Showing papers on "Depression (differential diagnoses) published in 1980"
TL;DR: A 30-item questionnaire was devised to measure the frequency of occurrence of automatic negative thoughts (negative self-statements) associated with depression as discussed by the authors, which was cross-validated and found to significantly discriminate psychometrically depressed from nondepressed criterion groups.
Abstract: A 30-item questionnaire was devised to measure the frequency of occurrence of automatic negative thoughts (negative self-statements)associated with depression. Male and female undergraduates were asked to recall dysphoric experiences and to report associated cognitions. One hundred representative cognitions were selected and administered to a second sample, along with the MMPI D scale and the Beck Depression Inventory. Thirty items discriminating between criterion groups of psychometrically depressed and nondepressed subjects were identified. The resultant 30-item automatic thoughts questionnaire (ATQ-30)was cross-validated and found to significantly discriminate psychometrically depressed from nondepressed criterion groups. No differences were found between males and females on the measure. Factor analysis indicated a four-factor solution, with a large first factor reflecting Personal Maladjustment, a second factor indicative of Negative Self-Concept and Negative Expectations, and two lesser factors. The ATQ-30 may provide a means of testing basic theory relating cognitive content to behavioral and affective processes and assessing change in cognitions associated with experimental manipulation or psychotherapeutic intervention.
1,371 citations
1,134 citations
TL;DR: A modest relationship between self-reported symptoms of depression and the diagnosis of a major or minor depression is indicated and symptom scales are only rough indicators of clinical depression in the community.
Abstract: The authors gave the CES-D, a self-report depression symptom scale, to 515 people drawn from a longitudinal community survey. The subjects were also interviewed using the Schedule for Affective Disorders and Schizophrenia (SADS). From the information collected on the SADS, the subjects were given diagnoses based on Research Diagnostic Criteria. The results indicate a modest relationship between self-reported symptoms of depression and the diagnosis of a major or minor depression. However, the groups defined as "cases" by such reports also include many people with other diagnoses or with no diagnoses at all. Thus, symptom scales are useful for the screening of depressed persons in research studies but are only rough indicators of clinical depression in the community.
779 citations
TL;DR: The authors surveyed 997 elderly people living in the community and found that the rate of significant dysphoric symptomatology was 14.7% and individuals with symptoms of a major depressive disorder had depressive symptoms associated with impaired physical health.
Abstract: The authors surveyed 997 elderly people living in the community and found that the rate of significant dysphoric symptomatology was 14.7%. Forty-five (4.5%) of these individuals suffered from dysphoric symptoms only, and 37 (3.7%) had symptoms of a major depressive disorder. Eighteen (1.8%) suffered from symptoms of primary depressive disorder and 19 (1.9%) from symptoms of secondary depressive disorder. Sixty-five (6.5%) had depressive symptoms associated with impaired physical health. The frequency of widowhood, impairment in social resources, and impairment in economic resources was greater for individuals with symptoms of a major depressive disorder. The entire sample used psychiatric services at a very low rate.
585 citations
TL;DR: The BDI was shown to be a sensitive screening test; its use is advocated to improve recognition of depression by primary physicians.
Abstract: • Previous studies of medical outpatients have documented a high prevalence of depression that is often unrecognized by primary physicians. However, the subjective methodologies of most of these studies limit their quantitative and comparative usefulness. By contrast, in the present study, 526 medical outpatients completed a self-report questionnaire, the Beck Depression Inventory (BDI). Questionnaire results were calibrated by psychiatric interviews of a subsample of 41 patients. The prevalence of depression was 12.2% when at least mild depression was used as a criterion; the rate for moderate depression was 5.5%, and the rate for severe, probably "psychotic," depression was 0.6%. A review of medical charts showed that primary physicians failed to diagnose about 50% of both depressed and otherwise impaired patients. The BDI was shown to be a sensitive screening test; its use is advocated to improve recognition of depression by primary physicians.
411 citations
TL;DR: Although children with a depressive disorder may also exhibit behavior disorders that overshadow the depression, an alert clinician conducting a thorough interview should be able to identify the "masked" depression.
Abstract: The authors examined depressive symptoms and behavior disorders in 102 systematically interviewed children aged 7 to 17 years to elucidate the category of masked depression. They found that it was possible to diagnose these children using adult research criteria and that more children with depression were identified using a systematic interview than were identified using standard evaluation procedures. Although children with a depressive disorder may also exhibit behavior disorders that overshadow the depression, an alert clinician conducting a thorough interview should be able to identify the "masked" depression.
