Showing papers on "Depression (differential diagnoses) published in 1985"
TL;DR: The survey found that insomnia afflicts 35% of all adults during the course of a year; about half of these persons experience the problem as serious; the majority of serious insomniacs were untreated by either prescribed or over-the-counter medications.
Abstract: Data for this report come from a nationally representative probability sample survey of noninstitutionalized adults, aged 18 to 79 years. The survey, conducted in 1979, found that insomnia afflicts 35% of all adults during the course of a year; about half of these persons experience the problem as serious. Those with serious insomnia tend to be women and older, and they are more likely than others to display high levels of psychic distress and somatic anxiety, symptoms resembling major depression, and multiple health problems. During the year prior to the survey, 2.6% of adults had used a medically prescribed hypnotic. Typically, use occurred on brief occasions, one or two days at a time, or for short durations of regular use lasting less than two weeks. The survey also found a small group of hypnotic users (11% of all users; 0.3% of all adults) who reported using the medication regularly for a year or longer. If we include anxiolytics and antidepressants, 4.3% of adults had used a medically prescribed psychotherapeutic drug that was prescribed for sleep; 3.1% had used an over-the-counter sleeping pill. The majority of serious insomniacs (85%) were untreated by either prescribed or over-the-counter medications.
1,021 citations
TL;DR: Depressed elderly patients with any of the following are at high risk to develop dementia: evidence of cerebrovascular, extrapyramidal, or spinocerebellar disease; a modified Hachinski ischemic score of 4 or greater; a Mental Status Questionnaire score under 8; a dementia behavior score of 7 or higher; or confusion on low doses of tricyclic antidepressants.
Abstract: Of 225 patients referred to a dementia clinic, depression occurred in 31 (70%) of 44 patients not thought to be demented, six (24%) of 25 with cognitive impairment not severe enough to warrant the label dementia, and 24 (15%) of 156 with various forms of dementia, including 19 (19%) of 99 with Alzheimer-type dementia. Follow-up over three years has shown that 16 (57%) of 28 of the depressed, nondemented patients went on to develop frank dementia. Thirteen of these 16 had some sign, often subtle, of organic neurologic disease. Depressed elderly patients with any of the following are at high risk to develop dementia: evidence of cerebrovascular, extrapyramidal, or spinocerebellar disease; a modified Hachinski ischemic score of 4 or greater; a Mental Status Questionnaire score under 8; a dementia behavior score of 7 or higher; or confusion on low doses of tricyclic antidepressants. Dementing illnesses can present as depression with relatively little cognitive impairment.
321 citations
TL;DR: In this article, a prospective study of 312 patients undergoing elective coronary artery bypass surgery was undertaken to determine the incidence, severity, and functional impact of postoperative neurological complications, and the results showed that neurological complications after surgery were common, occurring in 191 of the 312 patients (61%).
Abstract: A prospective study of 312 patients undergoing elective coronary artery bypass surgery was undertaken to determine the incidence, severity, and functional impact of postoperative neurological complications. Detailed evaluation of the patients showed that neurological complications after surgery were common, occurring in 191 of the 312 patients (61%). Although such a high proportion of the total developed detectable changes, serious neurological morbidity was rare. Neurological disorders resulted in death in only one patient (0.3%) and severe disability in only four (1.3%). Forty eight patients were mildly disabled during the early postoperative period, and the remaining 138 with neurological signs had no serious functional disability. The postoperative neurological disorders detected included one death from cerebral hypoxic damage. Prolonged depression of conscious level was observed in 10 patients (3%) and definite stroke in 15 (5%); 78 (25%) developed ophthalmological abnormalities and 123 (39%) primitive reflexes; postoperative psychosis was observed in four (1%); and 37 (12%) developed disorders of the peripheral nervous system. The incidence of serious neurological problems such as fatal cerebral damage, stroke, and brachial plexopathy is in accordance with experience elsewhere. Lesser abnormalities, whose detection required detailed neurological examination, were much commoner than expected from previous reports.
313 citations
TL;DR: It is concluded that the prevalence of depression in patients with moderate or severe COPD approaches 50 percent while the incidence of anxiety is much lower (2 percent).
