Showing papers on "Depression (differential diagnoses) published in 1973"

From art to science. The diagnosis and treatment of depression.

Abstract: In a review of the past and current literature on the classification of depression as a psychiatric disorder, it is apparent that diagnosis and treatment go hand-in-hand. The original Kraepelinian concept of dividing depression by etiological factors into endogenous and exogenous has persisted so that modern thinking in psychiatry still espouses aspects of this in various guises. While the art of diagnosis and treatment may have declined, the science of diagnosis and treatment has made great strides with the advent of high-speed computers, sophisticated statistical analyses, and the birth of neuropsychopharmacology as a science. I will summarize my own work on the formulation of an operational definition of depression as a disorder, its application into a rating instrument, the various validity and reliability studies performed, as well as clinical application of the rating scale.

Amitriptyline, weight gain and carbohydrate craving: a side effect.

Abstract: This paper reports excessive weight gain associated with craving for carbohydrates, occurring as a side effect of treatment with amitriptyline. Subjects were 51 depressed women who had responded to initial treatment with amitriptyline and remained well. Nineteen were maintained on amitriptyline for nine months; 32 had the medication withdrawn after three months. Both groups gained weight during recovery. Subsequently the amitriptyline group continued to gain weight excessively, while the drug withdrawal group did not. This difference was not due to persisting depression. Withdrawal of active drug after nine months treatment was followed by weight loss. Amitriptyline patients also reported a striking and dose-related craving for carbohydrates, developing within one or two months of starting the drug. Fasting insulin and glucose, and intravenous insulin tolerance were not affected, and the mechanism of the side effect is not clear. However, in confirmation of previous work, insulin resistance was found in subjects with minor residual depression.

Alcoholism and depression.

Abstract: In a study of relationships between alcoholism and unipolar affective disorder, three groups of patients collected in a research clinic were compared: a group with alcoholism without depression, a group with alcoholism plus affective disorder, and a group with unipolar affective disorder alone. The majority of patients with alcoholism and depression had a history of onset of alcoholism prior to that of depression. Patients with alcoholism plus depression more closely resembled those with alcoholism than those with depression. This finding is evidence that it is useful to separate affectively disordered patients into the groups with and without preexisting nonaffective psychiatric illness. The variables that separated alcoholic patients from patients with depression principally involved sociopathic symptoms that began prior to the onset of clinical alcoholism.

The diagnosis and management of depression

Abstract: "Since depression is a treatable disorder, and one whose diagnosis is not always clear, this is a book which should be read by every medical student and psychiatric resident as well as by psychiatrists already in practice."--American Journal of Psychiatry

Depression in the menopause.

Abstract: The author studied 71 women who had an affective disorder either before or after the menopause to determine if they were at greater risk for depression during the menopause than during other times of the life span. The difference was not significant: there was a 7.1 percent risk of developing an affective disorder during the menopause and a six percent risk during other times.

The Iowa 500: Follow-up of 225 Depressives

Abstract: Two hundred and twenty five cases of depressive illness were collected using rigorous diagnostic criteria. Of these patients, admitted to the hospital over 30 years ago, 213 were followed-up for periods of time varying between one month and 20 years; the material was recorded in the chart. Findings revealed that less than 5 per cent of the patients ever show a mania in the follow-up period. Depressive males are most likely to have subsequent episodes; depressive females are most likely to become chronic. Chronicity is a limited affair which may last up to 10 years but does not continue indefinitely. When early-onset females are compared to late-onset males, the latter have more subsequent episodes and less chronicity. It is possible that both early-onset females and late-onset males have the same illness, and that these differences are simply related to sex and age at index admission. However, these data may also be interpreted as support for the idea that there are two kinds of depressive illnesses. Early-onset females are considered to be the prototype of depression spectrum disease. They have a great deal of familial alcoholism and sociopathy. Late-onset males are the prototype of pure depressive disease. They have little familial sociopathy or alcoholism. The two groups are different in follow-up as regards frequency of subsequent episodes and chronicity.

Three types of childhood depression.

Abstract: This study appears to substantiate clinical impressions regarding the three types of prime symptom depression seen in children. The affectual group occurs in younger children, and seems to give way...

Depression and Marital Turmoil

Abstract: In this report (one in a series on divorce and psychiatric illness) we consider the 33 female and 12 male divorced probands with the diagnosis of definite unipolar affective disease. Of this group, 43 had an episode of depression of more than one month duration at the time of their marital separation or divorce and 20 of the 22 who had prior episodes of depression were again depressed at the time of marital disruption. The divorced depressives who had an episode of depression at the time of their separation or divorce were classified as "event associated" or "event nonassociated" on the basis of the temporal relationship of specific events to the onset of depression. There were 19 female and five male probands placed in the event-associated subgroup. The depressive symptoms, in the opinion of the interviewing psychiatrist, contributed to the marital disruption of six of the event-associated and 11 of the event-nonassociated divorced depressives.

A comparative review of patients with obsessional neurosis and with depression treated by psychosurgery.

