 53

A 50-year-old woman was admitted to our critical care center after pouring lamp oil on herself and setting herself on fire. Diagnosed with chronic hepatitis, she had received interferon-alpha at another hospital. During interferon therapy she developed anxiety, irritability, sleeplessness, and depression. At our hospital she underwent fluid resuscitation according to the method of Baxter. After treatment with topical cream and ointment, she underwent skin grafting. Interferon was not given. After discharge, wound healing proved satisfactory. She was intelligent and insightful, and her mental condition remained stable with no apparent emotional problems. As she had no significant past medical or psychiatric history and no history of substance abuse, we believe that her depression was a side effect of interferon therapy. A number of reports have described depression and other psychiatric disorders associated with interferon, but none of these accounts have concerned burns sustained in suicide attempts. This case underscores the potential seriousness of adverse reactions to interferon characterized by emotional disturbance and also illustrates that physicians who treat burn patients need to have an understanding of affective disorders and unusual side effects of medication.
 ...
PMID:Burns in a suicide attempt related to psychiatric side effects of interferon. 977 2

This paper reviews recent literature which suggests that sleep disturbance in members of the general population, whether or not they have ever had a formal psychiatric disorder, is a risk factor for the onset of a formal psychiatric diagnosis at a later time. Based upon the current literature, the strongest link is between subjective insomnia, lasting at least 2 weeks, and the later onset of depression. Less well-established data suggest that lifetime reports of at least 2 weeks of insomnia, hypersomnia, or both hypersomnia and insomnia, are risk factors for the later development of depression, anxiety disorders or substance abuse. More tentatively, preliminary data suggest that increasing subjective sleep disturbance may signal a relapse in remitted depressed patients. Sleep disturbances are common manifestations of major depressive and anxiety disorders. Therefore, sleep complaints may be among the most robust prodromal symptoms reflecting partial depressive or anxiety disorders, which eventually declare themselves as full-blown clinical episodes.
 ...
PMID:Are sleep disturbances risk factors for anxiety, depressive and addictive disorders? 977 46

Patients with major affective disorders are more likely to complete suicide than patients in any other medical group. Established risk factors for completed suicide in affective disorders include acute depression (with turmoil, hopelessness, global insomnia, anhedonia, anxiety and/or panic), mixed episodes, rapid cycling, substance abuse, aggression and/or impulsivity, low serotonergic activity, and hypothalamic-pituitary-adrenal axis activation. Although anticonvulsants have mood-stabilizing and antidepressant properties, few data are available on the antisuicide effects of anticonvulsant treatment in manic-depressive patients. On the other hand, as reviewed elsewhere in this issue, massive data have been accumulated on the antisuicide effect of lithium. This article discusses lithium versus anticonvulsants in the prevention of suicide associated with affective disorders and future treatment strategies to reduce this most serious complication of manic-depressive illness.
 ...
PMID:Anticonvulsant therapy and suicide risk in affective disorders. 1007 94

Benzodiazepines are widely prescribed for a variety of conditions, particularly anxiety and insomnia. They are relatively safe and, with overdose, rarely result in death. However, used chronically, benzodiazepines can be addicting. These agents are often taken in combination with other drugs of abuse by patients with addiction disorders. In such patients, alternatives to benzodiazepines may be preferable and may include antidepressants, anticonvulsants, buspirone, antihypertensive agents and the newer neuroleptic medications. Caution must be used when prescribing benzodiazepines to patients with a current or remote history of substance abuse.
 ...
PMID:Addiction: Part I. Benzodiazepines--side effects, abuse risk and alternatives. 1077 53

The threat of separation from a parent theoretically increases the risk of adolescent suicide attempts. The present study evaluated this and other hypothesized risk factors in a sample of adolescent suicide attempters and nonsuicidal controls, using the Psychiatric Consultation Checklist (Lyon, 1987). Stepwise logistic regression was used to predict group membership. It was found that threat of separation from a parental figure, insomnia, neglect, substance abuse, suicidal ideation, and failing grades were the strongest predictors of suicide attempt. Ten predictor variables correctly identified 97% of suicide attempters and 86% of nonattempters. Unexpected findings included high levels of truancy, threatening others, and separation from a parent before the age of 12 among nonattempters.
 ...
PMID:Assessing African American adolescents' risk for suicide attempts: attachment theory. 1084 1