359 citations
TL;DR: The data suggest that the depressive syndrome is composed of separate illnesses, each of which has a distinctive pattern of hypothalamic-pituitary-adrenal axis activity during the depressed state as well as a specific clinical and familial psychiatric history.
Abstract: • Serum cortisol response to the 1-mg overnight dexamethasone suppression test was studied in 221 depressed patients and 109 nondepressed psychiatric controls. Nonsuppression distinguished patients with primary unipolar depression (65/ 146) from patients with secondary unipolar depression (0/42) and nondepressed controls (0/109). Furthermore, nonsuppression distinguished the three familial subtypes of primary unipolar depressive illness: familial pure depressive disease (FPDD; 38/50 patients), sporadic depressive disease (SDD; 24/55 patients), and depression spectrum disease (3/41 patients). Moderate elevations in baseline serum cortisol levels were found in FPDD, SDD, and bipolar depression. Medication did not affect the results. The data suggest that the depressive syndrome is composed of separate illnesses, each of which has a distinctive pattern of hypothalamic-pituitary-adrenal axis activity during the depressed state as well as a specific clinical and familial psychiatric history.
339 citations
TL;DR: It is concluded that exercise stress testing has increased with office-based testing undergoing the greatest expansion and this has been associated with few complications and greater safety.
242 citations
TL;DR: The clinical features, treatment, course and outcome of a consecutive series of 102 anorexia nervosa patients are reported in detail, and a disturbed premorbid relationship between patient and parents was found and this was often related to a disturbed parental relationship.
238 citations
TL;DR: It is concluded that in some patients serious affective disorder may be a presenting or complicating feature of multiple sclerosis.
Abstract: Thirty patients suffering from multiple sclerosis have been compared with 30 patients suffering from other chronic neurological diseases. The degree of disability was similar in these two groups. The patients with multiple sclerosis had experienced more episodes of severe depression both before and after the onset of neurological symptoms. The possible reasons for these episodes are discussed and it is concluded that in some patients serious affective disorder may be a presenting or complicating feature of multiple sclerosis.
227 citations
TL;DR: The use of audiometric techniques of assessment established that an association exists between deafness and depression that is not simply a function of differential reporting reflecting the emotional state of the respondent.
Abstract: Altogether 153 (60%) out of a sample of 253 people aged 70 years and over living in their own homes were found to have impaired hearing when tested by pure-tone audiometry. This is almost twice the prevalence found in all other studies, in which deafness was assessed clinically or by self-reporting. The prevalence of deafness increased with age. Evidence of organic brain syndrome (dementia), as determined by questionnaire, was present in 39 (16%) out of 245 respondents, and of depression in 82 (35%). Dementia and depression were both age related. An apparent association between deafness and dementia was shown to be due to age alone. A significant relation between deafness and depression was independent of age and socioeconomic state. The use of audiometric techniques of assessment established that an association exists between deafness and depression that is not simply a function of differential reporting reflecting the emotional state of the respondent.
TL;DR: Data suggest that pituitary adrenal disinhibition as assessed by the DST is selectively associated with primary depression, which may be a marker of a depressive subtype with a specific pathophysiology or pathogenesis.
Abstract: • This study examines the utility of the dexamethasone suppression test (DST) in identifying a clinically meaningful subtype of depression. Forty-nine inpatients who met research diagnostic criteria for major depressive disorder underwent DSTs and standard clinical assessments and ratings. Half of those with primary depression showed escape from dexamethasone suppression and are referred to as nonsuppressors, while few of those with secondary depression had this response. Most of the nonsuppressors were rated as having a good response to treatment, while only one third of the suppressors were rated as having a good response to treatment. These data suggest that pituitary adrenal disinhibition as assessed by the DST is selectively associated with primary depression. The DST may be a marker of a depressive subtype with a specific pathophysiology or pathogenesis.
TL;DR: Results showed that the therapeutic outcome was a function of the patient's ability to become involved in a therapeutic relationship and to work productively within the framework proffered by the therapist.
Abstract: • This is the fourth in a series of comparisons involving patients treated in time-limited psychotherapy. The two patients were young men suffering from anxiety, depression, and social withdrawal. Both were treated by a highly experienced psychotherapist. One of the patients achieved lasting therapeutic results from the sessions; the other was a therapeutic failure. The comparisons are based on a set of objective measures as well as intensive clinical study of all tape-recorded therapy sessions. Results showed that the therapeutic outcome was a function of the patient's ability to become involved in a therapeutic relationship and to work productively within the framework proffered by the therapist. Equally important were countertransference reactions that seriously interfered with successful confrontation and resolution of the patient's negative transference.
