Psychiatry
Article Abstract:
The field of psychiatry has been enhanced during the past decade by several epidemiologic studies which document disease prevalence, health care use, and variation in symptoms among different segments of the community. Unfortunately, even with improved treatment approaches, many psychiatric disorders remain untreated. The diagnosis of depressive disorder appears to vary according to the medical specialty of the clinician, with fewer patients detected by medical providers (50 percent, in one study) than by mental health specialists (80 percent). The impairment of function produced by depressive disorders is equivalent to that resulting from seven major medical illnesses, including diabetes, arthritis, and hypertension. People with depressive disorders, including manic-depressive disorder, are generally treated by mental health specialists, while those with depressive symptoms consult physicians in general health settings. Members of the latter group are also impaired. Increased mortality is associated with depressive disorders, either as a result of suicide (in younger people) or when they are associated with chronic diseases (in older people). Medical students and interns show a high incidence of depressive disorders and symptoms, compared with the general population. Depression does not seem to be correlated with the incidence of cancer or mortality. People who experience panic attacks (episodes of sudden, intense fear) have a high rate of suicide ideation, with 20 percent having made an attempt. Panic disorder is associated with poor health and poor social functioning, but can be treated with behavioral therapies and drugs; distinct improvements are often seen after 12 weeks of therapy. Affective disorders become chronic or recur relatively often (20 to 30 percent of cases), with maintenance therapy of six months' duration advantageous. Affective and anxiety disorders are familial: 18 percent of first-degree relatives are at risk for anxiety disorders. Their linkage to genetic markers is undoubtedly complicated and remains unknown. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Psychiatry
Article Abstract:
Psychiatry, like other fields of medicine, must occasionally reevaluate its practices in the light of accumulated evidence. This is happening in the case of depression. One important finding is the importance of 'subsyndromal' depression, which includes individuals with clear symptoms of depression, but who do not have all the symptoms necessary to justify a diagnosis of clinical depression. These people have been found to have more disability, more days lost from work, and an increased rate of anxiety disorders. Another set of findings confirms that many cases of depression are recurrent. Severe cases of depression are often treated without the recognition that the patient has experienced recurrent depression. There is evidence that suggests patients with recurrent depression should be treated aggressively with antidepressant drugs. Drug therapy will not reduce the time span of the depression, but the magnitude of depression will be reduced. Controlled studies have indicated that psychotherapy provides modest benefits, but is less effective in the treatment of depression than drugs such as imipramine or the combination of imipramine and desipramine. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Psychiatry
Article Abstract:
Discoveries in the field of pharmacology have changed ideas on both use the of drugs and the nature of psychiatric illness. The one in 40 people who suffer from obsessive compulsive disorders (OCD) can be treated with the antidepressant clomipramine and behavior therapy. Information from brain scans has shown abnormalities in the balance of function between specific parts of the brain, inferring that OCD may be a behavioral and functional disorder. It also has a genetic aspect. Other drugs, which are not tricyclic or solely antidepressant, block response to the neurotransmitter serotonin and have additional effects. Mixed anxiety depression, seen in most patients seeking treatment from their primary physician, may require both antidepressants and/or antianxiety medication. Reports that these drugs may cause suicide, motor restlessness (akathisia), violence or murder have been publicized in the press, which ignores scientific information showing these are safe and effective drugs.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
User Contributions:
Comment about this article or add new information about this topic: