Showing papers on "Depression (differential diagnoses) published in 1977"
TL;DR: The evidence for differing rates of depression between the sexes in the United States and elsewhere during the last 40 years is reviewed, and the various explanations offered are critically analyzed.
Abstract: • This article reviews the evidence for differing rates of depression between the sexes in the United States and elsewhere during the last 40 years, and then critically analyzes the various explanations offered. These explanations include the possibility that the trends are spurious because of artifacts produced by methods of reporting symptoms, or that they are real because of biological susceptibility (possibly genetic or female endocrine), psychosocial factors such as social discrimination, or female-learned helplessness.
1,811 citations
TL;DR: By reviewing causes of death among cohorts of various major disease entities or conditions, one may infer that a large majority of suicides are associated with a relatively small number of conditions.
Abstract: By reviewing causes of death among cohorts of various major disease entities or conditions, one may infer that a large majority of suicides are associated with a relatively small number of conditions. From the available follow-up studies, we might estimate that the following percentage of affected individuals will die by suicide: primary (endogenous) depression, 15 per cent; reactive (neurotic) depression, 15 per cent; alcoholism, 15 per cent; schizophrenia, 10 per cent; psychopathic personality, 5 per cent; opiate addiction, 10 per cent or more. Rough estimates of the number of suicides per year in the United States attributable to each condition might be as follows (using low incidence figures): depression, 12,900; alcoholism, 6,900; schizophrenia, 3,800; psychopathy, 2,000 (?); drug addiction, 900.
481 citations
TL;DR: It is concluded that mood disorder is a more specific complication of stroke than simply a response to the motor disability and that a controlled trial of antidepressant medication is indicated for patients with this complication.
Abstract: In an effort to discern whether cerebral vascular injuries provoke specific emotional disturbances, 20 consecutively admitted stroke patients were compared with 10 orthopaedic patients. Both groups were examined for functional disabilities (Activities of Daily Living) and for psychiatric symptoms. Reliable and valid instruments, the Hamilton Rating Scale, the Visual Analogue Mood Scale, the Present State Exam, and the Mini-Mental State Exam were employed to display the psychopathology. More of stroke patients than orthopaedic patients were depressed (45% versus 10%) even though the level of functional disability in both groups were the same. Patients with right hemisphere stroke seemed particularly vulnerable and and displayed a syndrome of irritability, loss of interest, and difficulty in concentration, in addition to depression of mood (70% of right hemisphere stroke patients versus 0% left hemisphere stroke patients and 0% orthopaedic patients). We conclude that mood disorder is a more specific complication of stroke than simply a response to the motor disability. We suggest that a controlled trial of antidepressant medication is indicated for patients with this complication.
407 citations
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TL;DR: It is argued that among patients all types of past loss by death are associated with psychotic-like depressive symptoms and other types with neurotic-type depressive symptoms (and their severity) and that these associations probably reflect direct causal links, and a sociopsychological theory to explain them is discussed.
Abstract: Recent losses occurring in the two years before onset of depression in women are distinguished from past losses occurring at any time before this. Of past losses only loss of mother before II is associated with greater risk of depression--both among women treated by psychiatrists and among women found to be suffering from depression in a random sample of 458 women living in London. Past loss of a father or sibling before 17 (or a mother between II and 17), or a child or husband, is not associated with a greater chance of developing depression. However, among patients all types of past loss by death are associated with psychotic-like depressive symptoms (and their severity) and other types of past loss with neurotic-type depressive symptoms (and their severity). It is argued that these associations probably reflect direct causal links, and a sociopsychological theory to explain them is discussed.
348 citations
Book•
01 Jun 1977
212 citations
01 Mar 1977-Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications
TL;DR: In this article, the authors present a pastoral counseling approach to help women with depression at about the same time their children leave home, their husband is realizing success in his work with increased eased demands on his time and she is going through the menopause.
Abstract: Depression can come from a sense ofloss or a change ofrole and from the loss of self-esteem and the anger that result from that loss or change. Depression often strikes a woman at about the same time her children leave home, her husband is realizing success in his work with increased eased demands on his time and she is going through the menopause. Through pastoral counseling the depressed woman perhaps can get in touch with her anger and express it in a nonjudgmental situation. She may begin to feel accepted, to regain her sense of value and self-esteem and be encouraged to enter into interesting and renewing activities.
127 citations
TL;DR: It is suggested that symptoms “equivalent” to depression such as hyperactivity, deviant behavior, and learning difficulties are not required in establishing clinical depression in childhood.
Abstract: One quarter of 29 parents hospitalized for depression had children with episodes of depression (eight out of a total of 75 children). None of the children in 41 families with well parents had episodes of depression (a total of 152 children). The differences were significant at the .01 level.It is su
109 citations
TL;DR: It is postulate that the slow behavioral and biological changes preceding switches in this patient are an important manifestation of the cyclic process in manic-depressive illness.