TL;DR: The overall data indicate that patients with inferior wall infarction who have associated precordial S-T segment depression have greater global and regional left ventricular dysfunction presumably due to associated ischemia orinfarction in areas remote from the inferior wall and they have relatively high in-hospital mortality and morbidity rates.
Abstract: Although S-T segment depression of various degrees is known to occur in the precordial electrocardiogram of patients with acute inferior myocardial infarction its prognostic significance is unknown. Left ventricular ejection fraction and regional wall motion were therefore measured noninvaslvely with radionucilde ventriculography and related to the electrocardiographic changes within 48 hours of the onset of acute transmural inferior infarction in 44 patients who had had no previous infarction. The mean ejection fraction of 0.45 ± 0.13 (standard deviation) in Group A (24 patients with greater than 1 mm S-T segment depression in at least two of six precordial leads) was lower (p The overall data indicate that patients with inferior wall infarction who have associated precordial S-T segment depression have greater global and regional left ventricular dysfunction presumably due to associated ischemia or infarction in areas remote from the inferior wall and they have relatively high in-hospital mortality and morbidity rates. Early noninvasive detection of this high risk subset may permit the testing of aggresive modes of therapy designed to limit the extent of myocardial ischemic damage with resultant decrease in mortality and morbidity.
TL;DR: The results suggest that the syndrome of painful diabetic neuropathy of the lower extremities represents a depressive equivalent in a large proportion of cases and that treatment with imipramine or amitriptyline is a successful mode of therapy for such persons.
Abstract: Fifty-nine patients referred for painful diabetic neuropathy of the lower extremities were evaluated for depression and response to antidepressant drug therapy in a double-blind controlled study All patients were found to have substantial degrees of depression during psychiatric interview and by Kupfer-Detre test scores (81±06, as compared with control values of 40 to 43±02) Treatment with imipramine hydrochloride or amitriptyline hydrochloride resulted in complete remission of lower extremity pains in all patients in 10±2 weeks, with concomitant relief of depression and return of depression test scores to 38 These results suggest that the syndrome of painful diabetic neuropathy of the lower extremities represents a depressive equivalent in a large proportion of cases and that treatment with imipramine or amitriptyline is a successful mode of therapy for such persons ( JAMA 243:1147-1150, 1980)
TL;DR: Studies of hypothalmic-pituitary-adrenocortical (HPA) function in five patients who had received corticosteroids for periods of years experienced steroid withdrawal symptoms when attempts were made to reduce or discontinue the drugs.
TL;DR: It is concluded that parental death during childhood has not been established as a factor of etiologic significance in adult depression or any subtype of adult depression studied to date.
Abstract: Parental death during childhood is widely viewed as an event so traumatic as to produce not only immediate grief and despondency but also a predisposition to react with depression when faced with loss or rejection in adult life. Empirical evidence relating to the relationship between parental death and depression is provided by more than 20 controlled studies conducted during the past 2 decades. A critical review of these studies is presented, and it is concluded that parental death during childhood has not been established as a factor of etiologic significance in adult depression or any subtype of adult depression studied to date.
TL;DR: Depression in Cushing's syndrome might result from a substance other than Cortisol produced by the adrenal under excessive pituitary and/or hypothalamic stimulation, which could play a part in the aetiology of depressive illness in general.
Abstract: Among a consecutive unselected series of 29 patients with Cushing's syndrome 21 had bilateral adrenal hyperplasia and 8 had tumours. Twenty-five (86 per cent) were significantly depressed; three of the tumour patients, but only one of the hyperplasia group were free of symptoms so that if there are no psychiatric symptoms there is a three in four chance that the patient has a tumour. There was a family history of depression or suicide or a history of early bereavement or separation in half the cases. In six of the hyperplasia patients a major emotional disturbance had preceded the onset, and in five this was a loss. The severity of the depression was not related to the level of circulating cortisol. The depression was rapidly relieved when the tumour or hyperplastic glands were removed. Depression in Cushing's syndrome might result from a substance other than cortisol produced by the adrenal under excessive pituitary and/or hypothalamic stimulation, which could play a part in the aetiology of depressive illness in general.
TL;DR: In this article, three types of data are reviewed: (1) studies of the children of depressed parents; (2) studies on the childhood histories of depressed adults; and (3) direct studies of depression in children.
TL;DR: It is shown that social variables may be relevant n the production of the syndrome, consisting of headache, neckache, neck stiffness, and depression, as well as anxiety, all of which are strongly correlated with each other.
