I’m Not Crazy!

2002 ◽  
Author(s):  
Daniel J. Wallace ◽  
Janice Brock Wallace
Keyword(s):  
Major Depression ◽  
Life Events ◽  
Musculoskeletal Pain ◽  
Minnesota Multiphasic Personality Inventory ◽  
Office Visit ◽  
Endogenous Depression ◽  
Reactive Depression ◽  
Medical Centers ◽  
Historical Factors ◽  
History Of

“You look fine, and I can’t find anything wrong with you. Maybe you’re just depressed or stressed out.” Nearly all of my patients have heard this before. And they start to wonder: Am I really crazy? How could it all be in my mind? This chapter will summarize the small number of behavioral surveys that rheumatologists and psychiatrists have performed on fibromyalgia patients. The treatment of fibromyalgia will be reviewed in Parts VI and VII. Why are there so few studies that we can rely upon? First, most research is conducted at university medical centers, where fibromyalgia patients tend to be more symptomatic and have not responded to interventions by community physicians. Second, depression itself is associated with high rates of musculoskeletal pain. Also, few people have had comprehensive psychological evaluations before they became ill that can be used for comparison. Finally, instruments of psychological assessment were devised before we knew what fibromyalgia was, and popular tests such as the Minnesota Multiphasic Personality Inventory (MMPI) cannot distinguish between pain from a disease and pain from depression. Is fibromyalgia a manifestation of depression or the reverse? Well-designed studies have addressed this issue, but many used different methods, populations, ethnic groupings, referral sources, and geographical distributions. In any case, the results were reasonably similar. On average, these studies showed that about 18 percent of fibromyalgia patients have evidence of a major depression at any office visit and 58 percent have a history of major depression in their lifetime. What does this mean? At any point in time, the overwhelming majority of fibromyalgia patients are not seriously depressed. And if they are depressed, it’s usually because they do not feel well. This condition is called reactive depression and is reversible with treatment, as opposed to endogenous depression, which is caused by chemical imbalances and is much harder to treat. A well-designed study of depressed patients demonstrated that fewer than 10 percent had two or more tender points. Certain life events or historical factors are statistically present more often in fibromyalgia patients than in those without the disorder.

The epidemiology of psychiatrist-ascertained depression and DSM-III depressive disorders Results from the Eastern Baltimore Mental Health Survey Clinical

1992 ◽  
Vol 22 (3) ◽  
pp. 629-655 ◽  
Author(s):  
A. J. Romanoski ◽  
M. F. Folstein ◽  
G. Nestadt ◽  
R. Chahal ◽  
A. Merchant ◽  
...  
Keyword(s):  
Major Depression ◽  
Life Events ◽  
Depressive Disorders ◽  
Multiple Logistic Regression ◽  
Adverse Life Events ◽  
Future Studies ◽  
Symptom Profiles ◽  
Examination Method ◽  
Treatment Of Depression ◽  
History Of

SynopsisPsychiatrists used a semi-structured Standardized Psychiatric Examination method to examine 810 adults drawn from a probability sample of eastern Baltimore residents in 1981. Of the population, 5·9% was found to be significantly depressed. DSM-III major depression (MD) had a prevalence of 1·1% and ‘non-major depression’ (nMD), our collective term for the other depressive disorder categories in DSM-III, had a prevalence of 3·4%. The two types of depression differed by sex ratio, age-specific prevalence, symptom severity, symptom profiles, and family history of suicide. Analyses using a multiple logistic regression model discerned that both types of depression were influenced by adverse life events, and that nMD was influenced strongly by gender, marital status, and lack of employment outside the home. Neither type of depression was influenced by income, education, or race. This study validates the concept of major depression as a clinical entity. Future studies of the aetiology, mechanism, and treatment of depression should distinguish between these two types of depression.

The rat hippocampus as a target for prolonged stress: Biochemical and behavioral effects

1995 ◽  
Vol 7 (2) ◽  
pp. 70-74
Author(s):  
H.J. Krugers ◽  
J. Korf
Keyword(s):  
Risk Factors ◽  
Major Depression ◽  
Major Depressive Episode ◽  
Stressful Life Events ◽  
Previous History ◽  
Endogenous Depression ◽  
Major Depressive ◽  
History Of ◽  
Parental Rearing ◽  
Prolonged Stress

The probability that an individual will suffer from a major depressive episode is often considered to be influenced by risk factors such as gender, premature parental loss, exposure to pathogenic parental rearing, personality, a history of traumatic events, a previous history of major depression, low social support, recent stressful life events and difficulties and predisposing genetic influences. Although several studies suffer from methodological limitations, major depression (endogenous depression) is regarded as a multifactorial disorder and understanding its etiology requires the rigorous integration of several risk factors.

