Depression - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

DEPRESSION A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J AMES N. ...

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DEPRESSION A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Depression: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83618-3 1. Depression-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on depression. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DEPRESSION .............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Depression................................................................................... 18 E-Journals: PubMed Central ..................................................................................................... 173 The National Library of Medicine: PubMed .............................................................................. 182 CHAPTER 2. NUTRITION AND DEPRESSION .................................................................................. 309 Overview.................................................................................................................................... 309 Finding Nutrition Studies on Depression ................................................................................. 309 Federal Resources on Nutrition ................................................................................................. 315 Additional Web Resources ......................................................................................................... 316 CHAPTER 3. ALTERNATIVE MEDICINE AND DEPRESSION ............................................................ 323 Overview.................................................................................................................................... 323 The Combined Health Information Database............................................................................. 323 National Center for Complementary and Alternative Medicine................................................ 324 Additional Web Resources ......................................................................................................... 340 General References ..................................................................................................................... 368 CHAPTER 4. DISSERTATIONS ON DEPRESSION .............................................................................. 369 Overview.................................................................................................................................... 369 Dissertations on Depression ...................................................................................................... 369 Keeping Current ........................................................................................................................ 410 CHAPTER 5. CLINICAL TRIALS AND DEPRESSION ........................................................................ 411 Overview.................................................................................................................................... 411 Recent Trials on Depression ...................................................................................................... 411 Keeping Current on Clinical Trials ........................................................................................... 429 CHAPTER 6. PATENTS ON DEPRESSION ......................................................................................... 431 Overview.................................................................................................................................... 431 Patents on Depression................................................................................................................ 431 Patent Applications on Depression............................................................................................ 488 Keeping Current ........................................................................................................................ 505 CHAPTER 7. BOOKS ON DEPRESSION ............................................................................................ 507 Overview.................................................................................................................................... 507 Book Summaries: Federal Agencies............................................................................................ 507 Book Summaries: Online Booksellers......................................................................................... 510 The National Library of Medicine Book Index ........................................................................... 523 Chapters on Depression ............................................................................................................. 525 Directories.................................................................................................................................. 529 CHAPTER 8. MULTIMEDIA ON DEPRESSION.................................................................................. 531 Overview.................................................................................................................................... 531 Video Recordings ....................................................................................................................... 531 Audio Recordings....................................................................................................................... 532 Bibliography: Multimedia on Depression .................................................................................. 533 CHAPTER 9. PERIODICALS AND NEWS ON DEPRESSION............................................................... 535 Overview.................................................................................................................................... 535 News Services and Press Releases.............................................................................................. 535 Newsletters on Depression......................................................................................................... 540 Newsletter Articles .................................................................................................................... 541 Academic Periodicals covering Depression................................................................................ 543 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 547 Overview.................................................................................................................................... 547

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NIH Guidelines.......................................................................................................................... 547 NIH Databases........................................................................................................................... 549 Other Commercial Databases..................................................................................................... 553 The Genome Project and Depression ......................................................................................... 553 APPENDIX B. PATIENT RESOURCES ............................................................................................... 557 Overview.................................................................................................................................... 557 Patient Guideline Sources.......................................................................................................... 557 Associations and Depression...................................................................................................... 575 Finding Associations.................................................................................................................. 582 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 585 Overview.................................................................................................................................... 585 Preparation................................................................................................................................. 585 Finding a Local Medical Library................................................................................................ 585 Medical Libraries in the U.S. and Canada ................................................................................. 585 ONLINE GLOSSARIES................................................................................................................ 591 Online Dictionary Directories ................................................................................................... 594 DEPRESSION DICTIONARY..................................................................................................... 595 INDEX .............................................................................................................................................. 683

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with depression is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about depression, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to depression, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on depression. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to depression, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on depression. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON DEPRESSION Overview In this chapter, we will show you how to locate peer-reviewed references and studies on depression.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and depression, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “depression” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Depression and HIV Source: STEP Perspective; Vol. 5, No. 3. Contact: Seattle Treatment Education Project, 1123 E John St, Seattle, WA, 98102, (206) 329-4857, http://www.thebody.com/step/steppage.html. Summary: This journal article defines depression, remarks on the differences between symptoms resulting from HIV and those stemming from depression, and considers the relationship between HIV disease and depression. It states that the most important step in the treatment of depression is recognition and the most effective treatment is consistent counseling with or without the use of medications. The article identifies and describes four classes of anti-depressant medications: tricyclics, heterocyclics, selective serotonin inhibitors, and monoamine inhibitors.

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AD-venture Program: Therapeutic Biking for the Treatment of Depression in LongTerm Care Residents With Dementia Source: American Journal of Alzheimer's Disease and Other Dementias. 17 (2): 121-127. March/April 2002. Summary: This article describes the effects of AD-venture, a therapeutic biking program, on long-term care residents with dementia and depression. Forty-one residents of a skilled nursing facility and 29 residents of an assisted living facility were randomly assigned to intervention and control groups. The intervention group used a wheelchair bicycle in a recreation therapy protocol consisting of a 2- week period of intensive biking (one-on-one ride with staff member 5 days a week) followed by a 10week maintenance program (ride with staff, family member, or volunteer twice a week). Data were collected at baseline and following each intervention period. Depression levels, measured with the Geriatric Depression Scale, were significantly reduced after 2 weeks of intensive treatment and continued to improve during the 10-week maintenance period. Sleep and activity engagement levels also were improved. An educational videotape and training manual were developed as part of this project. 4 tables, 21 references.

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Early Detection and Differential Diagnosis of Alzheimer's Disease and Depression With Neuropsychological Tasks Source: Dementia and Geriatric Cognitive Disorders. 12(4): 265-280. 2001. Summary: This article examines the utility of neuropsychological tasks in the early detection and differential diagnosis of Alzheimer's disease (AD) and depression. Computerized and traditional tests of memory, attention, and executive function were administered to 26 patients with mild AD, 43 with questionable dementia (QD), 37 with major depression, and 39 healthy controls. Whereas several mnemonic tests were sensitive to QD, attentional and executive tests were more sensitive to depression. The paired associates learning (PAL) test accurately distinguished AD from the combined group of depressed patients and controls, and revealed an apparent subgroup of QD patients who performed like AD patients. Scores on tests from the mnemonic, attention, and executive function categories, but not the global cognitive function category, significantly correlated with the degree of subsequent cognitive decline. The authors suggest that elements of contextual and cued recall in the PAL may account for the task's sensitivity and specificity for AD. 2 figures, 5 tables, 75 references. (AA-M).

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Depression Among Alzheimer's Caregivers: Identifying Risk Factors Source: American Journal of Alzheimer's Disease and Other Dementias. 16 (6): 353-359. November/December 2001. Summary: This article examines risk factors for the development of depression among caregivers of patients with Alzheimer's disease (AD). Data were obtained from 77 pairs of AD patients and their caregivers seen at two primary care geriatric clinics (of 92 patient/caregiver pairs evaluated, 15 were excluded due to missing data and 77 were included in the analysis). The Yesavage Geriatric Depression Scale was used to assess depression in patients and caregivers. Cognitive, functional, and behavioral status also was assessed in patients only. Caregivers were mostly spouses (49.4 percent) and adult children (42.9 percent); their mean age was 63.1 years. Twenty-nine caregivers (38 percent) were found to be depressed. A multivariate logistic regression analysis indicated that patient depression, hallucinations, and poor functional status are significant and independent risk factors for depression in caregivers. The authors

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suggest that early recognition of these factors may help to identify caregivers at risk for depression. 5 tables, 39 references. •

Olfactory Dysfunction Discriminates Probable Alzheimer's Dementia from Major Depression: A Cross-Validation and Extension Source: Journal of Neuropsychiatry and Clinical Neurosciences. 12(1): 29-33. Winter 2000. Summary: This journal article concerns the loss of the sense of smell (olfactory dysfunction) as an indicator of brain pathology, and a way to discriminate between persons with Alzheimer's disease (AD) and those with major depression. The entorhinal cortex, a major component of the olfactory system, is the first brain area affected by neurofibrillary tangles, one of the markers of AD. Forty people, 20 diagnosed with AD and 20 with major depression, all over age 55, were assessed with the 3-item Pocket Smell Test (PST), and with the Mini-Mental State Examination. The AD group had significantly lower scores than the depressed group on the PST. Results indicate that assessment of olfactory functioning can provide information for the clinician in the differential diagnosis of AD versus major depression in elderly patients. 4 tables, 28 references.

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Controlled Clinical Trial of Sertraline in the Treatment of Depression in Nursing Home Patients With Late-Stage Alzheimer's Disease Source: American Journal of Geriatric Psychiatry. 8(1): 66-76. Winter 2000. Summary: This journal article describes a controlled trial of sertraline for the treatment of depression in nursing home residents with late stage Alzheimer's disease. Female residents with advanced dementia and depression were randomly assigned to sertraline or placebo for eight weeks. Two members of each group were discontinued due to adverse effects. Measures of depression included various objective scales and two measures of facial expressions of emotion. Analysis indicated that both the sertraline and placebo groups improved over time, with a significant time effect seen on three of six measures. Only the 'knit- brow' facial measure approached significance. Although sertraline had no significant effects over placebo in this trial, the authors suggest that further study may be warranted if, as hypothesized, the 'knit- brow' response is a more sensitive indicator of depression in late dementia. 5 tables, 38 references.

