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Depression (differential diagnoses)

About: Depression (differential diagnoses) is a research topic. Over the lifetime, 56557 publications have been published within this topic receiving 2048357 citations.


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Journal ArticleDOI
TL;DR: The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported, and the high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening.
Abstract: Context A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse, or aggressive behavior as comorbid factors occurring with PTSD and depression. Objectives To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq. Design Population-based, cross-sectional study. Setting United States Army posts and National Guard armories. Participants A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams. Interventions Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment. Main Outcome Measures Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior. Results Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers. Conclusions The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.

913 citations

Journal ArticleDOI
12 May 1999-JAMA
TL;DR: There is substantial continuity, specificity, morbidity, and potential mortality from suicide into adulthood in adolescent-onset MDD patients.
Abstract: ContextMajor depressive disorder (MDD) that arises in adolescence impairs functioning and is associated with suicide risk, but little is known about its continuity into adulthood.ObjectiveTo describe the clinical course of adolescent-onset MDD into adulthood.Design and ParticipantsProspective case-control study. Seventy-three subjects had onset of MDD based on systematic clinical assessment during adolescence (Tanner stage III-V) and 37 controls had no evidence of past or current psychiatric disorders, and also were assessed in adolescence (assessment years: 1977-1985). Follow-up was conducted 10 to 15 years after the initial assessment by an independent team without knowledge of initial diagnosis (follow-up years: 1992-1996).SettingCases were identified at Columbia Presbyterian Hospital, New York City, NY; controls were recruited from the community.Main Outcome MeasuresSuicide and suicide attempts, psychiatric diagnoses, treatment utilization, and social functioning.ResultsClinical outcomes of adolescent-onset MDD into adulthood compared with control subjects without psychiatric illness include a high rate of suicide (7.7%); a 5-fold increased risk for first suicide attempt; a 2-fold increased risk of MDD, but not other psychiatric disorders; an increased occurrence of psychiatric and medical hospitalization; and impaired functioning in work, social, and family life. Thirty-seven percent of those with adolescent MDD survived without an episode of MDD in adulthood vs 69% of the control participants (relative risk, 2.2 [95% confidence interval, 1.0-4.7; P<.05]).ConclusionThere is substantial continuity, specificity, morbidity, and potential mortality from suicide into adulthood in adolescent-onset MDD patients. Now that empirically based guides to their treatment are becoming available, early identification and treatment seems warranted.

913 citations

Journal ArticleDOI
TL;DR: Pregnancy per se is not associated with increased risk of the most prevalent mental disorders, although the risk of major depressive disorder may be increased during the postpartum period.
Abstract: Pregnancy and the postpartum period are widely considered periods of increased vulnerability to psychiatric disorders.1–12 Psychiatric disorders during pregnancy are associated with poor maternal health13–19 and inadequate prenatal care.20–22 Maternal psychiatric disorders during pregnancy and the postpartum period are also associated with numerous adverse outcomes for the offspring, including maladaptive fetal growth and development,22–36 poor cognitive development and behavior during childhood and adolescence,23–32 and negative nutritional and health effects.13, 33–38 For these reasons, accurate information about the mental health status of women during pregnancy and the postpartum period is urgently needed. Most of what is known about psychiatric problems among pregnant women comes from findings among clinical samples, often without non-pregnant control groups. In these samples, the prevalence of psychiatric disorders ranges from 15% to 29%.15, 20–22, 39–47 Risk factors identified in these studies include lack of romantic partner, prior history of psychiatric disorder, and lifetime exposure to traumatic events. 22, 41, 42, 45, 48–50 Only 5% to 14% of women received treatment for the psychiatric disorder.15, 40, 41 However, no previous study used sampling methodology permitting accurate estimation of the prevalence of psychiatric disorders among pregnant women in the United States. Further, no previous study included non-pregnant women of comparable age drawn from the general population in order to identify the specific contribution of pregnancy or the postpartum period to the risk of psychiatric disorders. Many studies were limited by use of screening scales rather than diagnostic measures for DSM-IV criteria. Finally, prior studies assessed only mood and anxiety disorders rather than a broader range of psychopathology. As the result of these gaps in research on mental disorders during pregnancy and the postpartum period, accurate national information on the mental health of pregnant women is lacking. Such information is needed for focused planning at the national and local level, and to inform the development of prevention and intervention programs. The current study addresses these critical gaps in knowledge. In a nationally representative sample of pregnant women, we present 12-month prevalence of DSM-IV psychiatric disorders, compare these with the prevalence of psychiatric disorders in non-pregnant women of childbearing age, identify risk factors for such disorders, and provide estimates of lifetime and 12-month rates of treatment-seeking among pregnant and non-pregnant women with DSM-IV psychiatric disorders.

