Showing papers on "Depression (differential diagnoses) published in 1971"

Relation of Sex and Aging to Monoamine Oxidase Activity of Human Brain, Plasma, and Platelets

Abstract: Monoamine oxidase (MAO) activity was determined in blood from 113 normal subjects ranging from 21 to 84 years of age and in hindbrain obtained at autopsy from 26 patients. MAO activity correlated highly with increasing age for all three sources of enzyme studied (hindbrain, plasma, and platelets). Women were found to have significantly higher mean platelet and plasma MAO activity than men. The tendency for greater MAO activity in women and with aging is intriguing because it is consistent with clinical observations about the incidence of depressive illness. Increased enzyme activity related to aging and sex may be a biologic factor that, in association with Psychological and social stresses, predisposes certain individuals to the development of depression.

Cardiac conduction in patients with symptomatic sinus node disease.

Abstract: Cardiac conduction was investigated at the time of pacemaker insertion in 15 patients with symptomatic sinus node disease. Techniques included recording of His bundle potentials, atrial pacing at various heart rates, and atropine administration. Atrioventricular (AV) conduction was impaired in eight patients who manifested one or more of the following: P-R prolongation, P-H prolongation, and development of second degree AV block with atrial pacing at heart rates below 130 beats/min. Five patients had intraventricular conduction defects diagnosed electrocardiographically; none of these had H-Q prolongation. One of these five, with left bundle-branch block, subsequently developed complete heart block and had a calcific lesion involving the His bundle. Depression of cardiac automaticity was noted in four patients, with asystolic periods greater than 2 sec after sudden cessation of atrial pacing at rates of 100-160 beats/min. Responses to 1 mg of intravenous atropine were varied, but no patient developed sinus rates greater than 90 beats/min, suggesting the presence of primary sinus node dysfunction. In conclusion, abnormalities of conduction and automaticity in specialized tissue in addition to the sinus node are common in patients with symptomatic sinus node disease. These abnormalities should be recognized when present, so that the ideal site for permanent pacing may be chosen.

Assessing Clinical Characteristics of the Manic State

Abstract: The authors found that 11 of the 26 items of the Manic-State Rating Scale characterized common elements of mania in 12 manic-depressive patients and that these items were highly correlated with independent ratings of change in the severity of mania Eight other items provided a basis for dividing the patients into two groups: one showing elation and grandiosity but little paranoid or destructive symptomatology, and the other with minimal euphoria and grandiosity but more marked paranoid and destructive behavior The authors also found ratable depression in 11 of these 12 patients

Relation of depression of attempted suicide and seriousness of intent.

Abstract: Forty-five patients admitted to Philadelphia General Hospital after having attempted suicide were studied using the Beck Depression Inventory (omitting the suicidal ideation item) as the measure of depression, it was found that 80% of the patients attempting suicide scored in the depressed range Their mean depression score was significantly higher than the mean score of 394 psychiatric inpatient controls There was no significant difference between the depression scores of attempters admitted to medical and surgical wards and the scores of those admitted to the psychiatric wards The patient's wish to die was measured by the suicidal intent scale A significant correlation between the depth of depression and the degree of suicidal intent was found Statistical analysis indicated that this correlation was not a function of age

Depression and attempted suicide: a study of 91 cases seen in a casualty department

Abstract: 1. The severity of depression and some attitudes towards the suicide attempt were recorded in 91 cases seen in the casualty department of a Scottish university city. The sample contained 23 teenagers (25.3 per cent). 2. The self-administered depression rating scale had been used in a previous study of patients receiving E.C.T. There was found to be no significant difference in the depressive symptomatology of the E.C.T. treated patients and attempted suicides of comparable age distribution though the mean depression scores were lower in the attempted suicide group. 3. A significant relationship was demonstrated between the wish to die at the time of the attempt and the depression rating score. 4. There appeared to be no relationship between the level of consciousness and the severity of depression, but a significantly higher proportion of those who lost consciousness were recommended for admission. 5. A significant relationship was demonstrated between the period of contemplation of the attempt and the wish to die: of those who had wanted to die proportionally more had thought about it longer. The mean depression scores were higher the longer the period of contemplation. 6. Though the assessing psychiatrists had not seen the depression rating score those patients recommended for admission were shown to be significantly more depressed. 7. The use of the questionary as a possible screening procedure of attempted suicides seen in casualty departments was considered.