262 citations
TL;DR: Thirty-seven patients with chronic pain admitted to a 3-week inpatient pain program were interviewed using the NIMH Diagnostic Interview Schedule and the family history method and found that more than half of the patients had a history of one or more episodes of major depression and/or alcohol abuse before the onset of their chronic pain.
Abstract: Thirty-seven patients with chronic pain admitted to a 3-week inpatient pain program were interviewed using the NIMH Diagnostic Interview Schedule and the family history method. The most frequent psychiatric diagnoses were major depressive disorder (current episode = 32.4%, past episode = 43.2%) and alcohol abuse (40.5%). More than half of the patients had a history of one or more episodes of major depression and/or alcohol abuse before the onset of their chronic pain. Family history revealed that 59.5% of the patients had at least one first-degree family member with chronic pain, 29.7% had a family member with affective illness, and 37.8% had a family member with alcohol abuse.
257 citations
TL;DR: The utility of the CES-D for detecting major depression was approximately equal to its utility for detecting generalized anxiety and that the two disorders had additive effects on CES- D.
Abstract: This study evaluates the validity of the Center for Epidemiologic Studies Depression Scale (CES-D) by comparing it to DSM-III diagnoses of major depression and generalized anxiety, using the National Institute of Mental Health Diagnostic Interview Schedule (DIS). Data were gathered on a sample of 310 mothers of children with chronic disabilities. The utility of the CES-D for detecting major depression was approximately equal to its utility for detecting generalized anxiety. Multivariate analysis revealed that the unique association of CES-D with current depression was equal to its association with current generalized anxiety and that the two disorders had additive effects on CES-D. The analysis did not identify any individual CES-D symptom as specific to either disorder. The findings, therefore, do not support the notion that the CES-D measures depression specifically.
252 citations
TL;DR: It is suggested that children and adolescents are capable of providing valid self-reports of depressive symptoms and parents' ratings of their own depression correlated significantly with their perceptions of depression in their children.
Abstract: The correspondence between child- and parent-reports of the child's depression was evaluated in a group of 60 children (ages 8–17 years) referred for psychiatric evaluation of depression. Children completed two self-report measures of depression, the Children's Depression Scale and the Children's Depression Inventory. In a separate interview parents completed a self-report scale evaluating depression in their child. Results indicated that children who met DSM-III criteria for major depression reported significantly more severe depressive symptoms than children who received other psychiatric diagnoses. In contrast, parent-reports of depression in their children failed to discriminate between children receiving different psychiatric diagnoses. While parents' ratings of depression in themselves was not related to their child's self-reports of depression, parents' ratings of their own depression correlated significantly with their perceptions of depression in their children. Results suggest that children and adolescents are capable of providing valid self-reports of depressive symptoms. Factors which may influence parent-reports are discussed.
236 citations
TL;DR: Patients attending their general practitioner were screened and a group with unrecognised major depressive disorder identified, and they were more likely to have feelings other than those of normal sadness and to respond with change of mood to intercurrent events.
Abstract: Patients attending their general practitioner were screened and a group with unrecognised major depressive disorder identified. This group was interviewed and the findings compared with those in a group of patients recognised correctly as depressed by their general practitioners. Half of the patients with severe depression screened in their doctors' waiting rooms went unrecognised, and they differed in few ways from those who were recognised. The differences found were that the patients with unrecognised depression were less obviously depressed and their illness had lasted longer. Physical illness was present in nearly 30% of patients in the unrecognised group, and the depression seemed related to it. Patients with unrecognised depression were more likely to have feelings other than those of normal sadness and more likely to respond with change of mood to intercurrent events. These data suggest that patients might benefit if general practitioners were better trained to recognise depression, although it is not known whether treatment would be effective.
229 citations
TL;DR: Thirteen of 40 patients with acquired immune deficiency syndrome (AIDS) admitted to the wards of a large city hospital were seen by the staff of a psychiatric consultation service; recurrent psychological themes were dealing with a life-threatening illness, uncertainty about the implications of an AIDS diagnosis, social isolation, and guilt over their previous life style.
