Showing papers on "Mood disorders published in 1986"

Psychiatric disorders in the biological and adoptive families of adopted individuals with affective disorders.

Abstract: • To investigate the contribution of genetic and environmental factors in the etiology of mood disorders, a study was initiated to examine the frequency of psychiatric disorders in the biological and adoptive relatives of adult adoptees with mood disorders and in matched normal adoptees. Psychiatric evaluations of the relatives were made on the basis of independent blind diagnoses based on mental hospital and other official records. Analysis of the data showed an eightfold increase in unipolar depression among the biological relatives of the index cases and a 15-fold increase in suicide among the biological relatives of the index cases. These data demonstrate a significant genetic contribution to unipolar depression and suicide. They fail to disclose a significant contribution of family-associated transmission in the genesis of the mood disorders.

Depression, hopelessness and suicide in chronic schizophrenia.

Abstract: Hospital records for 104 schizophrenic patients, 15 of whom subsequently committed suicide, were rated blindly for individual depressive symptoms comprising DSM III major depressive episode, and for hopelessness. Our results indicate that a large proportion of schizophrenic patients experienced major depressive episodes, and that these can be reliably identified. Presuicidal schizophrenics also experienced depressed mood, but only a minority developed the full syndrome; they typically exhibited the psychological, but not somatic symptoms. The relationship between depression and suicide disappears when hopelessness is taken into account.

Two-year longitudinal study of post-stroke mood disorders: comparison of acute-onset with delayed-onset depression

Abstract: Patients who developed post-stroke depression 3 to 24 months after hospital discharge (N = 21) were compared with patients who developed depression during hospitalization (N = 26) and patients who never developed depression over 24 months of follow-up (N = 15). During the acute hospitalization and at follow-up, the three groups were not significantly different in their demographic characteristics, neurological impairment, intellectual impairment, or quality of social support. The acute depression group, however, showed an increased correlation between impairment and depression from hospitalization to follow-up. Findings suggest that impairment does not produce depression, but, once depression occurs, it may interact with impairment to influence post-stroke recovery.

The Heredity of Behavior Disorders in Adults and Children

Abstract: Current trends in morbidity suggest that by the beginning of the twen ty-first century, psychiatric illness may become the most pressing problem in public health in many of the advanced countries. As ably demonstrated by Vandenberg, Singer, and Pauls, the principal identifia ble etiology of the major psychiatric disorders is heredity; if progress is to be made in prevention and treatment of these disorders, it may have to come from improved understanding of their inheritance. A relentless increase has been observed in the frequency of mood disorders, primarily major depression but also manic-depressive ill ness, appearing earlier and more frequently in each age cohort born since (approximately) 1940. Because major depression is a recurrent disorder, whose episodes increase in frequency with age, the number of observed depressions can be expected to increase dramatically as these people reach middle and old age. The rate of suicide has also increased enormously, according to birth cohort. Starting with people born around 1935, the rate of suicide between 15 and 19 years of age has increased more than 10 times from the earliest to the most recent birth cohorts. What is not clear is if there will be a compensatory reduction in suicide rate as this cohort ages, because people likely to commit suicide will have done so earlier, or if this presages a general increase in suicide, comparable to the increase in mood disorders and perhaps a function of them."

GABA and mood disorders : experimental and clinical research

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Descriptive validity of DSM-III depressions.

Abstract: There are five categories of psychiatric disorders in DSM-III that embrace depressive moods: adjustment disorder with depressed mood (group 1), bipolar depression (group 2), major depression (group 3), dysthymic disorder (group 4), and atypical depression (group 5). A large sample of patients seen in a metropolitan university psychiatric referral center, with these categories as primary diagnoses in axis I, constitute the subjects studied (N = 2988). The study includes a comparison of the cross-sectional clinical properties of these patients, including an inventory of psychopathological symptoms, entries in axes II to V (i.e., as described in DSM-III, plus a sixth axis measuring current adjustment) and immediate dispositions rendered by clinicians. This study addresses the descriptive validity of DSM-III diagnostic categories of depression. A clustering of depressions based on a continuum of severity is uncovered as well as unique features of certain subtypes that point to categorical aspects of DSM-III mood disorders. The nature and implication of these findings are discussed.

Mood Alterations and Sleep

Abstract: We have reviewed literatures about neurobiological aspect of mood disorders in the light of abnormalities of REM sleep. A shortened REM latency is a consistent finding in depressed patients and may be considered a biological marker for depression. Most depressed patients with shortened REM latency also show non-suppression on dexamethasone-suppression test (DST). The commonly used antidepressant drugs cause a significant reduction in REM sleep. Patients with abnormal DST show a better response to sleep deprivation than those with normal DST. Recent studies indicated that borderline patients, primary dysthymic patients and obsessive-compulsive patients (OCD) have shortened REM latency. Farthermore, patients with OCD have a fairly good response to antidepressant clomipramine. Diagnostic and therapeutic strategies can conceivably be related on the examination of sleep patterns of psychiatric patients.

Obsessional symptomatology and adverse mood states.

Abstract: Patients suffering from obsessional neurosis without other psychiatric diagnosis were examined with reference to the association of the mood disorders of depression, anxiety, and outwardly and inwardly directed irritability. All mood disorders were common, and many occurred together in individual patients, but anxiety was the most prevelant. Inwardly directed irritability was significantly related to the overall severity of obsessions, and to the degree of handicap or interference in everyday life experienced by the patient.

Seasonal Affective Disorders: Seasonal Energy Syndrome?

Abstract: To the Editor.— Having extensive experience in the diagnosis and treatment of seasonal affective disorders, 1 which we would better classify as seasonal energy syndrome , we wish to alert clinicians to several major concerns. 1. The disorder is not limited to the fall-winter period but indeed involves a spring-summer syndrome of hyperphoria, impulsivity, violence, and agitated psychosis. Of 47 patients thus far studied, 17 patients were hospitalized for a total of 71 admissions. Of these admissions, 51 occurred between March and August and just 20 between September and February. 2. Summer symptoms can often be precipitated or exacerbated by fullspectrum light. 3. The disorder often mimics an atypical bipolar disorder but differs insofar as patients, when carefully questioned, report energy-anhedonia symptoms rather than true affective complaints. Thus, anhedonia and low energy level in the fall-winter period and hyperphoria, racing thoughts, and agitation in the spring-summer period are the hallmarks of

Clinical aspects and treatment of rapid cycling mood disorders.

Abstract: Eight female patients with rapid cycling mood disorders (at least four discrete affective episodes per year) were examined from a clinical perspective. Assessment suggested several different etiologies to the rapid cycling pattern in these patients. These included that the rapid mood swings were: a natural expression of the affective disorder, tricyclic induced, a result of frequent medication changes and/or poor medication compliance, and a combination of the aforementioned etiologies. All patients were helped significantly with treatment. Treatment was individualized for each patient's unique illness and possible etiological factors in the rapid cycling. Treatment strategies and guidelines include: A psychotherapeutic approach involving the patient and his family which emphasizes the lengthy nature of treatment before expected results; The necessity of rigorous drug adherence, The sole use of "high dose" lithium therapy (greater than 1.2 MEQ/L) in some patients, and the consideration of "high dose" lithium in conjunction with tricyclics, MAO inhibitors or "adjuvant" medication in certain bipolar II patients; The discontinuation of tricyclics in bipolar rapid cyclers; The combination of lithium salts and carbamazepine or the use of carbamazepine alone in selected patients.

Positron emission tomography in depression research: principles--results--perspectives.

Abstract: At present, PET is the only technology affording the quantitative, three-dimensional imaging of various aspects of brain function. In the few PET studies of mood disorders performed so far, usually ce

Underdocumentation of benzodiazepine prescriptions in a general medicine clinic.

Abstract: During a three-month period the authors reviewed the charts of patients prescribed benzodiazepine and non-benzodiazepine medications by 73 housestaff practicing in an ambulatory medical clinic. Compared with non-benzodiazepine prescriptions, benzodiazepine name (p<0.001), instructions (p<0.001), and targeted problems (p<0.0001) were significantly underrectorded. In 11% of the records reviewed there was no indication that a mood disorder had been identified or a benzodiazepine prescribed (p<0.0001). Problems targeted for benzodiazepine management were found less frequently in the records of elderly patients than in those of patients <65 years of age (p<0.05). The authors conclude that many houseofficers significantly underdocument the prescriptions they write for benzodiazepine medications and that this may be a marker of their regard for managing mood disorders with benzodiazepines.

Recent Genetic Findings in Mood Disorders

Abstract: The scope of genetic research in psychiatric illness includes family diagnostic studies and studies of biological markers of illness vulnerability. In the area of family studies, recent research has focused on the relationship of other diagnostic entities to major affective illness, particularly the eating disorders, and childhood depression.

[Usefulness of self-assessment scales for anxiety and depression in internal medicine].

Abstract: The rating scales and questionnaires of quantitative psychopathology constitute an aid for the resident physician in the recognition of depressive and anxiety disorders in medical wards. The specific interest of these scales is more in the symptomatic intensity than in the diagnosis. A structured questionnaire leading to a DSM-III diagnosis of mood disorders shows the differences of these two approaches. Analyses of the results of two new self-assessment scales for depression compared to those of a diagnostic instrument permit to appreciate the respective prevalence of mood disorders and the intensity of depressive symptomatology.