Tricyclic Antidepressants and Monoamine Oxidase Inhibitors: Combination Therapy in the Treatment of Depression

Abstract: The combination of a tricyclic and a monoamine oxidase inhibitor (MAOI) has been reported effective in the treatment of depression but is avoided in this country due to concern over adverse reactions. A review of the case reports on which this concern with morbidity is based reveals no convincing evidence that the antidepressant combination taken in therapeutic doses was responsible for the illness reported. An informal review of 350 outpatients, a record examination of 50 inpatients, and a drug trial with 10 current patients has shown no drug-related morbidity. We conclude that the present evidence does not indicate the combined drug regimen unsafe. A suggestion is made for controlled clinical trials of MAOI-tricyclic antidepressant therapy to evaluate better its clinical effectiveness.

Drugs of Dependence Though Not of Abuse: Fenfluramine and Imipramine

Abstract: Measures of subjective feeling used by five patients indicated that depression of mood occurred about four days after fenfluramine withdrawal. An experiment in which another 11 patients took fenfluramine 80 mg for 28 days confirmed the depression, maximal on the fourth withdrawal day. It also indicated that in the first week of administration there was some mood elevation, but with feelings of impaired ability to concentrate. The drug reduced appetite and weight. A comparison is drawn with imipramine, which was found to induce initial and withdrawal changes of subjective experience (of dreaming) in six volunteers. It is suggested that certain mood-influencing drugs may not be drugs of abuse because of some unpleasant initial effects, though they can be drugs of dependence.

Anxiety State or Masked Depression?: A Study based on the Action of Monoamine Oxidase Inhibitors

Abstract: The frequency with which symptoms of the depressive functional shift occurred in 101 adults suffering from anxiety states which responded to monoamine oxidase inhibitors and in 147 depressed patients were compared. The symptoms were classified as typical or atypical according to the direction of change in function. The difference in symptomatology between the groups was small. Typical symptoms were commoner among older patients, whereas atypical symptoms were commoner in the younger subjects in both groups. The possibility is discussed that anxiety states responsive to monoamine oxidase inhibitors are a form of depression, and that the different clinical picture is partly determined by chronological age.

Personality patterns in patients with affective disorders

Abstract: In a previous report (Perris 1966) i t was shown that bipolar (manicdepressive) and unipolar depressive psychotics have different personality traits. The series comprised 108 patients (50 bipolar and 58 unipolar) who were studied with an abridged version of the Nyman-Marke Temperament Scale (NMTS: Nyman & Marke 1958) during a symptomfree interval. Bipolar patients showed higher scores in the ”substability” (syntony) variable, the unipolar ones, on the other hand, in the ”subvalidity” (psychasthenia) variable; the difference was independent of sex and age. Global personality evaluation by Angst (1966) gave results in line with the above-mentioned study and agrees, by and large, with results presented by Leonhard et al. (1962, 1963). In a recent careful investigation von Zerssen et al. (1968) came to the conclusion that unipolar patients frequently show psychasthenic and anancastic traits. Metcalfe (1968) suggested a tendency to repetitive worrying as well as a rigid attitude in recovered depressive patients; this also agrees with the opinion of Kielholz (1959) as regards patients classified as suffering from ”involutional melancholy”. There are a few studies concerned with the Maudsley Personality Inventory (MPI: Eysenck 1959) and depressive disorders (Astroim & Olander 1960, Wretmark et al. 1961, 1970, Coppen & Metcalfe 1965, Metcalfe 1968, Thelma et al. 1969, Kerr et al. 1970). Most of these studies have been concerned more with the influence of a depressive disorder on MPI scores than with possible differences between different groups of depressed patients. Changes in MPI scores were reported by all investigators in patients who improved or recovered. E-scores increased and N-scores decreased from the phase of illness to that of recovery both in patients diagnosed as ”endogenous” and ”reactive”. Astrom & Olander (1960) found on discharge higher E-scores in ”endogenous” than in ”reactive” patients, but no difference in N-scores. Kerr et al. (1970) among