Abstract: Thirteen of 40 patients with acquired immune deficiency syndrome (AIDS) admitted to the wards of a large city hospital were seen by the staff of a psychiatric consultation service. Eleven were gay men and two were bisexual men. "Depression" was the stated reason for referral of 10 patients; of these, two met DSM-III criteria for major depression, one had dysthymic disorder, and seven had adjustment disorder with depressed mood. Recurrent psychological themes of the 13 patients were: dealing with a life-threatening illness, uncertainty about the implications of an AIDS diagnosis, social isolation, and guilt over their previous life style. The role of the primary physician and of the mental health professional in the psychological care of AIDS patients is discussed.
228 citations
TL;DR: It is difficult in the early stages of AIDS to separate reactive depression and psychomotor retardation from symptoms associated with central nervous system complications.
Abstract: The acquired immunodeficiency syndrome (AIDS) and its related conditions are a public health problem of unprecedented proportions due to the debilitating and fatal nature of the disease, the sociocultural implications related to contagion, and its initial appearance in certain socially stigmatized groups. The ability of patients to tolerate the consequences of the disease depends on their psychological ability to cope based on emotional strength and the availability of social support. The psychological and social impact of AIDS may result in psychiatric symptoms similar to those seen in other life-threatening diseases, including anxiety, depression, and delirium. Neurologic complications are frequent, the commonest being an encephalopathy and dementia that is poorly understood. It is difficult in the early stages of AIDS to separate reactive depression and psychomotor retardation from symptoms associated with central nervous system complications. Guidelines are needed to manage the psychological problems posed by AIDS and its related conditions.
01 Jan 1985
TL;DR: The findings largely support the hypothesis of a continuum from mild and short to more severe, longer lasting depressive syndromes, but they do not exclude heterogeneity of RBD.
Abstract: How common and how significant are brief depressive episodes (BDE) lasting less than 2 weeks? The authors propose splitting the BDE into two groups: one occurring monthly over 1 year of observation, termed 'recurrent brief depression' (RBD), and those occurring less frequently, labeled 'nonrecurrent brief depression' (NRBD). From a medical point of view, the RBD are a relevant group. Different thresholds of definition are tested, the narrowest of which (including occupational impairment and predetermined minimum number of symptoms) is accepted for 'case'-definition. The such defined RBD (SYM) group differs from major depression only by length and frequency of episodes. In a young cohort, its 1-year prevalence rate was found to be 4.4% (males 3.9%, females 4.9%). One-third of these cases needed treatment, a fourth suffered from pronounced subjective and social impairment as well as from persistent suicidal ideation. The self-reporting of subjective impairment, assessed with the SCL-90 symptom inventory and an analog-rating, yields high scores which are in no way inferior to major depression diagnosed with RDC, DSM-III or EDE (SYM) criteria. The RBD (SYM) demonstrate less hypomania than the major depressive disorders. On the other hand, a family history of depression is equally frequent across all groups. The validity of the RBD (SYM) group has yet to be confirmed by a follow-up study, and further research is needed to delineate it from secondary depression. The findings largely support the hypothesis of a continuum from mild and short to more severe, longer lasting depressive syndromes, but they do not exclude heterogeneity of RBD (Angst and Dobler-Mikola 1984b).(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: The most common forms of affective disorder are ‘major depression' and ‘bipolar disorder' (i.e. major depression plus mania occurring at some time in the person's life). There is now consistent evidence from epidemiological, family and clinical studies that the rates of major depression are about twofold higher among women than men, and the sex ratios of bipolar disorder are equal as mentioned in this paper.
TL;DR: A family history study of 36 patients with chronic posttraumatic stress disorder revealed a positive history of familial psychopathology in 66% of the patients, and the patients more closely resembled probands with generalized anxiety than proband with depression.
Abstract: A family history study of 36 patients with chronic posttraumatic stress disorder revealed a positive history of familial psychopathology in 66% of the patients. Alcoholism, depression, and anxiety disorders were the disorders most commonly found. The patients also had a higher prevalence of alcoholic siblings than did a retrospectively derived control group of depressed and anxious male patients. With respect to the proportion of familial anxiety to familial depression, the probands with posttraumatic stress disorder more closely resembled probands with generalized anxiety than probands with depression. Every patient had experienced at least one significant psychiatric illness during his lifetime, most commonly alcohol abuse or depression.
TL;DR: Of the existing animal models of severe depression, the olfactory bulbectomy model holds the most promise for elucidating the neurobiology of depression and the neurochemistry of antidepressant drugs.
