[Effectiveness and security of venlafaxine XR in the treatment of major depression]. / Efectividad y seguridad de la venlafaxina XR en el tratamiento de la depresión mayor.

OBJECTIVES: An open 4-month evaluation of the effectiveness, tolerability and safety of venlafaxine XR in the treatment of outpatients with major depression. MATERIAL AND METHODS: We conducted a multi-center, open, not placebo-controlled, phase IV clinical trial. Participants had to be outpatients, female or male, between 18 and 66 years of age, with a diagnosis of major depressive disorder according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-IV) and a minimal score of 20 points on the 21-item Hamilton Scale for Depression (HAM-D21). No patients with a deteriorated condition participated in this study. The evaluations confirmed the physical conditions of all participants as well as the application of HAM-D21 and Clinical Global Impressions (CGI) for up to 4 months. The doses managed for venlafaxine XR started with 75 mg/day, which was increased in the same proportion up to a maximum dose of 225 mg/day, depending on medical judgment. Descriptive statistics were used, t paired for HAM-D21 and CGI. RESULTS: 96 patients were recruited and participated in this study, 74 patients completed the study. Baseline score for HAM-D21 was 30.9 +/- 5.5 and the score for the final visit was 4.9 +/- 6.1 (95% CI, p < .0001). Baseline CGI score of 4.6 +/- 1.2 and final CGI score of 1.5 +/- 0.9 (95% CI p < .0001), between baseline and final visit. The most frequent adverse events in a descending order were dry mouth, nausea, headache, somnolence, and dizziness. Five adverse events were catalogued and reported as serious adverse events. Patients did not show any modifications in laboratory analysis results, vital signs or weight. CONCLUSION: This open evaluation of venlafaxine XR in a Mexican population shows the effectiveness, good tolerability and safety of venlafaxine XR in the treatment of depression.

Increased incidence of anxiety and depression during bone marrow transplantation.

BACKGROUND: Since the first organ transplantation in the 1950s, there have been reports that patients who underwent organ transplantation had a poor prognosis if they were depressed and/or anxious prior to transplantation. Our objective in this study was to determine the prevalence of anxiety and depression in the different stages of bone marrow transplantation (BMT). METHODS: Mood disorders (MD), anxiety disorders (AD), and adjustment disorders (ADD) were measured five times with DSM IV. The Beck Inventory of Depression (BID) and Hamilton Rating Scale of Anxiety (HRSA) were used to measure levels of depression and anxiety, respectively, at registration and at days -1, +21 +/- 7, +30 +/- 10, and 90 +/- 10 days from BMT. Analysis between diverse periods was made for allogeneic BMT (allo-BMT) with chi square test, while Fisher exact test was used for the autologous BMT (auto-BMT). RESULTS: We report on 26 patients, including 18 with allo-BMT, and eight with auto-BMT. The allo-BMT was associated with depression during post BMT period (chi(2) = 11.924; p = 0.01). Slight anxiety without statistical significance was found in all stages. There was a high prevalence of anxiety and adjustment disorder in the immediate posttransplantation stage. Anxiety and adjustment disorders were more frequently found in all posttransplantation stages, particularly in the immediate stage (chi(2) =11.104, p = 0.02). After 3 months, no survivor received a psychiatric diagnosis. We did not find any differences in MD. There were five deaths. CONCLUSIONS: The auto-BMT group did not show significant associations between different stages and psychiatric variables studied. One death occurred at 1 month. This patient had severe depression. We recommend that the depressive syndrome be intentionally researched during the different stages of BMT, specifically in the immediate transplantation stage.

Ansiedad, depresión, desesperanza y riesgo de suicidio en pacientes internados por síndrome de inmunodeficiencia adquirida / Anxiety, depression, hopelessness and risk in bedridden hospitalized AIDS patients

Nuestro objetivo fue investigar la prevalencia de diversos síndromes psiquiátricos en pacientes hospitalizados por complicaciones del síndrome de inmunodeficiencia adquirida. Fueron estudiados 43 pacientes con edades entre 17 y 90 años, con media de 37.17 años. La prevalencia de las problemas fue desesperanza 65.11 por ciento, ansiedad 55.81 por ciento, riesgo de suicidio 46.51 por ciento y depresión 37.2 por ciento. Concluimos que los síndromes psiquiátricos constituyen un problema frecuente en esta población

Costo de los síntomas somatoformes / Cost of somatoform symptoms

Se estudiaron 47 expedientes de pacientes con síntomas somatoformes (grupo A) y un grupo control de 60 expediantes de nacientes médico/quirúrgicos (grupo B) del Hospital de Especialidades, Centro Médico Nacional La Raza, para comparar los gastos generados en cada grupo, de acuerdo con la hoja de costos unitarios proporcionada por el Departamento de Finanzas de este hospital. Para el análisis estadístico se utilizó la gráfica de distribución de frecuencia, media, mediana y la prueba de Pearson. Los pacientes del grupo B mantuvieron consistentemente costos más bajos. El número de pacientes con costos superiores a $ 40 000.00 fue mayor en el grupo A (somatizadores), quienes gastan más en el diagnóstico, mientras que el paciente médico/quirúrgico invierte más en el tratamiento