Family studies in individuals with selective absence of gamma-A-globulin.

Abstract: The immunoglobulins were studied in twenty-one individuals with isolated lack of γA-globulin and in eleven of their families. The propositi were normal blood donors and patients with ataxia telangiectasia, with rheumatoid arthritis, or in a few cases other conditions. With the exception of one family where the mother and one child lacked γA, no family members other than the propositi were affected. In the family members, the levels of γA-globulin and of other immunoglobulins were mostly within normal ranges. Furthermore, there was no association between the lack of γA-globulin and the Gm marker system. Anti-γA antibodies were found in seven propositi. The findings demonstrated that the lack of γA-globulin was usually not due to structural gene defects, but indicated some regulatory mechanism, with depression of γA synthesis.

A Study of Eye-Contact Changes in Depressed and Recovered Psychiatric Patients

Abstract: We have shown a very significant difference between the frequency and length of eye contact in a group of depressed patients. We have adequately controlled for the variable of reinforcement by the interviewer. Eye-contact is therefore a very useful non-verbal cue in the affective change of depression.

Acetophenazine and Diazepam in Anxious Depressions

Abstract: Sixty-seven newly admitted depressed patients were classified on the basis of their presenting signs and symptoms as having the syndrome of anxious depression. They were assigned randomly either to treatment with the phenothiazine derivative, acetophenazine, or with the antianxiety drug, diazepam. After four weeks of treatment, both groups were equally improved. Study of the interactions between drugs and demographic variables revealed that patients with less long-term and uncomplicated depressions responded better to diazepam, the converse being true for acetophenazine. Although our previous studies indicated that phenothiazine derivatives were preferable to conventional tricyclic antidepressants in patients with anxious depressions, antianxiety agents are also effective. In fact, because most patients fall into the group which responds best to them, as well as because of their greater safety, drugs such as diazepam might be the first choice for treating the most common depressive syndrome, that of anxious depression.

Prediction of anxiety and depression patterns among coronary patients using a markov process analysis

Abstract: A Markov process analysis was applied in a study of anxiety and depression patterns among 31 male patients with coronary heart disease and 46 healthy male controls. Anxiety and depression were measured at six- to eight-week intervals over a period of 15 months by the subjects' completion of shortened versions of the Bendig Anxiety and Welsh Depression subscales of the MMPI. The sequence of anxiety and depression states for each subject at each examination was used as input to the Markov analysis system. Patients had significantly higher anxiety scores over time than the controls. Patients under age 50 showed a fivefold greater incidence of anxiety and a higher degree of retention of high anxiety over time than controls in the same age group. The anxiety level of controls was low irrespective of age. While depression was a more persistent state among patients than controls, it was not found to be age-related among either patients or controls. The implication of these findings in planning strategies of therapeutic intervention to circumvent the cumulative effects of anxiety and depression is discussed.

Ethology and Psychiatry

Abstract: SYNOPSISSome of the principles underlying the science of ethology are described. Analogies are drawn between ethological and psychiatric observations in the psychiatric areas of reactions to separation, bereavement, depression, anxiety, sexual disorders and hysteria. It is suggested that in other areas also, notably obsessional states and schizophrenia, ethological concepts may be relevant. The implications and limitations of these analogies are briefly explored.