910 citations

Journal ArticleDOI
TL;DR: The current study suggests that the degree of HPA hyperactivity can vary considerably across patient groups, consistent with HPAhyperactivity as a link between depression and increased risk for conditions, such as diabetes, dementia, coronary heart disease, and osteoporosis.
Abstract: Objectives To summarize quantitatively the literature comparing hypothalamic-pituitary-adrenal (HPA) axis function between depressed and nondepressed individuals and to describe the important sources of variability in this literature. These sources include methodological differences between studies, as well as demographic or clinical differences between depressed samples. Methods The current study used meta-analytic techniques to compare 671 effect sizes (cortisol, adrenocorticotropic hormone, or corticotropin-releasing hormone) across 361 studies, including 18,454 individuals. Results Although depressed individuals tended to display increased cortisol (d = 0.60; 95% confidence interval [CI], 0.54-0.66) and adrenocorticotropic hormone levels (d = 0.28; 95% CI, 0.16-0.41), they did not display elevations in corticotropin-releasing hormone (d = 0.02; 95% CI, -0.47-0.51). The magnitude of the cortisol effect was reduced by almost half (d = 0.33; 95% CI, 0.21-0.45) when analyses were limited to studies that met minimal methodological standards. Gender did not significantly modify any HPA outcome. Studies that included older hospitalized individuals reported significantly greater cortisol differences between depressed and nondepressed groups compared with studies with younger outpatient samples. Important cortisol differences also emerged for atypical, endogenous, melancholic, and psychotic forms of depression. Conclusions The current study suggests that the degree of HPA hyperactivity can vary considerably across patient groups. Results are consistent with HPA hyperactivity as a link between depression and increased risk for conditions, such as diabetes, dementia, coronary heart disease, and osteoporosis. Such a link is strongest among older inpatients who display melancholic or psychotic features of depression.

910 citations

Journal ArticleDOI
TL;DR: The findings suggest a possible link between recurrent sport-related concussion and increased risk of clinical depression and emphasize the importance of understanding potential neurological consequences of recurrent concussion.
Abstract: GUSKIEWICZ, K. M., S. W. MARSHALL, J. BAILES, M. MCCREA, H. P. HARDING JR, A. MATTHEWS, J. R. MIHALIK, and R. C. CANTU. Recurrent Concussion and Risk of Depression in Retired Professional Football Players. Med. Sci. Sports Exerc., Vol. 39, No. 6, pp. 903–909, 2007. Purpose: The purpose of our study was to investigate the association between prior head injury and the likelihood of being diagnosed with clinical depression among retired professional football players with prior head injury exposure. Methods: A general health questionnaire, including information about prior injuries, the SF-36 (Short Form 36), and other markers for depression, was completed by 2552 retired professional football players with an average age of 53.8 (T 13.4) yr and an average professional football-playing career of 6.6 (T 3.6) yr. A second questionnaire focusing on mild cognitive impairment (MCI)-related issues was completed by a subset of 758 retired professional football players (50 yr and older). Results: Two hundred sixty-nine (11.1%) of all respondents reported having prior or current diagnosis of clinical depression. There was an association between recurrent concussion and diagnosis of lifetime depression (W 2 = 71.21, df =2 ,P G 0.005), suggesting that the prevalence increases with increasing concussion history. Compared with retired players with no history of concussion, retired players reporting three or more previous concussions (24.4%) were three times more likely to be diagnosed with depression; those with a history of one or two previous concussions (36.3%) were 1.5 times more likely to be diagnosed with depression. The analyses controlled for age, number of years since retirement, number of years played, physical component score on the SF-36, and diagnosed comorbidities such as osteoarthritis, coronary heart disease, stroke, cancer, and diabetes. Conclusion: Our findings suggest a possible link between recurrent sport-related concussion and increased risk of clinical depression. The findings emphasize the importance of understanding potential

908 citations


Performance
Metrics
No. of papers in the topic in previous years
YearPapers
202251
20213,717
20203,369
20193,005
20182,810
20172,737