Abstract: All patients with primary obsessional illnesses who underwent operation at least three years previously attended for a detailed review and a relative also came to give additional information. These 24 obsessional patients were compared to 24 patients with primary depressive illnesses, matched for sex and age, who also had psychosurgical operations at least three years before, and who also brought a close relative. Only two patients in each diagnostic group reported no improvement of any kind in the three years since operation, but more definite improvement (I and II) occurred in 67 per cent of the obsessionals and 71 per cent of the depressed patients. In this series no patient reported having become worse since operation. The backgrounds of the two groups were quite closely similar, except for a higher incidence of disturbed relationships with parents during childhood, especially the father, among the obsessionals, and there were a larger number of depressed patients reporting the death of one or other parent before the patient was 16 years old. In addition, there was evidence of more psychiatric illness among the close relatives of the obsessionals than was the case with the depressive group, but one quarter of the latter reported the loss of either a parent or sibling by suicide. However, these background factors could not be related to prognosis after operation. It was found that obsessionals who did poorly tended to have illnesses of an earlier onset (mean 22 years) compared to those who did well (33 years), and their illnesses tended to have begun suddenly. In the case of the depressed group the age of onset showed no relationship to outcome, and there was a tendency for illnesses of gradual onset to have a better prognosis. For all patients an onset in pregnancy or the puerperium was associated with a particularly good response. There was evidence to suggest that in general the presence of prominent depression improved the prognosis. Psychological tests given to the patients at the time of the review discriminated well between those of good outcome and those whose response was poor, but there was less differentiation between the two diagnostic groups.

Stages of schizophrenic decompensation and reintegration.

Abstract: As part of a rater blind outpatient drug study, 27 chronic schizophrenic patients experienced acute psychotic decompensation when removed from active medication. On close clinical observation, it was discovered that the patients passed through four distinct phenomenological stages during decompensat

The role of dopamine in depression.

Abstract: Il est maintenant universellement accepte que la catecholamine, la noradrenaline et l'indoleamine, 5-hydroxytryptamine (serotonin) sont d'importantes substances neuro-transmutrices ou leurs modulat...

Oral contraceptives pyridoxine and depression.

Abstract: Taking steroid hormones for the control of ovulation may be associated with depressive mood changes in women who are predisposed to depression. The author postulates that such depression may in som...

Pseudo-senility: acute and reversible organic brain syndromes.

Abstract: : The cerebral blood flow in healthy elderly men is not notably different from that in 20-year-old control subjects. Only in the presence of a significant degree of arteriosclerosis is there a decrease in cerebral blood flow. Eventually there is a decrease in cerebral metabolic function associated with a decline in mentation. To explain much of the early mental change in many elderly persons, the environment must be assessed. In an 11-year NIMH study of more than 600 variables, 2 factors proved to be accurate predictors of survival and mortality in the healthy elderly: (a) a new health indicator, viz, the organization of the subject's daily behavior; and (b) the presence or absence of chronic cigarette smoking. Behavior patterns of today's elderly are discussed. Pseudosenility, i.e., acute and potentially reversible mental change, is common in the elderly and may often be overlooked or misdiagnosed. Some causes are: medications, metabolic imbalance, depression, malnutrition, malignancy, hepatic disease, diminished cardiac output, cerebrovascular syndromes, febrile conditions, and chronic lung disease. Chronic, possibly reversible, mental syndromes include the depressions, dementias, deficiency states, and alcoholic encephalopathies. The treatment is outlined.

Alcoholism and Depression; The Factor Structure of Alcoholics' Responses to Depression Inventories

Abstract: A factor analysis of the responses of items in self-reported depression revealed major similarities between the affect described by alcoholics and that of primarily depressed patients.

Spinal-cord depressant effects of ketamine and etoxadrol in the cat and the rat.

Abstract: The effects of ketamine and etoxadrol an spinal reflexes were studied in the cat and the rat. At doses of 0.1 to 10 mg/kg, iv, ketamine and etoxadrol produced dose-related depression of flexor reflexes without affecting patellar reflexes in unanesthetized, acute high spinal cat preparations. Recordi

Depression in childhood.

Abstract: Although depressive illness in childhood is a somewhat controversial subject, recent literature suggests that it is being recognised with increasing frequency. The symptoms of 20 children regarded as suffering from depression were compared with those described as indicative of depression in standard texts. Not only did the children fit the clinical picture well, but there was some indication that the rudiments of the two types of depressive illness seen in adults may be recognisable in childhood.

Head injury in the chimpanzee. 2. Spontaneous and evoked epidural potentials as indices of injury severity.

Abstract: ✓ The effect of experimental head injury on the electroencephalogram (EEG) and cortical evoked response was studied in 11 awake, moderately restrained chimpanzees. As a base for comparison with injury effects, the waking and sleeping electroencephalogram (EEG) and the somatic and visual evoked responses (SER and VER) were investigated first. Unusually high voltage occipital waves and a propensity for photic driving characterized the EEG. Controlled blows to the occiput in 10 animals produced reversible depression of consciousness in only four. In those four, the EEG and SER were affected differently immediately after the injury; the SER showing marked suppression while the early EEG was unaffected. Recovery of the SER and of consciousness paralleled each other. With injuries causing prolonged or irreversible loss of consciousness, the later EEG showed depression or large amplitude slow waves, which became isoelectric if the blow was fatal.

Psychological "biopsy" in self-poisoning of children and adolescents.

Abstract: A "psychological biopsy" to assess suicidal intent was conducted by public health nurses on 50 subjects, ages 6 to 18, treated at a poison control center. The hospital diagnoses were accident in 42% and suicide attempt in 58%. After assessment, the diagnoses were accident in 4%, suicide gesture in 70%, suicide attempt in 2%, intoxication in 22%, and homicide in 2%. Prior suicide gestures had been made by 26% of the subjects. Extremes or divergence of parental expectations and control were found in 60%. A dominant pattern of hostility and low lethality of intent was associated with low parental control and low expectations as contrasted to a dominant depression in the high control-high expectations group. The authors propose a "rejection cycle" in which the parental response to the suicide gesture and to acting-out behavior favors recidivism.