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Mental Status Change in Older Surgical Patients: Cognition, Depression, and Other Comorbidity Source: American Journal of Geriatric Psychiatry. 8(1): 40-46. Winter 2000. Summary: This journal article examines the effect of elective surgery on the mental status of older patients over the postoperative year. A sample of 251 patients scheduled for cataract, joint replacement, or general surgeries participated in assessment interviews conducted one week pre-surgery and one week, six weeks, six months, and one year post-surgery. Change in cognitive function was associated with age, physical disability, and depression. However, persistent cognitive decline was associated with identifiable factors related to the surgery in only three cases. The authors conclude that the risk of cognitive decline after elective surgery was minimal and should not obscure the possible benefits of surgery. 3 tables, 30 references.

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Is Depression a Risk Factor for Dementia or Cognitive Decline?: A Review Source: Gerontology. 46: 219-227. 2000. Summary: This journal article describes a research review that investigated whether depression earlier in life is a risk factor for subsequent dementia or cognitive decline. The author reviewed epidemiological evidence from prospective and case-control studies that showed a relationship between depression and later cognitive decline. The review examined evidence for six hypotheses that could explain this relationship. The author concluded that the following four hypotheses have limited support: depression is a prodrome of dementia, depression is an early reaction to dementia, depression affects the threshold for manifesting dementia, and depression is a causal factor in dementia. Further research is needed to explore these possible relationships between depression and subsequent dementia. 4 tables, 64 references.

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Distinction Between Preclinical Alzheimer's Disease and Depression Source: JAGS. Journal of the American Geriatrics Society. 48(5): 479- 484. May 2000. Summary: This article examines the prevalence of depression in preclinical Alzheimer's disease (AD) and the possibility of differentiating patients with preclinical AD and depression from those with depression- related cognitive impairment. Data on depression and cognitive function were collected for 111 older individuals with cognitive impairment but not dementia. The course of cognitive impairment and presence of dementia were assessed after 2 and 5 years. Twenty-five participants, defined as the preclinical AD group, were diagnosed with AD at follow-up; 15 (60 percent) of these individuals were depressed at baseline. Participants with depression and preclinical AD had poorer baseline performance on cognitive tasks and were older than those with depression-related cognitive impairment (those without dementia at follow-up). In logistic regression analyses, age and memory performance were identified as the best predictors of future AD in depressed participants; these predictors had a sensitivity of 90 percent and a specificity of 94 percent. 1 figure, 2 tables, 39 references.

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Dementia and Depression in Elderly Medical Inpatients Source: International Psychogeriatrics. 12(1): 67-75. March 2000. Summary: This article examines the prevalence and correlation of cognitive impairment, major depression, and depressive symptoms in elderly medical patients. It also compares cognitive impairment and depression in subgroups with possible Alzheimer's disease (AD) or vascular dementia (VD). One hundred patients aged 65 years and older were recruited from a department of internal medicine. The patients were assessed with the Modified Mini-Mental State Examination, Hachinski Ischemic Scale, and Hamilton Rating Scale for Depression. Forty-four patients were diagnosed with possible AD and 14 with possible VD. Eleven patients had major depression. Sixty-six patients were cognitively impaired; the degree of impairment was mild in 30 patients, moderate in 19, and severe in 17. Forty-six patients had mild depressive symptoms and 27 had severe symptoms. There was no association between the severity of cognitive impairment and depressive symptomatology. There was no difference in the prevalence or severity of depression or the severity of cognitive impairment in subgroups of patients with AD and VD. 4 tables, 46 references.

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Randomized, Placebo-Controlled, Double-Blind Clinical Trial of Sertraline in the Treatment of Depression Complicating Alzheimer's Disease: Initial Results from the Depression in Alzheimer's Disease Source: American Journal of Psychiatry. 157(10): 1686-1689. October 2000. Summary: This article describes a randomized, placebo controlled, double blind clinical trial of sertraline for the treatment of major depression in patients with Alzheimer's disease. Twenty-two patients received either sertraline (n=12) or placebo (n=10) for 12 weeks. The main outcome measure was response to treatment as rated by two psychiatrists. Another principal measure was the Cornell Scale for Depression in Dementia, given at baseline and at 3, 6, 9, and 12 weeks after treatment initiation. Secondary outcome measures were the Hamilton Depression Rating Scale, the activities of daily living subscale of the Psychogeriatric Dependency Rating Scales, and the MiniMental State Examination. At 12 weeks, nine of the patients given sertraline and two of those given placebo were rated as full or partial responders. Patients given sertraline had significantly greater improvements in mood than those given placebo. Sertraline also appeared to protect against the functional declines observed in placebo-treated patients, but it had no effect on cognition. Side effects were generally mild and did not differ between groups. 1 table, 13 references.

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Treating Depression in Alzheimer's Disease: Integration of Differing Guidelines Source: International Psychogeriatrics. 12(3): 353-358. September 2000. Summary: This article analyzes and integrates recommendations for the treatment of depression in Alzheimer's disease (AD). In May 1997, the American Psychiatric Association (APA) and the American Academy of Neurology (AAN) published in their respective official journals supplements devoted to the management of patients with AD. References used by these publications were extracted, and those relevant to the pharmacological treatment of depression were reviewed. Seven references were cited by the AAN and 11 by the APA; of these, 2 were used by both publications. The analyzed guidelines recommend selective serotonin reuptake inhibitors (SSRIs) as the treatment of choice for depression in AD patients. These drugs include fluoxetine, paroxetine, fluvoxamine, sertraline, and citalopram. Their side effect profile is more benign than that of the tricyclic antidepressants, and they do not have the cardiac adrenolytic and anticholinergic adverse effects. 37 references.

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Changes in Cognitive Functioning Following Treatment of Late-Life Depression Source: American Journal of Psychiatry. 157(12): 1949-1954. December 2000. Summary: This article examines the cognitive effects of treatment for depression in older patients. The sample consisted of 62 elderly patients with major depression, and 20 elderly controls were studied. Although some patients exhibited cognitive impairment at baseline, none met the diagnostic criteria for dementia. Of the 60 patients, 45 achieved remission of depressive symptoms after 12 weeks of treatment with the tricyclic agent nortriptyline or the selective serotonin reuptake inhibitor paroxetine. All participants completed a battery of clinical measures, including cognitive screening instruments, before and after treatment. Depressed patients with normal cognition at baseline showed no change in cognitive function after treatment, whereas those with cognitive impairment at baseline showed significant improvement in the domains of initiation/perseveration and conceptualization. Despite this improvement, however, patients with baseline cognitive impairment remained mildly impaired, especially in the memory and initiation/perseveration domains. This subgroup of elderly depressed

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patients may be at higher risk of developing progressive dementia. 3 tables, 29 references. •

Depression and Risk of Cognitive Decline and Alzheimer's Disease: Results of Two Prospective Community-Based Studies in the Netherlands Source: British Journal of Psychiatry. 176: 568-575. 2000. Summary: This article investigates whether depression is associated with increased risk of cognitive decline and Alzheimer's disease (AD) in elderly people with normal cognition. Two independent samples of older people with normal cognition were selected from the Amsterdam Study of the Elderly (AMSTEL; n=3,147) and the Longitudinal Aging Study Amsterdam (LASA; n=2,399). Data on incident AD were obtained in the AMSTEL using a two-step procedure. Data on cognitive decline were obtained in the LASA with the Mini-Mental State Examination. Depression was diagnosed with the Geriatric Mental State Schedule in the AMSTEL and with the Center for Epidemiological Studies Depression Scale in the LASA. Depression was associated with an increased risk of AD and cognitive decline in the AMSTEL and LASA samples, respectively, but only in people with higher levels of education. The findings suggest that depression may be an early manifestation of AD before cognitive symptoms become apparent. 2 figures, 7 tables, 35 references.

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Physical Aggression in Dementia Patients and its Relationship to Depression Source: American Journal of Psychiatry. 156(1): 66-71. January 1999. Summary: This article discusses a study that determined the frequency of physically aggressive behavior in community-residing patients with dementia and the relationship of physically aggressive behavior to depression. Researchers evaluated 541 patients with DSM-IV-defined dementia using the Cornell Scale for Depression in Dementia, the MiniMental State Examination, the Psychogeriatric Dependency Rating Scale, and the General Medical Health Rating. Data showed that 79 patients exhibited physically aggressive behavior in the 2 weeks before evaluation and this behavior was closely associated with moderate to severe depression, male gender, and greater impairment in activities of daily living after adjustment for delusions, hallucinations, sleep disturbance, and severity of cognitive impairment. The authors concluded that a substantial minority of patients with dementia exhibit physically aggressive behavior, and this aggression is linked strongly with the presence of depressive symptoms. They also describe the limitations of the study by saying they cannot be confident that treatment and resolution of depression would lead to resolution of the aggression. 1 table, 37 references.