TL;DR: It is suggested that death wish, suicidal intention, and other psychologic symptoms should receive particular attention in the clinical assessment of depression in patients with end-stage renal disease.
TL;DR: The overall prognosis was good, except for schizophrenia, in which more than 50 % of patients had chronic disability, and further childbirth intensified, and caused deterioration of, the underlying schizophrenia process.
Abstract: Eighty-two patients, who were treated for post partum illness between 1946 and 1971, were identified and followed up. Diagnostically, the sample comprised unipolar depression (52%), bipolar disorder (18%), schizophrenia (16%), abnormal personality with depression (8%), organic disorder (2%), and obsessional state with depression and paranoid disorder (1% each). The overall prognosis was good, except for schizophrenia, in which more than 50% of patients had chronic disability. Further childbirth intensified, and caused deterioration of, the underlying schizophrenia process. Following an initial illness in the puerperium, the probability of a recurrent affective illness was 43% for unipolar and 66% for bipolar disorder. The risk of developing another post partum illness varied from 1 in 3 to 1 in 5 pregnancies. Five percent of the sample ultimately committed suicide, and the probable incidence of infanticide was 4%.
TL;DR: There was evidence that being married and having a higher educational level were associated with lower risk for depression as measured by the CES-D (but not the RDC).
Abstract: A large sample (N = 3159) of noninstitutionalized older adults (aged 65 to 105 years) residing in two rural Iowa counties participated in an assessment of a wide range of health-related factors, including depression. Prevalences of significant depressive symptomatology (9.0%; based on a modified version of the Center for Epidemiological Studies Depression Scale [CES-D]) and clinical depression (2.9%; based on self-report of Research Diagnostic Criteria [RDC]-like criteria) were low. The relationships between several demographic measures and the depression indices were examined. While expected sex differences were obtained for the CES-D, they were not found for the depression RDC. Subjects who lived alone and subjects with lower incomes were more at risk for depression. There was also evidence that being married and having a higher educational level were associated with lower risk for depression as measured by the CES-D (but not the RDC). The role of social support in rural communities was discussed as a factor contributing to the low rate of depression found in this study. The importance of sex, social support, and economic resources in accounting for depression among the elderly was also discussed.
TL;DR: Male and female depressed and non‐depressed chronic pain patients did not differ on demographic and medical history data, but sex differences were found in patterns of the relationships of depression, activity, and pain.
Abstract: Depression is commonly reported among chronic pain patients and receiving increased attention from clinicians and researchers. There is, however, little empirical evidence concerning variables that differentiate depressed from non-depressed chronic pain patients, and whether depression is related to factors such as gender, pain report, and activity. As part of a study to address these questions, 63 chronic pain patients completed daily diaries of activity, pain levels, and medication intake, and completed questionnaires and interviews assessing depression, medical history, and demographic variables. Male and female depressed and non-depressed chronic pain patients did not differ on demographic and medical history data, but sex differences were found in patterns of the relationships of depression, activity, and pain. For women, depression was closely related to pain report, whereas for men depression was more strongly related to impairment of activity. Pain report was related only minimally to activity for male and female patients. Implications of the results of behavioral research on depression in chronic pain patients are discussed. Researchers are urged to carefully consider sex differences in future research with chronic pain patients.
TL;DR: Results suggest that the environmental factors occurring prior to adoptees age 18 predisposed to depression.
TL;DR: There is a considerable overlap in the severity of depressive conditions between those seen by psychiatrists and those defined as cases in population surveys; any differences that do exist may relate more to the way symptoms are expressed than to the severeness of the depressive disorder as such.
Abstract: Surveys using clinical-type interviews have documented a high rate of depression among working-class women, and this is discussed in the light of a recent survey in an inner-city area. While women with caseness of depression contacting a psychiatrist did not differ in number of core depressive symptoms from those who did, they did in certain characteristics that would make them worrying for a general practitioner to deal with. It is concluded that there is a considerable overlap in the severity of depressive conditions between those seen by psychiatrists and those defined as cases in population surveys; any differences that do exist may relate more to the way symptoms are expressed than to the severity of the depressive disorder as such.
TL;DR: The occurrence of clearly defined depression points to several avenues of research aimed at clarifying the incidence etiology and treatment of depression in patients with major depression.