Abstract: A condition commonly seen after motor vehicle accidents is studied. This is the "late whiplash" syndrome, which is defined as a collection of symptoms and disabilities seen more than six months after a neck injury occurring in a motor vehicle accident. A series of 300 cases is examined. With the use of factor analysis the syndrome is defined as consisting of headache, neckache, neck stiffness, and depression, as well as anxiety, all of which are strongly correlated with each other. There is, on the other hand, a poor correlation with physical or radiological abnormalities. The condition is common in women, especially in the 21 to 40 years' distribution. It is shown that social variables may be relevant n the production of the syndrome.
TL;DR: After eight months, depression scores were significantly lower in all drug abuse groups, and reducations were not related to type or length of treatment.
Abstract: The authors examined the relationship between depressive symptoms, drug-use pattern, and demographic variables in 432 substance abusers. Assessment was at intake and at 4 and 8 months. Depression was measured by using the Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the Current and Past Psychopathology Scales. At intake 46% of the subjects reported moderate or high levels of depression on the Beck scale and 29% of subjects scored in the high or moderate range of depression on the Hamilton scale. After eight months, depression scores were significantly lower in all drug abuse groups. These reducations were not related to type or length of treatment.
TL;DR: Results generally confirmed hypotheses made by the E that Autobiographical Recollections was the superior method for inducing and altering depression and anxiety in a population that included both sexes.
Abstract: Compared two primary induction methods that have cognitive bases, Autobiographical Recollections and Structural Set of Mood Statements, by assessing their effectiveness in inducing depression and elation moods, respectively. Eighty-three male and 123 female undergraduate college students were assigned randomly to 1 of 15 groups. Each person who participated in the experiment received a depression-related induction or a control followed by an elation-related induction or a control. The effects of each induction were measured by three independent variables: Two depression measured and one anxiety measure. Results generally confirmed hypotheses made by the E that Autobiographical Recollections was the superior method for inducing and altering depression and anxiety in a population that included both sexes.
TL;DR: The authors feel that care must be taken in the use of the term childhood depression lest future epidemiologic, treatment and natural history studies be complicated by imprecise terminology.
Abstract: SUMMARY
Admission symptoms on 210 children referred to UCLA-Neuropsychiatric Institute's Child Division were gleaned for those relating to depression. Children were additionally asked to complete a self-rating depression inventory (SCDI) which assessed cross sectionally and systematically the presence of a depressive syndrome. A subsample of 102 children and parents were psychiatrically interviewed and diagnosed by the American Psychiatric Association's Diagnostic and Statistical Manual (DSM III) criteria. Sixty per cent of the children had depressive symptoms, 49% a cross-sectional depressive syndrome and 28% met criteria for the presence of an affective disorder. Although depressive symptoms and syndrome appeared statistically significantly more frequent in children with affective disorder, they appeared often in children with other diagnoses. The authors feel that care must be taken in the use of the term childhood depression lest future epidemiologic, treatment and natural history studies be complicated by imprecise terminology.
TL;DR: This study suggests that the predictive accuracy of CAC and a positive exercise test in the middle-aged nonhyperlipidemic asymptomatic male is very high and that Cac and apositive exercise test predict an early appearance of angina or myocardial infarction in previously asymPTomatic men.
Abstract: To determine the predictive accuracy of fluoroscopically detected coronary artery calcification (CAC) and a positive submaximal exercise test, 129 asymptomatic men were screened; 13 had both coronary artery calcification and positive exercise test (greater than or equal to 1.0 mm ST-segment depression). These 13 men were studied at coronary arteriography. They had a mean age of 44 years (range 41-56 years); none had history or symptoms of heat disease and all had normal resting ECGs at entry. CAC was detected in one artery in 10 men, in two arteries in two men, and in three arteries in one man. Coronary artery disease (CAD) was considered clinically significant if any major coronary branch was narrowed > 50%. Coronary arteriography revealed 12 men with clinically significant CAD (one-vessel CAD in four, two-vessel CAD in five and three-vessel CAD in three men) and one man with minor one-vessel CAD. The predictive accuracy was 100% for minor CAD and 92% for clinically significant CAD. The location of CAC and CAD correlated, but the absence of CAC did not rule out the presence of CAD at coronary arteriography. Furthermore, CAC did not indicate the location of the highest stenotic (most occlusive) lesions seen at arteriography. Follow-up for the 13 patients was 36 months; three patients developed typical angina and one patient developed a transmural myocardial infarction. This study suggests that the predictive accuracy of CAC and a positive exercise test in the middle-aged non-hyperlipidemic asymptomatic male is very high (100% for CAD and 92% for clinically significant CAD) and that CAC and a positive exercise test predict an early appearance of angina or myocardial infarction in previously asymptomatic men.