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Health Care Utilization by Older Patients With Coexisting Dementia and Depression Source: American Journal of Psychiatry. 156(4): 550-556. April 1999. Summary: This journal article compared the use of medical services by older people with both depression and dementia to older people who had either disorder alone. The goal was to evaluate utilization of inpatient and outpatient services of a sample of 7,115 older veterans. Patients with coexisting depression and dementia had more psychiatric inpatient days and nursing home admissions than patients with only dementia or depression. However, they did not utilize more outpatient resources. The findings suggest that aggressive outpatient treatment approaches might decrease use of inpatient care for people with both depression and dementia. 24 references, 2 tables (AA-M).

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Late-Life Depression as a Possible Predictor of Dementia: Cross-Sectional and ShortTerm Follow-Up Results Source: American Journal of Geriatric Psychiatry. 7(2): 151-159. Spring 1999. Summary: This journal article reports on a study that explored cognitive functioning in a group of elderly subjects with depression. The group as a whole-and especially the lateonset group- demonstrated cognitive impairment on a dementia rating scale. Data showed that 47.5 percent of the late-onset group, compared to 31.5 percent of the earlyonset group, scored below the cutoff for a clinical diagnosis of dementia. Age-at-onset status in a logistical regression model predicted the rating scale category; treatment of depression had little effect on cognition. These results support the theory that late-life depression, especially in patients with late-onset dementia, is associated with cognitive impairment that may represent early Alzheimer's disease. 7 tables, 41 references. (AAM).

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Association Between Premorbid History of Depression and Current Depression in Alzheimer's Disease Source: Journal of Geriatric Psychiatry and Neurology. 12: 72-75. Summer 1999. Summary: This journal article presents a study of the association between a premorbid history of depression and current depression in patients with Alzheimer's disease (AD). The sample consisted of 243 AD outpatients evaluated consecutively at a universityaffiliated memory disorders center. Information about each patient's psychiatric history was obtained through semistructured interviews with the patient and caregiver. Current depressive symptoms were assessed with the Cornell Scale for Depression in Dementia. A positive history of depression was significantly more common among patients with current depression (23%) than among those without current depression (11%). This relationship remained significant after controlling for the effects of age, education, gender, ethnicity, and level of cognitive impairment. Neither gender nor the interaction of gender and history of depression was associated with risk of depression. 2 tables, 25 references.

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Predictors of Depression Among Chinese Family Caregivers of Alzheimer Patients Source: Alzheimer Disease and Associated Disorders. 13(3): 171-175. 1999. Summary: This article looks at predictors of depression among Chinese family caregivers of people with Alzheimer's disease (AD). Seventy-four AD patients and their caregivers were recruited for comprehensive assessment at a tertiary care teaching hospital in Taipei, Taiwan. The mean age of the patients was 72.2 years, and that of caregivers was 53.5 years. Patients were assessed with the Chinese version of the Cognitive Abilities Screening Instrument and the caregiver-rated Revised Memory and Behavior Problems Checklist. Caregivers also completed the short version of the Geriatric Depression Scale (GDS-S) and a scale assessing coping strategies. Twenty-six of the 74 caregivers (35.1 %) were classified as depressed. Caregivers' GDS-S scores were correlated positively with use of the management of stress coping strategy and frequency of patients' disruptive behaviors, and negatively with caregivers' educational level. 3 tables, 29 references.

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Early-Onset and Late-Onset Depression Are Independent of the Genetic Polymorphism of Apolipoprotein E Source: Dementia and Geriatric Cognitive Disorders. 10: 258-261. 1999.

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Summary: This journal article examines the association between apolipoprotein E (apoE) genotype and depressive illness in a large sample of Alzheimer's disease (AD) patients (n=102, mean age 74.4 years), depressed patients (n=160, mean age 68.0 years) recruited from the outpatient memory disorders clinic of the Psychiatric Department of the University of Bonn in Germany, and healthy controls (n=191, mean age 70.6 years). The depressed patients were divided into those with early-onset depression (EOD, n=129), defined as onset before age 60 years, or late-onset depression (LOD, n=31). AD patients were significantly more likely than the other groups to have at least one apoE4 allele. However, there was no significant difference in apoE4 allele frequency between the EOD, LOD, and control groups. Survival analysis was used to examine the cumulative incidence of depression depending on age-of-onset. There was no significant difference between depressed patients with at least one apoE4 allele and those with no apoE4 allele. In the authors' opinion, the results do not exclude the possibility that depression shares some pathophysiologic features with AD, but it is unlikely that apoE genotype will elucidate the assumed common mechanisms. 1 figure, 1 table, 22 references. •

History of Depression and Other Psychiatric Illness as Risk Factors for Alzheimer Disease in a Twin Sample Source: Alzheimer Disease and Associated Disorders. 13(1): 47-52. 1999. Summary: This journal article explores the association between history of depression and other psychiatric illness and the risk of developing Alzheimer's disease (AD). Putative psychiatric risk factors were examined in a registry-based sample of 65 Swedish twin pairs discordant for AD. Risk ratios were calculated both for psychiatric illness at any time and for episodes more than 10 years before the onset of dementia. Results revealed that prior episodes of depression or other psychiatric illness were significantly associated with elevated risk for AD. When analyses were restricted to twins whose mental illness occurred more than 10 years prior to AD, however, the magnitude of the odds ratio decreased markedly. The findings suggest that a history of psychiatric illness, including depression, may be associated with an elevated risk for AD. They further suggest that symptoms of depression and similar complaints may represent prodromal phases of dementia. 2 tables, 33 references. (AA-M).

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Longitudinal Patterns of Risk for Depression in Dementia Caregivers: Objective and Subjective Primary Stress as Predictors Source: Psychology and Aging. 14(1): 34-43. 1999. Summary: This journal article examines longitudinal patterns of risk for depression in caregivers of dementia patients. A sample of 188 dementia caregivers were followed for one year to determine whether patterns of risk for depression could be predicted by objective (patient behavior problems) and subjective (role captivity and overload) primary stress. The 20-item Center for Epidemiological Studies Depression Scale (CESD) was used to assess caregiver's risk for depression at baseline, 3 months, and 12 months. Results revealed that all primary stressors differentiated caregivers who remained at low levels of symptomatology over the course of one year from those who were at risk for experiencing a depressive disorder. In addition, caregivers' subjective experience of role captivity predicted the chronicity of risk. The findings extend previous research on patterns of depressive symptomatology among dementia caregivers by highlighting the relationship between subjective primary stressors and stability and change in caregivers' mental health. 1 figure, 5 tables, 54 references. (AAM).

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Neuropsychological Correlates of Apathy and Depression in Patients With Dementia Source: Neurology. 52: 1403-1407. 1999. Summary: This journal article describes a study of the neuropsychological correlates of apathy and depression in patients with Alzheimer's disease (AD). A comprehensive neuropsychological and psychiatric examination was carried out in 72 patients with AD and both apathy and depression, 29 patients with AD and apathy only, 31 patients with AD and depression only, and 52 patients with AD but no apathy or depression (control group). Patients with apathy had significantly lower scores on tests of verbal memory, naming, set shifting and verbal fluency than did those without apathy. The performance of patients with both apathy and depression was no worse than that of patients with apathy only except on a test of abstract thinking. Depression in the absence of apathy was not associated with greater cognitive impairment when compared with the AD control group. The findings suggest that apathy, but not depression, is associated with significantly more severe frontal lobe-related cognitive deficits in AD. 2 tables, 28 references. (AA-M).

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Cerebral Blood Flow and Metabolism in Late-Life Depression and Dementia Source: Journal of Geriatric Psychiatry and Neurology. 12: 118-127. 1999. Summary: This journal article reviews the literature on cerebral blood flow and metabolism in late-life depression (LLD) and dementia. LLD is characterized by abnormalities in cerebral blood flow (CBF) and cerebral metabolic rate (CMR) for glucose. Unlike younger adults with major depression, global cortical CBF and CMR reductions have been reported in LLD. Patients with LLD also are characterized by topographic abnormalities, most commonly involving selective prefrontal, superior temporal, and anterior parietal cortex regions. Characteristic profiles of CBF and CMR abnormalities also have been demonstrated in samples with Alzheimer's disease and other types of dementia. Functional imaging has shown sensitivity to disease severity and progression. However, there is limited information about the sensitivity and specificity of the functional imaging modalities in the differential diagnosis of the dementias. Available evidence does not support the use of functional imaging in isolation as a diagnostic tool, but rather as an adjunct to careful clinical assessment. 111 references. (AA-M).

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Depression Does Not Aggravate the Episodic Memory Deficits Associated With Alzheimer's Disease Source: Neuropsychology. 13(4): 532-538. 1999. Summary: This journal article examines the potential effects of depression on memory performance in people with Alzheimer's disease (AD). In a population-based study of people aged 75 years and older in the Kungsholmen parish of Stockholm, Sweden, 296 healthy older adults, 45 patients with AD, and 9 patients with AD and depression (ADD) were compared on free recall and recognition of slowly and rapidly presented words and digit span. The healthy older group outperformed the two AD groups across all tasks except forward digit span. In free recall, only the healthy group performed better with slowly presented than rapidly presented words. In recognition, however, all three groups showed similar gains from receiving more study time. This pattern of results suggests that both AD and AD-D patients have deficits in the ability to use more study time for remembering. The main finding was that the AD and AD-D groups were indistinguishable for all task variables, indicating that depression does not further

12 Depression

impair episodic memory performance in people with AD. 2 figures, 2 tables, 46 references. •

Interrelations Between Psychosis, Behavioral Disturbance, and Depression in Alzheimer Disease Source: Alzheimer Disease and Associated Disorders. 13(Supplement 2): S3-S8. 1999. Summary: This journal article reviews the literature on behavioral disturbances, psychosis, and depression in Alzheimer's disease (AD), using data from a recent study. Behavioral changes are common in AD, and heterogeneous in their presentation. Subtle personality changes such as apathy, irritability, and the inability to pay attention, tend to occur early. In later stages, agitation, aggression, and disinhibited behaviors may appear. In a recent study, the Columbia University Scale for Psychopathology in Alzheimer's Disease was used to monitor a number of behavioral symptoms in 235 patients with early probable AD. Markov analyses were conducted to predict the probability of developing or retaining a particular symptom at 6-month follow-up. Results show that the symptoms of psychopathology in AD fluctuate over time. Agitation was both the most frequent and persistent symptom, whereas paranoid delusions and hallucinations were less common and moderately persistent. Most behavioral disturbances, except paranoid delusions, were associated with greater cognitive impairment. There was no association between depressive features and either cognitive or functional impairment. 37 references.

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Characterization of Depression in Alzheimer's Disease by the CERAD Behavior Rating Scale for Dementia (BRSD) Source: American Journal of Geriatric Psychiatry. 6(1): 53-58. Winter 1998. Summary: This journal article describes a study funded by the National Institute on Aging to evaluate whether symptom clusters on the Behavior Rating Scale for Dementia (BRSD) differentiate between patients with Alzheimer's disease with and without depression. Participants were 69 patients with AD, who were recruited from the Research Registry at the Alzheimer Center of University Hospitals of Cleveland and Case Western Reserve University, Ohio. The patients were classified as depressed (n=29) or nondepressed (n=40) based on the Behavioral Symptoms Interview. A comparison of the two groups on the six content scales of the BRSD revealed that depressed patients had significantly higher scores than nondepressed patients on items related to depression and anxiety, but not on items related to psychosis, agitation, apathy, or vegetative symptoms. Using responses to the BRSD depression and anxiety items, 70 percent of the patients were correctly classified as depressed or nondepressed. The authors conclude that the BRSD may be useful for identifying patients for more intensive evaluation of depression in settings where resources for clinical evaluation are limited. 3 tables, 19 references.

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Depression Among African American Nursing Home Patients With Dementia Source: American Journal of Geriatric Psychiatry. 6(2): 162-175. Spring 1998. Summary: This journal article describes a study of the prevalence, recognition, and treatment of depression among 286 black and white nursing home residents with dementia. The participants were 218 black residents, mean age 80 years, and 68 white residents, mean age 85 years, from 3 nursing homes in Brooklyn, New York. Five scales were used to assess depressive symptoms, and the Core Research Center Modified Schedule for Affective Disorders and Schizophrenia was used to make a diagnosis of

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depression. Significantly more whites were diagnosed with possible depression, but there were no appreciable racial differences in the diagnoses of probable or definite depression, in depressive symptomatology, or in the clinical, social, or demographic factors associated with depression. There were no significant differences in depressive symptoms or diagnosis between American and Caribbean blacks. Depression was often unrecognized by staff in both racial groups, and was undertreated. Several of the depression scales developed for use in dementia had good reliability and validity among blacks. The authors suggest that factors related to nursing home admission criteria and residents' response to institutionalization may account for the absence of differences between racial groups. 6 tables, 46 references. •

Factors Associated With Symptoms of Depression Among Informal Caregivers of Demented Elders in the Community Source: Gerontologist. 38(2): 247-253. 1998. Summary: This journal article describes a study of the risk factors for depression among 321 informal caregivers of community-dwelling patients with dementia identified by a population-based Canadian national survey. The variables examined included caregiver and patient demographics, the caregiver's relationship to the patient, living arrangements, duration of dementia, and measures of the patient's functional, behavioral, and cognitive status. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. Multiple regression analyses indicated that more severe depressive symptoms were associated with three caregiver variables (being a spouse or child of the patient, self-identified ethnicity other than English or French Canadian, and lower educational level) and two patient variables (greater behavioral disturbance and moderate to severe functional impairment). The authors conclude that physicians should be alert to depressive symptoms in informal caregivers of people with dementia, especially those at risk for more severe symptoms. 2 tables, 35 references. (AA-M).

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Frontal Lobe Hypometabolism and Depression in Alzheimer's Disease Source: Neurology. 50: 380-383. February 1998. Summary: This journal article describes a Japanese study of the association between focal brain metabolic abnormalities and depression in patients with Alzheimer's disease (AD). Regional cerebral glucose metabolism was determined by positron emission tomography in 53 patients with AD and mild to moderate levels of dementia. Depression and other psychiatric variables were assessed with the Neuropsychiatric Inventory (NPI), and the NPI scores were correlated with cerebral glucose metabolic rates for each brain region. Depression was present in 19 patients (35.9 percent). The NPI depression score was significantly correlated with normalized glucose metabolic rates in the bilateral superior frontal and left anterior cingulate cortices. Findings suggest an association between depression and decreased frontal lobe metabolic activity in AD. 2 tables, 28 references. (AA-M).

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Factor Structure of the Cornell Scale for Depression in Dementia Among Probable Alzheimer's Disease Patients Source: American Journal of Geriatric Psychiatry. 6(3):212-220. Summer 1998. Summary: This journal article describes the factor structure of the 19-item Cornell Scale for Depression in Dementia (CSDD) among 137 patients with probable Alzheimer's disease who were seen at an outpatient memory disorders clinic. The sample was 50.4

14 Depression

percent Hispanic and 49.6 percent white non-Hispanic; their mean age was 78.2 years, mean duration of illness was 4.1 years, and mean educational level was 10.4 years. Depressive symptoms were assessed with the CSDD as part of an extensive psychiatric clinical interview conducted by bilingual psychiatrists. A principal-factors analysis with varimax rotation resulted in a four-factor solution that accounted for 43.1 percent of the common variation. The four factors were general depression (lack of reactivity to pleasant events, poor self-esteem, pessimism, loss of interest, physical complaints, psychomotor retardation, sadness); rhythm disturbances (difficulty falling asleep, multiple night awakenings, early morning awakenings, weight loss, diurnal variation of mood); agitation/psychosis (agitation, mood-congruent delusions, suicide); and negative symptoms (appetite loss, weight loss, lack of energy, lack of reactivity to pleasant events). These factors showed moderate consistency with the five symptom clusters proposed in the original presentation of the CSDD. 4 tables, 43 references. •

Clinical Interface of Depression and Dementia Source: Journal of Clinical Psychiatry. 59(Supplement 10): 9-12. 1998. Summary: This article describes several aspects of the complex interface between depression and dementia. This area of clinical research has been studied primarily in Alzheimer's disease (AD). The author discusses depressive pseudodementia-depression as a prodrome and a risk factor for AD - and situations where depression complicates AD and presents treatment challenges for the clinician. Therapeutic efforts should be aimed at improving quality of life for patients and caregivers. A combination of behavioral treatment and judicious use of antidepressants should provide optimal management of depression in AD. 22 references.

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Diagnosis and Treatment of Depression in Patients With Alzheimer's Disease and Other Dementias Source: Journal of Clinical Psychiatry. 59(Supplement 9): 38-44. 1998. Summary: This article addresses the relationship of depression and dementia. Evidence is increasing that depression with reversible cognitive impairment may be a prodrome for dementia rather than a separate and distinct disorder. Questions have been raised about whether depression may be a risk factor for irreversible dementia. The author discusses the diagnosis of depression, rating depressive symptoms, potential confounding factors, clinical features of depression in dementia, treatment of depression in patients with dementia, and clinical guidelines. Randomized clinical trials have demonstrated that depression in patients with dementia responds to specific psychopharmacologic or psychosocial treatments. 86 references.