Abstract: An association between chronic pain and depression has been recognized for a long time. However, the exact nature of this relationship remains unclear. The authors studied 71 patients for affective disorders and schizophrenia-lifetime version (SADS-L). Based on the interviews, we were able to identify 31 patients with major depression, 8 patients with minor depression and 18 with intermittent depressive disorder as defined by Research Diagnostic Criteria. Item analysis using the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale showed that the items did not discriminate in patients with major depression the presence of organic findings. However, most of the items significantly discriminated between the various types of depression and patients without depression. The occurrence of clearly defined depression points to several avenues of research aimed at clarifying the incidence etiology and treatment of depression in these patients.
TL;DR: Analyses of the essential symptoms of depression among the four criteria sets indicated that the nonverbal rating was most strongly associated with a diagnosis of depression and the best predictor of the severity of depression.
Abstract: Comparison of diagnoses of childhood depression from four sets of criteria (i.e., Research Diagnostic Criteria, DSM-III, and those of Poznanski and Weinberg) used with 65 children referred to a psychiatric clinic showed complete agreement in 56 (86%) of the cases. The major disagreement resulted from differences between the clinician's rating of dysphoria based on the child's nonverbal behavior and the child's and parent's verbal report of no dysphoria. Analyses of the essential symptoms of depression among the four criteria sets indicated that the nonverbal rating was most strongly associated with a diagnosis of depression and the best predictor of the severity of depression.
TL;DR: Anxious mood, tension and general somatic symptoms of the sensory type were more common than any other type of anxiety symptoms, and the potential role of anxiety in chronic pain patients was discussed.
Abstract: The relationship between anxiety and chronic pain has been poorly studied. The authors studied the occurrence of symptoms of anxiety in chronic low back pain patients. Anxious mood and other symptoms of anxiety were commonly seen in patients with chronic low back pain. Symptoms of anxiety were more common in patients with depression, especially those with major depression. Anxious mood, tension and general somatic symptoms of the sensory type were more common than any other type of anxiety symptoms. The authors discuss the potential role of anxiety in chronic pain patients.
TL;DR: One hundred and fifty‐two women undergoing mastectomy were randomly assigned to routine care or routine care plus monitoring by a specialist nurse, and the effects of antidepressant medication plus cognitive therapy and cognitive therapy alone were compared.
Abstract: One hundred and fifty-two women undergoing mastectomy were randomly assigned to routine care or routine care plus monitoring by a specialist nurse. The nurse detected and referred 76% of her patients for psychiatric help. Only 15% of the routine care subjects that warranted help were referred. Twelve to eighteen months after surgery, morbid anxiety and depression were less common in the monitored (5% and 5%) than in the control (30% and 50%) group. This difference appeared to be due primarily to psychiatric treatment which included antidepressant medication, anxiolytic drugs, and supportive psychotherapy. Few affective disorders remitted without such treatment. In a further study, the effects of antidepressant medication plus cognitive therapy and cognitive therapy alone were compared. Both treatments alleviated depression in the short term but the improvement was sustained in the long term only in those given combined treatment.
Journal Article•
TL;DR: The frequency, differential diagnosis, and implications of depression occurring in the course of schizophrenia are considered in light of recently reported findings from a follow-up and family study of 500 psychiatric outpatients (the St. Louis 500 Study).
Abstract: The frequency, differential diagnosis, and implications of depression occurring in the course of schizophrenia are considered in light of recently reported findings from a follow-up and family study of 500 psychiatric outpatients (the St Louis 500 Study) Problems in diagnosis are illustrated in an interview of a schizophrenic patient with a history of depression Nearly 60% of the schizophrenics studied had suffered a depressive syndrome during the course of their schizophrenic illness, supporting the observations of others The majority of patients with a history of depression who were otherwise diagnosable as schizophrenic had a course of illness consistent with schizophrenia during follow-up The pattern of illness among first-degree relatives suggested that intercurrent depression did not represent a biologic unity with primary affective disorder Intercurrent depression should not be overinterpreted in excluding a diagnosis of schizophrenia
TL;DR: Data from experimental animals show that CRF may influence several processes known to be altered in the overall symptom complex of depression, including not only pituitary-adrenal function, but also motor activity, appetite regulation and sexual behavior.