REM latency and the recovery from depression: getting over divorce

Article Abstract:

Certain sleep disturbances, measurable in the sleep laboratory, have been noted to occur in patients suffering from depression. Decreased REM latency, the time from the point when sleep begins to the point of the first REM period, is one sleep disturbance frequently associated with depression. Meanwhile, divorce is one of the events of life associated with a high rate of depression. This study examined REM latency in people undergoing divorces who either met or did not meet diagnostic criteria for depressive disorder. Subjects also underwent one-year follow-up studies to see if remission of depressive symptoms or adjustment to divorce affected REM latency. Family history of depression or alcoholism was also examined to see whether such a history might correlate with REM latency. Seventy subjects underwent a three-night sleep study, of whom 61 returned a year later for a follow-up study. Major depression was diagnosed in 40 of the 70 subjects. Short REM latency periods were measured in 21 (30 percent) of the subjects. Of the 40 subjects with depression, 15 (37.5 percent) had short REM latency periods, and of the 30 subjects who did not have depression, six (20 percent) had short REM latency periods. Four of those six who were not suffering from depression at the time had recently been depressed. When current and recent depression were considered together, there was a significant relationship between depression and a short REM latency period. Of the 15 subjects who met the criteria for depression and had short REM latency periods, only seven had short REM latency periods one year later and none of the seven met the criteria for depression. Adjustment to the divorce was poorest in subjects who initially met the criteria for depression and who had normal initial and follow-up REM latency periods. Patients who met the criteria for depression were more likely to report a family history of depression. The results indicated that depression that occurs during a divorce might be of two types, one episodic and the other more chronic. A transient decrease in REM latency appeared to be related to a more episodic form of depression. Depressed individuals with normal REM latencies may be more in need of treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Abnormalities, Sleep, Divorce

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Substituting nonsomatic for somatic symptoms in the diagnosis of depression in elderly male medical patients

Article Abstract:

Older adults often succumb to poor physical health, and this puts them at risk of developing affective (emotional) disorders such as depression. The coexistence, or comorbidity, of physical and mental illnesses makes diagnosis and treatment difficult. Elderly patients with medical problems tend to consult their primary care physicians for treatment of their psychological problems although detection and therapy for psychological problems is frequently poor by non-mental health specialists. In addition, some common symptoms of depression--appetite loss, insomnia, fatigue, diminished concentration--may also indicate medical conditions or side effects of drugs. To evaluate current diagnostic criteria for depression in elderly patients, the authors assessed a version of the Research Diagnostic Criteria (RDC) for both sensitivity (the ability to detect a disorder) and specificity (the ability to distinguish a specific disorder from possible similar ones). Symptoms of major, minor and intermittent depression were evaluated in 150 elderly male patients hospitalized for medical problems. Four of the somatic (physical) symptoms in the RDC were replaced with nonsomatic symptoms to improve the diagnostic value of the criteria. Specifically, appetite change, sleep disturbance, fatigue and diminished concentration were replaced with tearfulness, social withdrawal, self pity and lack of reactivity, respectively. The sensitivity of the modified criteria was 87 percent, and specificity 97 percent. Misclassifications occurred among mildly depressed patients. The authors suggest the results support using nonsomatic depressive symptoms as diagnostic criteria when physical symptoms may be ambiguous.

Health aspects, Evaluation, Health status indicators, Cognition disorders in old age, Geriatric cognitive disorders, Aged men, Elderly men

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Belinda's puzzle: assembling the pieces of an illness

Article Abstract:

A 37-yr.-old woman was diagnosed with recurrent nonpsychotic unipolar depression and given pharmacotherapy. The diagnosis was based on her depressive symptoms of sadness, sleeplessness, loss of energy and loss of libido. Her condition was not caused by mental disorder but by her emotional connection to a childhood experience and the stress of living in a modern industrial society.

Stress (Psychology)

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