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Informant Interview for the Diagnosis of Dementia and Depression in Older Adults (IDD-GMS) Source: International Journal of Geriatric Psychiatry. 13(5): 298-309. May 1998. Summary: This study examined the development and validation of an informant interview for the diagnosis of dementia and depression in older adults (IDD-GMS). The IDD-GMS was based upon the Geriatric Mental State Schedule (GMS). Researchers identified 30 older adults with psychiatric illnesses and interviewed an informant/caregiver for each one. A total of 19 completed interviews using the GMS I, and 11 completed interviews using the IDD-GMS. Questions from the GMS were altered to reflect the informant nature of the interview. Researchers compared validity to ICD10 diagnoses agreed upon by two clinicians. They determined interrater reliability by

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one rater taping their interviews and the other making ratings according to the tape. Data analysis indicated that the validity and reliability of the IDD-GMS fell within acceptable limits. The researchers conclude that the IDD-GMS can be used as a diagnostic instrument for dementia and depression, and they note that it represents the first informant interview to achieve this. An appendix presents the IDD-GMS. 3 figures, 3 tables, 23 references. (AA-M). •

Clock Tests in Depression, Alzheimer's Disease, and Elderly Controls Source: International Journal of Psychiatry in Medicine. 28(4): 437-447. 1998. Summary: This study documents the clock-drawing, clock-copying, and clock-reading abilities of 33 older people with major depression and compares them to 42 people with Alzheimer's disease (AD) and 30 age-matched controls, to determine the test's usefulness in identifying depressed patients with underlying dementia. All patients with dementia met NINCDS-ADRDA criteria. Only those patients were selected who met the DSM-IV criteria for major depression within the past year. All subjects received detailed neurological, psychiatric, and mental status evaluations. Clock-task performance was analyzed with a repeated-measures analysis of covariance. The subject (AD, depression, older control) was the independent variable, and the dependent variables were the various clock task scores over multiple conditions. Education was included as a covariate. Linear regression assessed the effects of the Mini-Mental-State Examination, age, time post-onset of illness, education, and the Montgomery-Asberg Depression Rating Scale score on the clock tests within each group. Findings show that people with AD had significantly lower scores on all three clock tests than people with depression or the controls. Additionally, people with depression did not differ significantly from controls on quantitative scores or qualitative errors. These results indicate that clock tests may be useful for identifying depressed patients with underlying dementia. 2 tables, 26 references. (AA-M).

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Brief Measures of Depression and Cognitive Function Source: Generations. 21(1): 41-43. Spring 1997. Summary: This journal article reviews brief measures of depression and cognitive function that may be useful with older adults. The review of brief assessment instruments for depression focuses on the Center for Epidemiological Studies Depression Scale; and describes its structure, content, psychometric properties, strengths, and weaknesses. It also provides less detailed reviews of the Geriatric Depression Scale, Beck Depression Scale, Hamilton Depression Scale, and Cornell Scale for Depression. This article discusses general issues regarding the use of cognitive screening tests to identify symptoms that may be consistent with dementia. It describes one such test, the Mini-Mental Status Examination, and outlines its advantages and limitations. 18 references.

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Pleasant Events Schedule-AD: Psychometric Properties and Relationship to Depression and Cognition in Alzheimer's Disease Patients Source: Gerontologist. 37(1): 40-45. 1997. Summary: This article describes the psychometric properties of the Pleasant Events Schedule-Alzheimer's Disease (PES-AD) and the relationship among pleasant events, depression, and cognition in 42 outpatients with Alzheimer's disease (AD). Participants were recruited from the research roster of the Geriatrics and Family Services Clinic at the University of Washington Medical Center in Seattle, Washington. All AD patients

16 Depression

lived in the community with either a spouse or an adult child. None of the AD patients were taking antidepressants or other psychotropic medications; and none were suicidal, delusional, or hallucinating. Patients' participation in pleasant activities was measured with both the original, 53-item version of the PES-AD and a shortened, 20-item version. Overall cognitive functioning was assessed with the Mini-Mental State Examination (MMSE), and depression severity was measured with the Hamilton Depression Rating Scale (HDRS). The results suggest that both versions of the PES-AD had good reliability and were significantly correlated with each other and with the MMSE and HDRS. Both depression and decreased cognitive functioning were associated with reduced frequency of enjoyable activity. The loss of interest in pleasant activities was greater in depressed than in nondepressed patients, regardless of their cognitive level. The authors conclude that both the long and short forms of the PES-AD may be useful tools for identifying enjoyable activities for patients with AD. 5 tables, 27 references. •

Recognition and Psychopharmacologic Treatment of Geriatric Depression Source: Journal of the American Psychiatric Nurses Association. 3(2): 32-41. April 1997. Summary: This journal article discusses difficulties faced by nurses in the diagnosis and treatment of geriatric depression. It reviews the prevalence and risk factors of depression in older adults, and lists medical conditions and drug therapy associated with geriatric depression. Two major obstacles to diagnosing depression in older people are explored: distinguishing between physical and psychiatric causes, and between depression and dementia. Important elements to include in the medical evaluation of depressed older patients are noted. The article discusses antidepressant treatment issues, including pharmacokinetics in the elderly metabolism of antidepressants, and available antidepressants. Among the pharmacological treatment options for older people with depression are tricyclic antidepressants, newer agents such as buproprion, and selective serotonin reuptake inhibitors. The article concludes with a discussion of dosing strategies and factors affecting medication compliance in older patients. 4 tables, 34 references.

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Depression and Dementia in Relation to Apolipoprotein E Polymorphism in a Population Sample Age 75+ Source: Biological Psychiatry. 42: 898-903. 1997. Summary: This journal article describes a study of the co-occurrence of depression and dementia in relation to apolipoprotein E (apoE) gene status in a population-based sample of 806 people, aged 75 years and older, in Stockholm, Sweden. All participants completed an extensive clinical examination, including a psychiatric assessment, the Mini-Mental State Examination, and apoE genotyping. Of the 806 participants, 184 (22.8 percent) were diagnosed with dementia and 43 (5.3 percent) with major depression. Depression was present in 11.4 percent of the people with dementia compared with 3.5 percent of those without dementia. In people who were not depressed, the prevalence of dementia increased with the number of apoE4 alleles and tended to be lower when an apoE2 allele was present. However, depression was not strongly associated with apoE gene status, and the overrepresentation of depression in dementia was found to a similar extent in each of the common apoE gene status categories. Despite an association between apoE gene status and dementia, and between depression and dementia, the authors conclude that apoE gene status does not appear to be associated with depression in older people with or without dementia. 2 tables, 27 references.

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To Treat or Not To Treat: Issues in Decisions Not To Treat Older Persons With Cognitive Impairment, Depression, and Incontinence Source: Journal of the American Geriatrics Society. 45(9): 1094-1101. September 1997. Summary: This journal article describes a study of decisions not to treat problems of cognitive impairment, depression, and urinary incontinence in older people. The participants were 128 patients who were assessed at 1 of 4 outpatient geriatric assessment units in Allegheny County, Pennsylvania, and were identified as having cognitive impairment (55 percent), depression (50 percent), and/or incontinence (43 percent). More than 75 percent of the sample was female, 69 percent were white, and the mean age was 75.4 years. The patients' medical charts were reviewed to obtain information about presenting problems, diagnosis, and treatment recommendations. Although most of the identified problems received treatment recommendations, slightly more than a third of the cognitive impairment and depression problems and nearly half of the incontinence problems did not receive treatment recommendations. Six categories of reasons for decisions not to treat were identified: patient or family refused treatment, assessment not completed, intervention already in place, concurrent problems which might have interfered with treatment, no documented diagnosis, and no documented reason. 1 figure, 4 tables, 35 references.

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Case Study: Tetraaminotacrine Treatment and Depression Source: Alzheimer's Research. 3(3): 115-117. June 1997. Summary: This journal article describes two cases of depression associated with the use of tetrahydroaminotacrine (tacrine or Cognex) in patients with Alzheimer's disease (AD). One patient was a woman, age 82 years, who was admitted to the hospital with major melancholic depression. She had been diagnosed with AD 6 months earlier, and treatment with tacrine 40 mg/day was started 1 month after the diagnosis. The other patient was a woman, age 70 years, who was admitted to the hospital after attempting suicide by ingesting drugs. AD had been diagnosed 7 months earlier, and she had been treated with tacrine 40 mg/day for 9 months. In both cases, no other psychotropic or somatic drug was used. Depression regressed upon discontinuation of tacrine and administration of antidepressants or electroconvulsive therapy. Discussion of the cases focuses on possible explanations for induction of depression by tacrine. 15 references.

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Treatment of Depressive Disorders of Spousal Caregivers of Persons With Alzheimer's Disease: A Review Source: American Journal of Alzheimer's Disease. 14(5): 289-293. September-October 1999. Summary: This journal article reviews studies on the methods and efficacy of interventions for depressive disorders in spousal caregivers of people with Alzheimer's disease (AD). Support groups are one of the most popular forms of caregiver interventions; and research suggests that these groups are helpful for information sharing and peer support, but they do not adequately meet the affective needs of the participants. Psychoeducational intervention groups are more focused on helping caregivers develop a specific set of coping skills to deal with their depression while managing the problematic behaviors of the person with AD. These groups appear to be the most effective treatment for depression in AD caregivers. Although research on psychotherapy and counseling for caregivers is limited, one study suggests the efficacy of cognitive therapy. The author recommends further research on psychoeducational intervention groups and cognitive therapies. 31 references.