TL;DR: The classification of elective mutism into subgroups is clinically relevant for a better understanding of the etiology and for devising appropriate intervention.
Abstract: In this study of 68 children displaying elective mutism, four types of mutism are distinguished: (a) symbiotic mutism, characterized by a symbiotic relationship with a caretaker and a submissive but manipulative relationship with others; (b) speech phobic mutism, characterized by fear of hearing one's own voice and use of ritualistic behaviors; (c) reactive mutism, characterized by withdrawal and depression which apparently resulted from trauma; and (d) passive-aggressive mutism, characterized by hostile use of silence as a weapon. The prevalence of physical and sexual child abuse in all four groups was high. The classification of elective mutism into subgroups is clinically relevant for a better understanding of the etiology and for devising appropriate intervention.
TL;DR: It may not be necessary to offer both treatments to the situationally depressed patients; however, situational and endogenous are not mutally exclusive diagnoses, and it would be of clinical interest to obtain a longer group of patients with both diagnoses for further study.
Abstract: • We studied the usefulness of the research diagnostic criteria subtypes in the prediction of response to amitriptyline and short-term interpersonal psychotherapy (IPT) in a 16-week, controlled, randomized clinical trial with 81 ambulatory depressed patients. Both patients with a situational depression and patients with an endogenous depression responded to combined treatment; those with an endogenous depression did not respond to IPT alone, whereas those with a situational depression responded to IPT or tricyclic medication alone. It may not be necessary to offer both treatments to the situationally depressed patients. However, situational and endogenous are not mutually exclusive diagnoses, and it would be of clinical interest to obtain a longer group of patients with both diagnoses for further study.
TL;DR: It is concluded that abnormal blood pressure and marked ischemic ST–segment depression during exercise testing are helpful in identifying a subset of patients with advanced coronary artery disease.
Abstract: The usefulness of an abnormal blood pressure response and a marked ischemic ST-segment depression during exercise testing as predictors of severe coronary artery disease was assessed in 378 consecutive patients who had a maximal symptom-limited exercise test before coronary arteriography. An abnormal blood pressure response occurred in 90 patients. The sensitivity of this response for three-vessel or left main disease was 38.6%, the specificity 87.4% and the predictive value 70%. A marked ischemic ST-segment abnormality (MIST) appeared in 85 patients. The sensitivity of MIST for three-vessel or left main disease was 38.6%, the specificity 89.8% and the predictive value 74.1%. One hundred thirty-eight patients had either an abnormal blood pressure response or a marked ST-segment change. The sensitivity of either response for three-vessel or left main disease was 56.4%, the specificity 78.6%, and the predictive value 66.7%. Exercise duration and ejection fraction were not significantly different in patients with normal or abnormal blood pressure. We conclude that abnormal blood pressure and marked ischemic ST-segment depression during exercise testing are helpful in identifying a subset of patients with advanced coronary artery disease. The physiologic mechanism for these responses is probably exercise-induced ischemia.
TL;DR: Medical records of 150 medical ambulatory care patients randomly assigned to groups in which screening for depression, physician sensitization about depression, and informational feedback to physicians were systemically varied were reviewed for physician notations about depression and its treatment.
Abstract: Medical records of 150 medical ambulatory care patients randomly assigned to groups in which screening for depression, physician sensitization about depression, and informational feedback to physicians were systemically varied were reviewed for physician notations about depression and its treatment. Forty-two percent of the 100 patients screened with the Zung self-rating depression scale had scores outside the normal range. Chart notation about depression was effectively and appropriately increased by feedback and sensitization from 8 to 25 percent, but these procedures were less effective in increasing treatment interventions, which were noted for 12 percent of the entire sample. Physicians responded to patient information about depression presented to them in the format of a laboratory test, and such previsit screening devices may increase physician attention to psychological problems in general medical settings.
TL;DR: Blood pressure levels as recorded in a community-wide screening programme were compared with findings in an earlier mental health study for persons who participated in both programmes, suggesting that depression, hostility, psychosomatic reactions to stress, or the felt need for help with emotional problems were not important in the pathogenesis of hypertension.
Abstract: Blood pressure levels as recorded in a community-wide screening programme were compared with findings in an earlier mental health study for persons who participated in both programmes. Blood pressure was not related to previously ascertained psychosocial characteristics among persons who were not under treatment for hypertension, suggesting that depression, hostility, psychosomatic reactions to stress, or the felt need for help with emotional problems were not important in the pathogenesis of hypertension. Treatment for hypertension, however, was associated with an excess of psychosomatic symptoms, a factor which needs to be taken into account in assessing the benefits of treatment.