Abstract: • Biochemical and electrophysiological factors were studied longitudinally in a rapidly cycling manic-depressive patient. Slow changes in mood, motor activity, sleep, and urinary norepinephrine levels during the course of each depressed and manic episode are reported, as well as rapid alterations in many variables at the time of mood switch. Urinary concentrations of norepinephrine and its metabolite, 3-methoxy-4-hydroxyphenyl glycol (MHPG) were significantly lower in depression than in mania; norepinephrine but not MHPG excretion increased prior to the switch. We postulate that the slow behavioral and biological changes preceding switches in this patient are an important manifestation of the cyclic process in manic-depressive illness.
104 citations
TL;DR: Depression scores of the depressed group did not improve within the given treatment period, in contrast with improved scores for the non‐depressed subjects who reported increased feelings of well‐being following hormone replacement therapy.
Abstract: A study of the effects of conjugated oestrogens (Premarin) upon the depression scores of depressed and non-depressed menopausal women was carried out. Depression levels were obtained for both groups before and after four weeks of hormone replacement therapy. The Beck Depression Inventory (BDI) was used to assess depression levels, while a semistructured interview provided information related to the physiological, psychological and sociocultural stresses affecting individual women. Depression scores of the depressed group did not improve within the given treatment period, in contrast with improved scores for the non-depressed subjects who reported increased feelings of well-being following hormone replacement therapy.
100 citations
TL;DR: Evidence is presented to support the hypothesis that depression may be not only reactive but biochemically related to the disease and to suggest that ECT has a specific antiparkinsonian effect.
Abstract: The author reviews the association between Parkinson's disease and depression and presents evidence to support the hypothesis that depression may be not only reactive but biochemically related to the disease. A psychotically depressed patient with parkinsonism responded positively to ECT as shown by improvement on a depression rating scale, two extrapyramidal rating scales, and handwriting samples. The beneficial effect on parkinsonian signs occurred before the improvement in depression, which suggests that ECT has a specific antiparkinsonian effect. Possible explanations for this observation based on biochemical theories of depression are discussed.
88 citations
Journal Article•
Journal Article•
TL;DR: People who have primary affective disorders and chronic alcohol abuse with depression should be given antipsychotic medication, stimulants, or diazepam only after extremely careful consideration.
Abstract: We reviewed all Mayo Clinic case histories in which a diagnosis of tardive dyskinesia or dyskinesia might have been recorded during the years 1965 through 1973 and interviewed 18 consecutive patients in the Department of Psychiatry and Psychology. Among the histories and patients, we found a high incidence of primary affective disorders. Four of the five men had a history of chronic alcohol abuse and symptoms of depression. We recommend that people who have primary affective disorders and chronic alcohol abuse with depression should be given antipsychotic medication, stimulants, or diazepam only after extremely careful consideration.
TL;DR: It was found that there was no correlation between elevated scores on the Zung SDS and diastolic BP, and the diagnosis of anxiety, however, was significantly associated both with depression and hypertension.
Abstract: The study consisted of 1101 Caucasian, male outpatients, who were screened for depression and hypertension in order to test the hypothesis that there is a unique relationship between these two illnesses. Depression was assessed by the Zung Self-Rating Depression Scale (SDS) while diastolic blood pressure (BP) was accepted as the index of hypertension. Medical records were reviewed to determine whether the patient's clinical diagnoses would have an effect on any relationship between depression and hypertension. It was found that there was no correlation between elevated scores on the Zung SDS and diastolic BP. The diagnosis of anxiety, however, was significantly associated both with depression and hypertension.
01 Jan 1977
TL;DR: These findings suggest the pathogenetic importance of the hypothalamo-pituitary dysfunction in depressed patients and suggest a number of patients, especially those with diminished and delayed TSH responses to TRH, are prone to develop latent hypothyroidism which might make them resistant to antidepressants.
TL;DR: The corticosteroid response to methylamphetamine was lower in ten patients when they were depressed than when they was recovered, which may indicate a functional deficiency of noradrenaline at alpha adrenergic receptors in these patients during the time they are depressed.
Abstract: The corticosteroid response to methylamphetamine was lower in ten patients when they were depressed than when they were recovered (P less than .026). The growth hormone responses to the same injection in the depressed and recovered states were not significantly different. This pattern of responses is seen in normal subjects after blockade of alpha adrenergic receptors. These findings may indicate a functional deficiency of noradrenaline at alpha adrenergic receptors in these patients during the time they are depressed.
01 Aug 1977
TL;DR: It is believed that orthostatic hypotension is a significant event in patients who have primary affective disorders treated with tricyclic antidepressants, and this sign should be looked for in all patients regardless of age or the presence of significant cardiovascular disease.