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Psychopathologic and Functional Outcome in the Treatment of Elderly Inpatients With Depressive Disorders, Dementia, Delirium, and Psychoses Source: International Psychogeriatrics. 10(1): 71-83. March 1998. Summary: This journal article describes a study of the psychopathologic and functional outcomes of 148 older patients with depressive disorders, dementia, delirium, and psychoses admitted for inpatient treatment at the psychogeriatric university clinic in Aarhus, Denmark. The sample consisted of 80 patients with major depression, 34 with dementia, 26 with delirium, and 8 with psychoses. The average ages were 79, 80, 83, and 76 years, and median lengths of stay were 53, 35, 24, and 24 days, respectively, in the four groups. The patients were assessed at admission and again at discharge for psychopathology, behavioral disorders, depression, cognitive function, activities of daily living, and gait. Treatment included physiotherapy, occupational therapy, and drug therapy. At the end of their stay, patients with depression and delirium improved significantly on all health measures, and patients with psychosis showed a trend toward improvement in psychopathology and gait. Patient with dementia improved in psychopathology, but the other measures remained unchanged. The authors conclude that some older patients with depression, delirium, and dementia may benefit from treatment in a psychogeriatric hospital setting. 9 tables, 19 references.

Federally Funded Research on Depression The U.S. Government supports a variety of research studies relating to depression. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to depression. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore depression. The following is typical of the type of information found when searching the CRISP database for depression: •

Project Title: 5-HT2A RECEPTOR IN DEPRESSION: MOLECULAR MECHANISMS Principal Investigator & Institution: Garlow, Steven J.; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2002; Project Start 15-JUL-2000; Project End 30-JUN-2004 Summary: (Adapted from applicant's abstract) Dysfunction of the serotonergic system is considered to play a central role in the genesis of major depression and schizophrenia. In particular, the 5-HT2A receptor has been implicated in the pathophysiology of depression and schizophrenia and as the site of action of various psychotherapeutic

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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agents. The most important and consistent finding of serotonergic dysfunction in major depression is increased B of the S-HT2A receptor. This has been documented in the CNS and in the periphery of depressives. The molecular mechanisms that underlie the changes in receptor expression in depression are not understood. The objectives of this proposal are to identify and characterize the factors that regulate the expression of the 5HT2A receptor, and relate those mechanisms to the pathophysiology of depression. Three Specific Aims are proposed that examine the different levels of regulation of the receptor. The goal of the first Specific Aim is to map genes that control the level of expression of the 5-HT2A receptor in the brain, and begin to identify those genes. This will be accomplished through genetic analysis of Recombinant Inbred (RI) strains of mice, with QTL analysis. The final step in the genetic analysis will be to identify the relevant genes. The experiments in this Aim will also test whether the same genes control the expression of the receptor throughout the body. The goal of the second Specific Aim is to identify critical elements in the promoter for the S-HT2A gene that direct cell specific expression of the receptor. A series of transgenic animals will be produced that have different versions of the S-HT2A promoter driving expression of a reporter gene. The hypothesis tested is that the expression of the receptor is controlled by the interplay of positive and negative response elements in the receptor promoter. The goal of the third Specific Aim is to determine whether a number of growth factors control the expression of the S-HT2A receptor. These experiments will use a number of cells in culture that express the S-HT2A receptor. These cells have been derived from both the CNS and peripheral tissues. The factors that will be tested include glucocorticoids, and a series of immune regulators. These factors are known to be altered in depression and can exert powerful regulatory influences on the expression of a number of genes. As the factors are characterized in the in vitro systems, their relevance to the regulation of the S-HT2A receptor in the brain will be tested in experimental animals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: A GROUNDED THEORY STUDY OF DEPRESSION IN ADULT LESBIANS Principal Investigator & Institution: Barnard, Amy G.; None; University of Arizona P O Box 3308 Tucson, AZ 857223308 Timing: Fiscal Year 2001; Project Start 15-SEP-2001 Summary: (provided by the applicant) Depression is a serious mental health issue. The World Health Organization has predicted that by the year 2010 depression will be the second leading cause of disability in the world. Women are diagnosed with depression at twice the rate of men. Within the population of women is a subgroup of lesbians. Lesbians? lives are considerably different from the lives of heterosexual women because their sexual orientation leads to marginalization and stigmatization. Though extensive research has been conducted investigating higher rates of depression in women, little research has been conducted on the psychological effects of living as a member of a sexual minority. The experience of depression in lesbians is even less studied. This proposed study will use grounded theory methodology to describe the experience of depression in adult lesbians. The findings of this study will establish a foundation for continued work in this area with the eventual goal of developing a community-based intervention to improve the mental health care of lesbians and other sexual minorities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: A MOOD MANAGEMENT INTERVENTION FOR PREGNANT SMOKERS Principal Investigator & Institution: Cinciripini, Paul M.; Professor; Immunology; University of Texas Md Anderson Can Ctr Cancer Center Houston, TX 77030 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 30-APR-2008 Summary: (provided by applicant): The majority of studies evaluating smoking cessation treatments for pregnant smokers have employed minimal intervention strategies that have achieved limited success. We believe a significant reason for this lack of efficacy is the failure of minimal treatment approaches to address symptoms of depression and stress among pregnant smokers who fail to quit on their own. Data from our recently completed trial of a videotape smoking cessation intervention for pregnant smokers indicated that significant levels of affective impairment were present in this group. Over 50 percent of the women met DSM-IV criteria for major depression on the Prime MD, or had CES-D scores > 16. Depressive symptoms were frequently chronic. In addition, research indicates that high levels of stress, poor coping resources, and low levels of social support satisfaction are predictive of depression and continued smoking during pregnancy. The proposed study will address these issues by evaluating the efficacy of an intervention designed to impact these risk factors. Approximately 375 women will be randomized to either a mood management (MM) intervention, health education (HE), or usual care (UC) control condition. The MM and HE interventions will be delivered in 7 60-minute counseling sessions that will incorporate 10 minutes of brief smoking cessation counseling based on the Clinical Practice Guidelines that will include a specific focus on smoking and pregnancy. Participants in the MM condition will receive an additional 50 minutes of counseling emphasizing the development of affect management skills. The MM protocol will be based on Cognitive Behavioral Analysis System of Psychotherapy (CBASP), a psychotherapy developed for the treatment of chronic depression that has been shown to be highly effective in reducing depression in this difficult-to-treat population. HE participants will receive an additional 50 minutes of standard pre/postnatal health education focused on non-smoking related issues relevant to maintaining a healthy pregnancy. The UC condition will receive 7 3 to 5minute Clinical Guidelines-based brief counseling sessions that will be similar in content to the smoking cessation counseling component of the MM and HE interventions. We hypothesize that cessation rates during pregnancy and at 3 and 6 months postpartum will be significantly greater for smokers in the MM versus the HE and UC control conditions. In addition, we hypothesize that smokers with significant levels of depression and/or positive histories of depression at the start of the intervention will quit significantly less often than nondepressed smokers and negative depression history smokers. We will also evaluate the role of coping, self-efficacy, social support, perceived counselor support, perceived stress, negative affect, and depression as mediators of treatment outcome. As secondary aims we will assess whether levels of depression are significantly reduced for smokers in the MM condition relative to those in the HE or UC conditions, and we will assess the role of neuroticism in the relationship between depression and nicotine dependence. We will also evaluate the extent of smoking reduction (cigarettes smoked/cotinine) among women who fail to quit, as a function of treatment, depression history, and current depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: A NOVEL THERAPY FOR DEPRESSION WITH CO-OCCURRING PANIC Principal Investigator & Institution: Frank, Ellen; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: Complication of major depression by the co-occurrence of panic attacks or panic disorder is both common and clinically significant. Patients with this condition show more severe symptom profiles, greater risk of suicidality, poorer psychosocial functioning, and a poorer response to traditional depression treatments. The primary aim of the current proposal is to develop an effective yet efficient psychotherapeutic intervention for patients with major depression complicated by panic symptoms. This new treatment, interpersonal psychotherapy for depression with panic symptoms (I PTPS), will adapt and integrate components of cognitive behavior therapy (CBT) for panic and anxiety (Barlow & Craske, 1989) into the therapeutic framework of interpersonal psychotherapy for depression (IPT, Kierman et al., 1984) to treat this clinically severe yet treatment-resistant condition. Conceptually, this integrated treatment approach will seek to promote active resolution of interpersonal problems while concurrently addressing symptoms of panic and anxiety that interfere with active interpersonal problem solving. In Phase I of the proposed study, 12 patients with major depression complicated by panic symptoms will be treated with a 16-session course of the newly developed treatment. Specific aims of Phase I include the development, elaboration, and iterative refinement of a treatment manual for IPT-PS; development of therapist training procedures; and the development of measures of treatment adherence, competence, and satisfaction. In Phase II, 24 patients with depression complicated by panic symptoms will be randomly assigned to treatment using IPT-PS, and will be compared with 12 patients randomly assigned to receive standard IPT. Specific aims of this pilot study include: finalizing the treatment manual and measures of treatment adherence, competence, and satisfaction; testing treatment satisfaction with IPT-PS; evaluating characteristics of treatment responders and non-responders; and generating treatment effect size estimates for use in planning a larger efficacy/effectiveness study of IPT-PS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: A RANDOMIZED TRIAL OF LIAISON PSYCHIATRY IN PRIMARY CARE Principal Investigator & Institution: Katon, Wayne J.; Professor; Psychiatry and Behavioral Scis; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 01-JUL-1987; Project End 31-AUG-2005 Summary: (Applicant Abstract): Rationale - The overall goal is to integrate an organized program of improved care of depression into the management of other chronic diseases in primary care. Diabetes mellitus was selected for study because of its prevalence and its large impact on patients and society. If a Depression Care Program (DCP) improves disability and/or disease outcomes among diabetics, it would help establish the core importance of recognition and management of depression for chronic disease management in primary care. Research goals - (1) We will develop population-based data in a managed care setting concerning the effects of depression on the societal impacts of diabetes and on the quality of diabetes (self)-management. By (self)management we refer to both patients' and providers' roles in ongoing care of a chronic illness. (2) We will evaluate a generalizable and economically feasible Depression Care Program (DCP) for population-based management of depression among patients with