Empathy and Reactive Depression

1997 ◽  
Vol 80 (3) ◽  
pp. 1043-1049 ◽  
Author(s):  
Isabela Gawronski ◽  
Gayle Privette
Keyword(s):  
Social Workers ◽  
Life Events ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Endogenous Depression ◽  
Stressful Events ◽  
Reactive Depression ◽  
Additional Information ◽  
Questionnaire Measure ◽  
Best Fit

Empathy and reactive depression were investigated with 53 women, from 21 to 53 years of age, who worked or planned to work as nurses, counselors, or social workers. Empathy was measured using the Mehrabian and Epstein Questionnaire Measure of Empathic Tendency. The adapted Zung Self-rating Depression Scale was used to measure Depressive Symptomatology, and Paykel's Scale for Life Events was used to identify stressful events. A narrative questionnaire elicited additional information to assess stressful events and to screen clinically for endogenous depression. Reactive Depression scores were obtained using a best fit line to correct Depressive Symptomatology for severity of Life Events. A significant modest positive correlation of .39 was found between scores on Empathy and Reactive Depression.

scholarly journals Antidepressant Activity of Spirulina Platensis in Models of Depression

2017 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Addison Rosli
Keyword(s):  
Life Events ◽  
Affective Disorders ◽  
Stressful Life Events ◽  
Antidepressant Drugs ◽  
Antidepressant Activity ◽  
Premature Death ◽  
Unipolar Depression ◽  
Endogenous Depression ◽  
Reactive Depression ◽  
External Stresses

Depression is the most common of the affective disorders (disorders of mood rather than disturbances of thought or cognition); it may range from a very mild condition, bordering on normality, to severe (psychotic) depression accompanied by hallucinations and delusions. Worldwide, depression is a major cause of disability and premature death. Unipolar depression is commonly (about 75% of cases) non-familial, clearly associated with stressful life-events and accompanied by symptoms of anxiety and agitation; this type is sometimes termed reactive depression. Other patients (about 25%, sometimes termed endogenous depression) show a familial pattern, unrelated to external stresses, and with a somewhat different symptomatology. This distinction is made clinically, but there is little evidence that antidepressant drugs show significant selectivity between these conditions.

The Return of the Two Depressions (and an Anxious Postscript)

2013 ◽  
Author(s):  
Edward Shorter
Keyword(s):  
World War Ii ◽  
Major Depression ◽  
Common Sense ◽  
Endogenous Depression ◽  
Depressive State ◽  
World War ◽  
Reactive Depression ◽  
Death Spiral ◽  
Involutional Melancholia ◽  
The 19Th Century

Before 1980 there had been two depressions, melancholia—also called endogenous depression—and nonmelancholia, called a number of terms such as reactive depression and neurotic depression. DSM-III flattened this distinction, abolishing the clinical distinction between the two with the homogenizing term major depression. To be sure, DSM-III reinserted the term melancholia in the discussion as a subtype of major depression, but only in letter, not in spirit. In the decades after 1980 melancholia returned, but to a landscape of mood disorder that had been leveled and laid waste by the concept of “depression.” In a world where everybody is depressed, nobody is melancholic. Emil Kraepelin had sent the diagnosis of melancholia into a death spiral. The psychoanalysts had little interest in the concept, aside from venerating a single essay of Freud, and the only people interested in keeping melancholia alive as a notion after the 1930s were the British who, with their admixture of Heidelberg science and homegrown common sense, had turned into shrewd psychopathologists. The textbook that Willi Mayer-Gross, a Heidelberg refugee, published in 1954 together with Eliot Slater and Martin Roth gave pride of place to involutional melancholia as the serious melancholic illness that oft en affected people at midlife and afterward. But world psychiatry after World War II marched to an increasingly American beat, and the Americans had little use for the antique term melancholia. The glossary of Alfred Freedman’s Comprehensive Textbook of Psychiatry, the world’s leading textbook first published in 1967, had scads of psychoanalytic terms but claimed of melancholia: “Old term for depression that is rarely used at the present time.” In Europe after World War II, endogenous depression was the serious variety and melancholia was deemed as “contaminated by Freud and the 19th century novels that degraded it to grief,” as Tom Ban, who trained in Budapest in the early 1950s, put it. “For Kraepelinians, grief and depression were not the same, and they excluded each other. Anyone who had an identifiable precipitating factor could not be labeled as having a depressive state.”

External Validity of SCORS-G Ratings of Thematic Apperception Test Narratives in a Sample of Outpatients and Inpatients

2015 ◽  
Vol 36 (1) ◽  
pp. 58-81 ◽  
Author(s):  
Michelle B. Stein ◽  
Jenelle Slavin-Mulford ◽  
Caleb J. Siefert ◽  
Samuel Justin Sinclair ◽  
Michaela Smith ◽  
...  
Keyword(s):  
Life Events ◽  
Psychiatric Hospitalization ◽  
Clinical Care ◽  
Thematic Apperception Test ◽  
Clinical Samples ◽  
Cross Sectional ◽  
Conduct Disordered ◽  
Global Ratings ◽  
Thematic Apperception ◽  
History Of

Abstract. The Social Cognition and Object Relations Scale-Global Ratings Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker-Aspen, 2011 ) is a reliable system for coding narrative data, such as Thematic Apperception Test (TAT) stories. This study employs a cross-sectional, correlational design to examine associations between SCORS-G dimensions and life events in two clinical samples. Samples were composed of 177 outpatients and 57 inpatients who completed TAT protocols as part of routine clinical care. Two experienced raters coded narratives with the SCORS-G. Data on the following clinically relevant life events were collected: history of psychiatric hospitalization, suicidality, self-harming behavior, drug/alcohol abuse, conduct-disordered behavior, trauma, and education level. As expected, the clinical life event variable associated with the largest number of SCORS-G dimensions was Suicidality. Identity and Coherence of Self was related to self-harm history across samples. Emotional Investment in Relationships and Complexity of Representations were also associated with several life events. Clinical applications, limitations of the study, and future directions are reviewed.

Aesthetic Significance Of Holidays

2020 ◽  
Vol 2 (08) ◽  
pp. 647-651
Author(s):  
Shadimetova Gulchehra Mamurovna
Keyword(s):  
Life Events ◽  
Theoretical Basis ◽  
Aesthetic Perception ◽  
National Pride ◽  
Aesthetic Taste ◽  
National Values ◽  
Aesthetic Pleasure ◽  
History Of ◽  
Artistic Images ◽  
Methodological Aspects

Holidays have the power to reflect the nation's views, imagination, vision and national values about the scientist and man through artistic images. In addition, holidays form and strengthen feelings such as national pride and national pride, which are composed of such principles as nationhood, popularity, heroism, beauty, grandeur, as well as aesthetic pleasure, aesthetic interest, aesthetic taste and formation of aesthetic ideals – forming a composition of aesthetic perception that distinguishes people from other life events. In this article, the stages of development of holidays and their artistic and aesthetic features will be studied and studied on a scientific and theoretical basis. Also, the philosophical-aesthetic analysis of the concept of the holiday, the history of its development and scientific-methodological aspects are studied.

scholarly journals Factors related to age at depression onset: the role of SLC6A4 methylation, sex, exposure to stressful life events and personality in a sample of inpatients suffering from major depression

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Simon Sanwald ◽  
◽  
Katharina Widenhorn-Müller ◽  
Carlos Schönfeldt-Lecuona ◽  
Christian Montag ◽  
...  
Keyword(s):  
Major Depression ◽  
Life Events ◽  
Depressive Disorders ◽  
Stressful Life Events ◽  
Depressive Symptomatology ◽  
Age At Onset ◽  
Stressful Life ◽  
Entire Group ◽  
Affective Neuroscience ◽  
Depression Severity

Abstract Background An early onset of depression is associated with higher chronicity and disability, more stressful life events (SLEs), higher negative emotionality as described by the primary emotion SADNESS and more severe depressive symptomatology compared to depression onset later in life. Additionally, methylation of the serotonin transporter gene (SLC6A4) is associated with SLEs and depressive symptoms. Methods We investigated the relation of SLEs, SLC6A4 methylation in peripheral blood, the primary emotions SADNESS and SEEKING (measured by the Affective Neuroscience Personality Scales) as well as depressive symptom severity to age at depression onset in a sample of N = 146 inpatients suffering from major depression. Results Depressed women showed higher SADNESS (t (91.05) = − 3.17, p = 0.028, d = − 0.57) and higher SLC6A4 methylation (t (88.79) = − 2.95, p = 0.02, d = − 0.55) compared to men. There were associations between SLEs, primary emotions and depression severity, which partly differed between women and men. The Akaike information criterion (AIC) indicated the selection of a model including sex, SLEs, SEEKING and SADNESS for the prediction of age at depression onset. SLC6A4 methylation was not related to depression severity, age at depression onset or SLEs in the entire group, but positively related to depression severity in women. Conclusions Taken together, we provide further evidence that age at depression onset is associated with SLEs, personality and depression severity. However, we found no associations between age at onset and SLC6A4 methylation. The joint investigation of variables originating in biology, psychology and psychiatry could make an important contribution to understanding the development of depressive disorders by elucidating potential subtypes of depression.

scholarly journals Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States

2021 ◽  
Author(s):  
Nathaniel J Rhodes ◽  
Atheer Dairem ◽  
William J Moore ◽  
Anooj Shah ◽  
Michael J Postelnick ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Drug Therapy ◽  
Supportive Care ◽  
The United States ◽  
Primary Objective ◽  
Point Prevalence ◽  
Medical Centers ◽  
Academic Medical ◽  
History Of ◽  
Secondary Objective

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a non-interventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.

Sign in / Sign up

Export Citation Format

Share Document