Abstract: Previous studies have indicated that postural hypotension is an uncommon event when tricyclic antidepressants are used in the treatment of depression, and other studies have indicated that postural hypotension is a possible predictor of positive therapeutic response to antidepressant therapy. In this study, 20 depressed patients with the diagnosis of primary affective disorders were hospitalized and treated with tricyclic antidepressants. All patients had been without medication for at least 2 weeks before the study began. Blood pressure recordings were made after a 5-minute resting period and then followed by another reading after the patient had been standing for 2 minutes. Our findings indicate that these patients with primary affective disorders developed significant orthostatic hypotension. It is our belief that orthostatic hypotension is a significant event in patients who have primary affective disorders treated with tricyclic antidepressants, and this sign should be looked for in all patients regardless of age or the presence of significant cardiovascular disease.
TL;DR: In this paper, the relationship between depression and self-reinforcement behavior was examined in hospitalized medical patients and the results were discussed in terms of the possible explanatory role of self reinforcement in the development and maintenance of depressed behavior.
TL;DR: The switch into mania is viewed in the context of a longitudinal cyclic process and may be further studied with specific pharmacologic agents that block drug-induced maniclike states in man.
Abstract: Bipolar manic-depressive illness is a chronic disease in which patients experience recurrent episodes of mania and depression. Patients often change from a nonverbal, retarded depression o...
TL;DR: Evidence for a fault in hypothalamic pituitary regulation in some depressed patients but not in schizophrenic patients is provided, as no relationship was found between TSH response and severity of illness, clinical subtypes (unipolar/bipolar) and clinical remission.
TL;DR: Comparison of the depressed and nondepressed groups indicated that the former had higher frequencies of drug abuse, more marital difficulties, a higher unemployment rate, and more current legal problems than the latter.
Abstract: The authors evaluated the incidence of depression in a sample of 202 Viet Nam veterans an average of 28 months after their return from Viet Nam. Approximately one-third of the sample fell within the clinically depressed range of the Beck Depression Inventory. Comparison of the depressed and nondepressed groups indicated that the former had higher frequencies of drug abuse (particularly while in Viet Nam), more marital difficulties, a higher unemployment rate, and more current legal problems. This high incidence of depression, coupled with the finding that few of these men were being treated for the illness, indicates the need for an outreach approach to this population.
TL;DR: Important personality and course differences separate depressive spectrum disease from pure depressive disease.
Abstract: In a group of 191 women admitted to the University of Iowa Psychiatric Hospital for depression over a 45-year period and selected on the basis of alcoholism or antisocial personality, vs. depression, in a parent, 105 probands fit into the depression spectrum group (parental alcoholism or antisocial personality) and 86 into the pure depression group (parental depression). Few differences were found between the presenting clinical pictures (including precipitating factors) of the two groups; but depression spectrum patients and pure depressive patients showed study differences in the areas of personal problems and personality as well as course of illness. The depression spectrum patients were significantly less likely to have loss of interest in usual activities as a symptom at index admission. They were significantly more likely to have had a history of sexual problems, to have been divorced or separated before, to have been described as irritable, and to report having previously been depressed. They are nonetheless significantly more likely to recover completely and have no relapse of depression. The pure depression group were significantly more likely to have depressed sisters, and suicide was much more frequent in their ill parents. Thus, important personality and course differences separate depressive spectrum disease from pure depressive disease; Language: en
TL;DR: The scores on measures of depression and symptomatology and life events obtained in an initial interview and a 1-year follow-up interview for two community samples that provide data on the course of depression are examined.
TL;DR: The onset of depression before the age of 40 years predisposed to recurrences, there was risk of chronicity in those patients who developed the illness after 40, and the change of polarity from depression to mania occurred within three years after the initial depression, though in others the shift occurred between three years and twelve years.
Abstract: One hundred and nine out of one hundred and twenty-two cases of endogenous depression were followed-up after their index diagnosis 3-13 years earlier No recurrence occurred in 28 cases Forty-two cases turned out to be bipolar and 21 remained unipolar Manic episodes outnumbered the depressive ones The change of polarity from depression to mania occurred within three years after the initial depression, though in others the shift occurred between three years and twelve years The number of episodes of depression before the onset of mania varied from 1 to 3 While the onset of depression before the age of 40 years predisposed to recurrences, there was risk of chronicity in those patients who developed the illness after 40
Journal Article•
TL;DR: Three patients hospitalized solely due to recurrent emotional disorders are described, and a diagnosis of MS was made based on subtle neurologic signs, spinal fluid gamma globulin elevations, and abnormalities in neuropsychological testing.
Abstract: A diagnostic dilemma exists when clinicians face patients with atypical recurrent symptoms involving both physical and psychologic elements. Multiple sclerosis (MS) represents such a dilemma. Few authors address themselves to the significance of depressive illness as the initial presentation in MS. Three patients hospitalized solely due to recurrent emotional disorders are described. Depressive symptoms predominated. In each case no precipitant for depression was identified, no previous neurologic diagnosis was entertained by clinician or patient, and multiple prior psychotherapeutic interventions were unsuccessful. The episodic nature of the symptoms and poor response to usually effective treatments created a high index of suspicion for central nervous system disease. A diagnosis of MS was made based on subtle neurologic signs, spinal fluid gamma globulin elevations, and abnormalities in neuropsychological testing. Treatment involved integrated psychiatric and medical measures.