22 Depression

diabetes mellitus. These goals will be achieved by two related studies. Aims of Study 1: Study 1 will assess the impact and management of depressive illness among diabetic patients, in an epidemiologic study, which will include patients with and without depression. Study 1 will assess the effects of major depression on societal impacts of diabetes (health care costs and disability) and on the quality of diabetes (self) management. These analyses will control for medical co-morbidity and baseline severity of diabetes. Aims of Study 2: We will evaluate whether a Depression Care program (DCP) for major depression in adult patients with Type 2 diabetes mellitus improves depression outcomes, disability outcomes, and glycemic control (as measured by HemoglobinA1C). Secondary process and outcome measures will include adherence to antidepressant and to diabetic medications, severity of symptoms related to diabetes, self-efficacy in managing diabetes, adherence to diabetes (self) management regimens (diet, exercise, glucose monitoring and medications), and health care utilization and costs. We will assess the cost-effectiveness of the DCP relative to care as usual. Data collection: We will carry out these studies by assessing diabetes and depression status in 4500 diabetic patients. Among Type 2 diabetics with major depression, 290 eligible and willing patients will be randomly assigned to a Depression Care Program or to Usual Care, We will evaluate the effectiveness of the Depression Care Program using selfreport data collected at baseline, 3, 6, 12 and 24 months, and by HbA1C values assessed at baseline, 6, 12 and 24 months. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREGNANCY

ACUPUNCTURE

TREATMENT

OF

DEPRESSION

DURING

Principal Investigator & Institution: Manber, Rachel; Associate Professor; Psychiatry and Behavioral Sci; Stanford University Stanford, CA 94305 Timing: Fiscal Year 2002; Project Start 30-SEP-1998; Project End 31-AUG-2007 Summary: (TAKEN FROM APPLICANT): Objective: The aim of the proposed randomized controlled study is to assess the efficacy and effectiveness of acupuncture treatment of depression during pregnancy. Significance: Depression is, unfortunately common during pregnancy and it has significant deleterious effects on mother and infant, including low birth weight, preterm delivery, and continued depression into postpartum. Few medically acceptable treatments are available for the treatment of depression during pregnancy. Our preliminary work provides evidence that acupuncture may be a safe and acceptable treatment option for depression. Specific aims: 1) to evaluate the efficacy of brief 8-week treatment with SPEC acupuncture for major depression during pregnancy relative to the two control treatments; 2) to evaluate the efficacy and clinical significance (pregnancy outcome) of continued treatment with SPEC acupuncture relative to the two control treatments; and 3) to evaluate the differential impact of treatment with SPEC acupuncture for major depression on the incidence of postpartum depression. Participants. Design: To test the efficacy of acupuncture designed specifically to address depressive symptomatology during pregnancy (SPEC) it will be compared, using random assignment, to the following 2 control conditions: 1) valid acupuncture that does not directly address depressive symptoms (NSPEC), thus controlling for the belief in the efficacy of the treatment; and 2) prenatal massage (MSSG), thus controlling for attention, physical contact, relaxation and respite from daily stress. The study includes three phases, acute, continuation and follows up. Participants: 180 participants meeting western diagnostic criteria for Major Depression with a score >: 14 on the first 17 items of the 24-item Hamilton Depression Rating Scale (HRSD) will be randomized. The ethnic distribution of the sample will be

Studies 23

representative of the ethnic distribution in the San Francisco Bay Area. Treatments: The acute phase of treatment consists of 16 half-hour treatment sessions delivered over 8 weeks. To consolidate treatment gains and to prevent post partum depression, participants who have full or partial response at the end of the acute phase will continue to receive the same, but less frequent, treatment until 10 weeks post partum, and will be followed up for 6 more months. Main Outcome Measure(s): The primary outcome measures are the HRSD and the depression portion of the SCID-IV, to be administered monthly during the treatment phases and at 3 and 6 months follow up. Other important measures include the Beck Depression Inventory (weekly), expectations (of the participants and the providers), and delivery and infant measures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ADHERENCE TO DEPRESSION TREATMENT AMONG OLDER PATIENTS Principal Investigator & Institution: Bogner, Hillary R.; Family Practice and Cmty Med; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2003; Project Start 20-FEB-2003; Project End 31-JAN-2008 Summary: This application for an NIMH Mentored Patient-Oriented Research Career Development Award (K23 Award) seeks support to develop a program of research related to the treatment of depression in older adults with cardiovascular disease (CVD). This application capitalizes on my background in family medicine and clinical epidemiology and proposes activities aimed at developing my ability to design, implement, and evaluate interventions directed at the treatment of depression in older primary care patients with CVD. An intervention for depression designed to address CVD comorbidity would provide a model for integration of depression treatment with care for other chronic medical conditions among older adults in the primary care setting. My knowledge of clinical family medicine, epidemiology, and biostatistics, as well as my experience of implementing a large primary care-based study provide an excellent background for development as an intervention researcher. The University of Pennsylvania offers an outstanding research environment to help accomplish the goals of this K23: (1) to study the patient characteristics that place older adults with depression and CVD at risk for nonadherence to depression treatment; (2) to obtain expertise in advanced statistical methods, e.g. structural equation models and new study designs, both of which are integral to my study of adherence in primary care settings; and, (3) to design interventions for depression among older primary care patients with CVD. In addition to educational activities, this application lays out a research plan unfolding in three phases. Phase I will examine factors associated with adherence to recommended depression therapy in older primary care patients with CVD in an NIMH-funded study designed to test the effectiveness of an intervention aimed at improving the recognition and treatment of depression (the PROSPECT study). The focus will be on how cardiovascular comorbidity, executive and cognitive functioning, beliefs about depression and its treatment, social support, and other patient-level factors are associated with adherence to depression treatment in older primary care patients. In Phase 2, semi-structured interviews of older primary care patients will explore patient concepts of depression in relation to CVD and its treatment and patient preferences for possible strategies aimed at improving adherence to depression treatment. Phase 3 will test the feasibility of a protocol for an intervention aimed at the treatment of older adults with CVD. The protocol will be based on the results from Phases 1 and 2. During Phase 4, the findings from Phases 1, 2, and 3 will guide the final development of an R01 intervention study, sketched out in the final

24 Depression

section of this K23. This project will set the stage for the development and implementation of interventions to improve depression treatment adherence among persons with co-existing CVD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AGMATINE, NEUROPROTECTION AND DEPRESSION Principal Investigator & Institution: Zhu, Meng-Yang; University of Mississippi Medical Center 2500 N State St Jackson, MS 39216 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-AUG-2007 Summary: GRANT=6673599;P20RR Decreased hippocampal volume and reduced glial cell number in the cortex have been documented in major depression. Based largely on animal studies, stress-induced hypercortisolemia, leading to neurotoxicity and/or Active Cell Death (apoptosis) is the probable cause of the hippocampal volume loss in depression. Active Cell Death is known to involve NMDA glutamate receptor (NMDAR) activation and nitric oxide overproduction. Agmatine, an endogenous polyamine derived from decarboxylation of arginine and mainly stored in synaptic vesicles of neurons, has been found to antagonize both NMDA-R and Nitric Oxide synthase, and thereby to possess natural neuroprotective properties (i.e., shown against hypoxic ischemia). Hippocampal volume loss has been well-established to occur in animal models of chronic stress. Agmatine is normally abundant in the hippocampus where it may normally be co-released with glutamate to protect from excito-neurotoxicity through a polyamine site in the NMDA-R of normal rats. We hypothesize that in subjects suffering from major depression, agmatine becomes depleted as a consequence of long term release under prolonged stress, and therefore the hippocampal neurons become exposed to neuronal damage. The goal of my proposal is to examine the neuroprotective properties of agmatine against neurotoxicity induced by excitotoxins or higher concentrations of glucocorticoids as have been detected in patients with major depression. To address this goal, the neuroprotective effects of agmatine will be measured in 1) cultured fetal rat hippocampal neurons exposed to glutamate as well as related chemicals, or high concentrations of glucocorticoids in vitro which mimic conditions found in depressed patients in vivo, 2) the hippocampi of rats treated with excitotoxins, and 3) the hippocampi of rats after undergoing chronic mild stress. Concentrations of endogenous agmatine in hippocampi will be correlated with the extent of structural injury to neurons and glial cells in the hippocampal primary culture and in the hippocampus in vivo of treated rats and the rat chronic mild stress model. This research is designed to elucidate the functional significance of agmatine as an endogenous neuroprotective agent of relevance to the effects of chronic stress as occurs in depression. Clarification of structural and biochemical changes in the hippocampus of the chronic mild stress animal model will add to evidence of hippocampal neuron loss in depression, and hopefully suggest ways to augment agmatine's natural neuroprotective effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AMERICAN MELANCHOLY: DEPRESSION IN THE TWENTIETH CENTURY Principal Investigator & Institution: Hirshbein, Laura D.; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2006

