ABSTRACT
BACKGROUND: Depressive symptoms are associated with noncompliance and even sudden death in asthma patients. Some studies suggest that low-income, minority, inner-city asthma patients may be at high risk for asthma-related morbidity and mortality in which depression may be a risk factor. Minimal data are available on the prevalence of depression and other mood disorders in asthma patients. OBJECTIVE: In this pilot study, we examined the prevalence of depression and the association between depression and measures of asthma severity in patients at an inner-city asthma clinic. METHODS: Mood disorders were diagnosed using a diagnostic interview given to patients (N = 44) at asthma clinic visits. Inhaled steroid dose, FEV1 percentage, and asthma severity were also obtained. RESULTS: Eighteen patients (41%) had a lifetime mood disorder but only seven of these patients received pharmacotherapy. Patients with a past mood disorder had significantly higher FEV1 percentage predicted values (P = 0.03) than those without a mood disorder. Trends toward less severe asthma (P = 0.13) and lower inhaled steroid dose (P = 0.13) in patients with a mood disorder history were also found. CONCLUSIONS: The data suggest that mood disorders are common, but often unrecognized and untreated in asthma patients. The data also suggest that mood disorders are not necessarily associated with more severe asthma, at least in the population studied.
Subject(s)
Asthma/complications , Mood Disorders/epidemiology , Urban Health , Asthma/diagnosis , Depression/complications , Depression/epidemiology , Female , Forced Expiratory Volume , Humans , Male , Middle Aged , Minority Groups , Mood Disorders/complications , Pilot Projects , Poverty , PrevalenceABSTRACT
No data are available comparing the relative efficacy of different atypical agents in patients with bipolar disorder. A chart review of bipolar and schizoaffective disorder patients who had received courses of at least two atypical agents (n = 33) in a community psychiatry system was conducted. No differences in rates of hospitalizations were found between individual atypical agents or between atypical agents as a class and conventional neuroleptics. However, a significant reduction in rates of emergency room visits was found with atypical agents compared to conventional neuroleptics, with a trend toward greater reduction with clozapine compared to other atypical antipsychotics. Larger prospective studies are needed to confirm these preliminary observations.
Subject(s)
Antipsychotic Agents/therapeutic use , Bipolar Disorder/drug therapy , Psychotic Disorders/drug therapy , Adult , Bipolar Disorder/psychology , Emergency Medical Services , Female , Hospitalization , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Psychotic Disorders/psychology , Retrospective StudiesABSTRACT
LEARNING OBJECTIVES: Readers will learn the importance of psychiatric symptomatology with corticosteroid drug therapy, especially when combined with other medications. DATA SOURCES: A brief history of corticosteroid use over the last five decades was complied utilizing MEDLINE and PSYCHOINFO as sources of information which include peer-reviewed research articles, case studies, and relevant reviews in English. CONCLUSION: Corticosteroids are routinely prescribed for a variety of allergic and immunologic illnesses. Psychiatric side effects from corticosteroids include mania, depression and mood disturbances. Psychiatric symptoms usually occur within the first two weeks of corticosteroid therapy and seem to be dose related. Treatment with lithium or antipsychotics may be helpful. Physicians should carefully monitor patients for psychiatric and cognitive side effects of corticosteroid use.
Subject(s)
Adrenal Cortex Hormones/adverse effects , Psychoses, Substance-Induced/etiology , Bipolar Disorder/chemically induced , Delusions/chemically induced , Female , Hallucinations/chemically induced , Humans , Male , Mood Disorders/chemically inducedABSTRACT
Behavioral relevance of norepinephrine is associated with neuronal processing underlying arousal, affect, attention, learning and memory, and is associated with beta-adrenergic modifications of neuronal activation in the hippocampal formation. This study utilized l-isoproterenol to initiate pathway-specific activation of afferents to hippocampal CA1 pyramidal cells. The consistent effects of l-isoproterenol on the initiation of action potentials to field CA1 pyramidal neurons to single-pulse stimulation was repeatedly associated with the activation of the Schaffer collateral pathway. In contrast, l-isoproterenol plus single-pulse stimulation never elicited action potential initiation of the perforant pathway to CA1. We interpret these results as indicating that beta-adrenergic modification underlies the augmentation of information processing via the Schaffer collateral pathway in the trisynaptic circuit vs the direct perforant pathway.
