ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryIn contrast to the study of clinical heterogeneity in patients with functional (i.e., no known neuropathology) mood disorder, the study of clinical heterogeneity of mood disorder in patients with stroke has the advantage of providing another variable (i.e., lesion size or location) which can be correlated with clinical presentation. We have demonstrated the utility of this kind of correlation by presenting several studies in which heterogeneity in clinical presentation was found to correlate with site of lesion. Patients with major depression and prominent anxiety were significantly more likely to have left cortical lesions than patients with major depression without anxiety symptoms, who were more likely to have left subcortical (basal ganglia) lesions. Similarly, patients whose depression spontaneously remitted within six months had a significantly higher frequency of subcortical or brainstem lesions, compared to those without early remission, who had cortical lesions. Finally, patients with bipolar disorders were significantly more likely to have right subcortical (basal ganglia or thalamic) lesions than patients with mania only, who were more likely to have right orbitofrontal or basotemporal lesions. These findings suggest that there may be an underlying neuroanatomical and/or neurophysiological explanation for these differences in clinical presentation.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryVictims of traumatic brain injury (TBI) can suffer from profound cognitive and emotional changes. Many patients complain of feeling depressed after a traumatic brain injury, and neuroanatomical and neurochemical changes that occur after TBI may predispose patients to the development of this depression. The differential diagnosis and the prevalence of depressed mood after TBI is discussed. Also discussed are specific therapeutic interventions, including the appropriate use of medication, which can be of significant benefit in helping these patients effectively participate in rehabilitation efforts.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryAdvanced age is associated with an increased prevalence of depressive symptoms, but not of primary major depression. The increasing prevalence of disability and institutionalization with age contributes to the increase in depressive symptoms, but age-associated declines in dopaminergic and noradrenergic reserves may also play a role. In late-life depression, vegetative symptoms may predominate over mood changes, and symptoms may be misattributed to systemic illness; these problems may confound the diagnostic process. The outcome of late-life depression is influenced by comorbid personality disorders; although these occur frequently, they are poorly studied. Treatment of late-life depression may ameliorate physical disability. A naturalistic study of nursing home patients suggests that antidepressants may help disability even when depressive symptoms do not reach the threshold for formal psychiatric diagnosis.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryPseudodementia has many meanings: The term refers to depressed patients who are cognitively impaired, but who improve after treatment. De-pressed, cognitively impaired patients also are often slow moving. The syndrome of depression, cognitive impairment, and motor slowing is caused by disorders of the ascending aminergic systems, such as Parkinson's disease. The term pseudodementia, when it applies to depression, should be replaced by a term which recognizes the full syndrome of depression, cognitive impairment, and motor slowing. We suggest the termSOTAN, an acronym for Syndrome of the Aminergic Nuclei.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryAffective disturbances are frequently reported in diseases of the basal ganglia. Symptoms common to many basal ganglia diseases include depression, anhedonia, apathy, and withdrawal. While a reaction to the physical impairments caused by these diseases may account for certain aspects of depression, there is evidence to suggest biological systems may underlie mood disturbances. Depression in Parkinson's disease appears to be the result of depletion of serotonin. Evidence of hypometabolism of the frontal cortex with bilateral lesions of the basal ganglia is reviewed and neuroanatomical and biochemical mechanisms underlying depressive pathology in basal ganglia diseases are postulated.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryDepression is a prevalent and important psychiatric problem in the management of patients with seizure disorders. We lay stress on the heterogeneity of depressive reactions in epilepsy and the need for individualized assessment and treatment. To facilitate clinical evaluation, therapy, and research, we suggest a preliminary distinction among preictal depression; depressive auras (ictal depression); post-ictal depression; and, most importantly, interictal depressive syndromes. Among the many patients with the interictal behavior syndrome of temporal lobe epilepsy, the interaction of biological and psychosocial factors is a key to understanding and treatment.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryThis paper reviews research on depression and other affective disorders in multiple sclerosis, including bipolar disorder, euphoria, and pathological laughing and weeping. We discuss methodological limitations and suggest areas for future clinical research.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummarySystemic lupus erythematosus (SLE) is an immune-mediated, multi-system disease with a wide spectrum of neuropsychiatric manifestations including seizures, psychosis, strokes, movement disorders, and cognitive deficits. Whether affective disorders represent a manifestation of SLE is controversial. Studies in the literature have used a variety of techniques to assess depression in SLE patients and have reported divergent results. Our preliminary experience suggests that depression is more common among SLE patients than among a similar group of rheumatoid arthritis patients. This suggests that SLE predisposes patients to depression apart from the general effects of a chronic disease or its treatment. Further investigation in this area is needed to elucidate the etiology of this phenomena.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

SummaryThe evidence linking pain and depression is briefly reviewed. This evidence suggests that in the presence of more depressive symptoms painful conditions or stimuli are experienced as more severe. Recent ideas from the field of pain research have shown that pain has three components: sensory, affective and evaluative. Furthermore, pain transmission can be altered by the behavioral state of the person through the action of a pain-modulating system. A model is presented whereby factors controlling the patient's affect and cognition alter that patient's behavioral state, which in turn alters pain transmission through central nervous system modulatory networks.

ISSN:0894-878X    

出版商:OVID    

年代:1991

数据来源: OVID