Patients hospitalized for treatment of psychiatric illness commonly receive pro re nata (p.r.n.) anti-anxiety and hypnotic agents. The relationship between illicit drug use and p.r.n. anti-anxiety/hypnotic drug use in hospitalized psychiatric patients has not been extensively examined. The purpose of the present study was to examine this relationship. A retrospective review of 99 randomly selected hospitalized patients abstracted information regarding the utilization of p.r.n. anxiolytic and hypnotic medications. Seventy percent of the patients surveyed evidenced substance dependence. The substance users utilized p.r.n. anxiolytics (t = 2.29, df = 81, p < .05) and bedtime hypnotics (t = 4.23, df = 90, p < .0001) more frequently than the nonusers. Hospitalized substance abusers appear to continue their substance abuse in the hospital, substituting prescription preparations for illicit drugs. Nevertheless, cumulative literature now suggests that p.r.n. anxiolytic and hypnotic agents play a critical role in the management of aggressive behavior and insomnia in patients hospitalized with psychiatric illness.
 ...
PMID:Substance dependence and the use of pro re nata anxiolytic/hypnotic drugs in a hospital setting. 1089 Feb 98

Treating anxiety and depression in HIV patients was not a significant area of concern in the past. More mental health care is necessary as more HIV-positive patients survive longer. Health care providers need to be aware that some medications can hide or disguise symptoms, and some symptoms are by-products of the disease. Specific drugs and concerns are discussed for patients suffering from anxiety, depression, substance abuse, insomnia, and panic disorders. The need to be aware of the high correlation between AIDS diagnoses and suicide is highlighted.
 ...
PMID:Management of anxiety and depression in HIV-infected patients. 1136 92

HIV-positive individuals are at high risk of developing an anxiety disorder, with a prevalence rate as high as 38 percent. The symptoms may occur anytime during the course of the infection, and can become excessive in some patients, impairing the person's ability to cope with their circumstances. Signs and symptoms include chest pain, headache, numbness, and insomnia. HIV treatments that may cause anxiety symptoms include ddI, d4T, AZT, fluconazole, foscarnet, and isoniazid. Health care providers need to thoroughly evaluate anxiety symptoms during an initial evaluation to rule out substance abuse and pre-existing anxiety. Treatment of anxiety in HIV/AIDS ranges from benzodiazepines to alternative therapies such as massage and acupuncture. A chart lists potential drug interactions between common antidepressive and HIV antiretroviral drugs.
 ...
PMID:Anxiety and HIV infection. 1136 9

Many studies of antidepressants in the treatment of dysthymic disorder (DD) have been conducted, but none has included bupropion sustained-release (SR). The aim of this study was to provide preliminary data on the tolerability and effectiveness of bupropion SR for patients with DD. Twenty-one adult subjects meeting DSM-IV criteria for DD were enrolled in this 8-week open-label study. Bupropion SR was initiated at 150 mg/day and was increased to a maximum of 200 mg, twice daily. Response was defined as a 50% or greater decrease in score on the Hamilton Rating Scale for Depression (HAM-D). Of these 21 subjects, 15 (71.4%) responded to treatment. All paired sample t-tests were highly significant, demonstrating average improvement on all measures of symptomatology and functioning. Subject scores on the HAM-D decreased from 21.7 +/- 5.6 at baseline to 5.9 +/- 3.6 at week 8 (t[19] = 12.74, p < 0.001). The average final dosage was 364 mg/day. None of the subjects dropped out during the trial. Patients with a history of alcohol or chemical abuse were significantly less likely to respond to bupropion. Side effects were reported by eight subjects (38.1%), and the most frequently reported effects were headache, decreased appetite, insomnia, gastrointestinal problems, restlessness, and tremulousness. These findings suggest the effectiveness and high tolerability of bupropion SR for the treatment of DD. Double-blind prospective studies are needed for the comparison of bupropion SR to both placebo and other medications, assessing both initial and sustained responses to treatment.
 ...
PMID:Bupropion sustained-release for the treatment of dysthymic disorder: an open-label study. 1138 96


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