Studies 25

Summary: (provided by applicant): This project will examine depression in the United States between 1900 and 2000, particularly the social, cultural, political, economic, and professional forces that affected medical and popular ideas about this disease. For centuries, physicians have described an entity that today would be identified as melancholia or depression, but psychiatric diagnosis and treatment of depression have changed dramatically over the most recent century. Not only have medical ideas about depression changed in the last century, but also there have emerged popular ideas about depression that sometimes complement but also complicate professional ideas. The popular narratives about depression have grown in importance against a backdrop of expanding media sources, both visual and print. The proposed project will examine both medical and popular ideas about depression in the twentieth century. By using medical literature, this project will trace changes in the category of depression from involutional melancholia to the creation of specific diagnostic criteria with the third and subsequent editions of the Diagnostic and Statistical Manual (DSM). By rigorously analyzing magazine articles on mental illness and depression, it will be possible to understand cultural sources of information on this disease. Specific themes to be addressed throughout this study will be, 1) the role of gender in constructing categories; 2) the relationship between popular and psychiatric representations of depression and the role of culture in disease definitions; and 3) the shifting nature of psychiatric authority and professionalization. The product of this project will be a book length monograph, of interest to both historians and psychiatrists, to be published by a university press. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

AMYGDALOSTRIATAL

CIRCUIT--AFFECTIVE

BEHAVIOR--

Principal Investigator & Institution: Taylor, Jane R.; Associate Professor; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2002; Project Start 16-JUL-2002; Project End 30-JUN-2006 Summary: Neurobiological studies of major depression have identified dysfunctional cognitive-affective-motor regions; however, the details of these altered physiological and structural changes, and the molecular basis for these alterations, remain to be elucidated. Recent imaging data suggest that depressed patients have increased blood flow/metabolism in the amygdala concomitant with decreased blood flow and volume in orbitofrontal cortex and ventromedial striatum. These effects may be relevant to the psychopathology of depression because cortico-limbic - striatal dysfunction may contribute to hypersensitive stress, fea4r, and anxiety responses, anhedonia, affective alterations, and changes in cognitive function. Thus, it is critical to understand the molecular basis of neuroplasticity in these brain regions implicated in depression and mood disorders and the resulting cellular and behavioral correlates. This project will thus focus on the role for the extended amygdala (notably the central nucleus of the amygdala, and nucleus accumbens shell) in depression and alterations in PKA/CREB signaling in these regions because the involvement of PKA/CREB in learning/plasticity is well established and because antidepressant treatment increases PKA/CREB activity. Specifically the functional and molecular correlates of plasticity in response to stress and antidepressant treatment will be investigated. We hypothesize that alterations in the extended amygdala results in abnormal processing of affective/emotional stimuli and behavioral regulation by appetitive and aversive events. Combined with alterations of neural signaling within the ventral striatum that contribute to anhedonia, negative stimuli may also exert heightened suppressive consequences on behavior in depression.

26 Depression

In addition, sustained increases PKA/CREB produced by anti-depressants would be predicted modify behavior by enhancing plasticity associated with learning and affective processes. Using direct pharmacological manipulations, transgenic murine models, vector-mediated over-expression of CREB and stress-induced animal models of depression, we will investigate the role of PKA/CREB signaling within the extended amygdala in reactivity to unconditioned aversive stimuli and/or anhedonia (sensitivity to appetitive rewards), and appropriate control procedures, as well as the mechanism of action of anti-depressant drugs in order to evaluate and validate the relevance of these processes to models of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AN EXPERT SYSTEM TO REDUCE DEPRESSION IN PRIMARY CARE Principal Investigator & Institution: Levesque, Deborah A.; Pro-Change Behavior Systems, Inc. 2 Chafee Rd Kingston, RI 02881 Timing: Fiscal Year 2001; Project Start 25-SEP-2001; Project End 31-DEC-2002 Summary: A variety of effective interventions exist for people who seek help for depression. However, there is a lack of effective interventions for individuals who do not seek help or follow through with treatment referrals. We propose to fill this gap in services by developing and testing a Transtheoretical Model-based intervention that will be delivered proactively, on a population basis, to primary care patients who are experiencing symptoms of depression but are not currently involved in treatment. It is the first intervention for depression that is appropriate for individuals in all stages of change-not merely the minority who are prepared to take action. In Phase I of this Fast Track Initiative, the aims are to norm TTM measures, develop the TTM interventions, and determine the feasibility of this approach by assessing study recruitment rates and reactions to the intervention materials. Primary care patients who screen positive for mild to moderate depression and are not involved in treatment will complete surveys for measurement norming (n=100) or participate in a pilot-test of the intervention materials (n=50). If feasibility conditions are met, we will conduct a randomized clinical trial in Phase II to assess the efficacy of the expert system intervention for depression. PROPOSED COMMERCIAL APPLICATIONS: Depression is a costly illness for health care organizations, disability insurers, and employers because of increased health service utilization, disability claims, and lost productively among depressed individuals. An effective, low-cost expert system that can reduce the prevalence of depression on a population basis has significant commercial potential. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ANIMAL DEPRESSION

MODELS OF

CHILDHOOD

AND

ADOLESCENT

Principal Investigator & Institution: Bylund, David B.; Professor and Chair; Pharmacology; University of Nebraska Medical Center Omaha, NE 681987835 Timing: Fiscal Year 2003; Project Start 14-AUG-2003; Project End 31-MAY-2006 Summary: (provided by applicant): Major Depressive Disorder (clinical depression) is a severe and potentially incapacitating mental illness that is common in children and adolescents, with an estimated lifetime prevalence of 15 -20 % in this population. An important difference between clinical depression in children and adolescents, as compared to adults, is its response to antidepressant drugs. Tricyclic antidepressants have not been shown to be effective in treatment of child and adolescent clinical depression. Although antidepressant drugs have numerous neurochemical actions, the

Studies 27

therapeutic mechanisms of action of antidepressant drugs in relieving depression remain unknown. In non-depressed persons antidepressant drugs are not euphoriant or stimulant. Therefore, investigations related to which of the many neurochemical effects of antidepressant drugs are functionally related to their therapeutic efficacy in relieving depression requires research using a behavioral animal model of clinical depression. To better understand the neurobiology underlying the differences between children and adolescents, and adults in the response to pharmacological treatment of clinical depression, animal models of childhood and adolescent depression are needed. Currently, there are no established juvenile animal models of clinical depression. Although the models developed in adult animals can serve as a starting point, they must be adapted and validated in juvenile animals due the many differences between juvenile and adult animals. The overall goal of this proposal is to assess the validity and usefulness of two well-established rat animal models of adult clinical depression as models of childhood and adolescent clinical depression. Specifically, we propose to assess the usefulness of the forced-swim test and of learned helplessness as animal models for clinical depression in juvenile rats. The key questions which are addressed by this proposal are: 1) Do juvenile rats respond to antidepressant drugs with decreased immobility in the forced swim? 2) Do juvenile rats develop learned helplessness after inescapable stress in both the acute and persistent paradigms, as demonstrated by shuttlebox testing? 3) Do juvenile rats respond to antidepressant drugs in the both acute and persistent learned helplessness paradigms with decreased escape latencies in shuttlebox testing? Ultimately, the models may facilitate a better understanding of the underlying neurobiology of clinical depression, and serve as predictive measures of antidepressant efficacy in children and adolescents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SCLEROSIS

APATHY

AND

COGNITIVE

IMPAIRMENT

IN

MULTIPLE

Principal Investigator & Institution: Christodoulou, Christopher; Neurology; State University New York Stony Brook Stony Brook, NY 11794 Timing: Fiscal Year 2001; Project Start 28-AUG-2001; Project End 31-JUL-2003 Summary: (Adapted from Applicant's Description): While researchers have searched for a relationship between the cognitive deficits and depression that are both common in multiple sclerosis (MS), numerous investigations have failed to find an association. This failure may stem from the multifaceted nature of depression. Measures of depression tap a spectrum of symptoms (e.g., dysphoric/depressed mood, somatic complaints), and some may be more relevant to cognition than others in neurological disorders such as MS. While apathy has been historically associated with depression, recent evidence indicates that apathy represents an important and distinct neuropsychiatric phenomenon in its own right. Researchers recently found that apathy played a key role in predicting cognitive dysfunction in a variety of neurological disorders (e.g., Parkinson's disease, progressive supranuclear palsy). In contrast, no link was found between cognitive impairment and dysphoric mood, a core feature of depression. While a relationship between apathy and cognitive impairment has been identified in over half a dozen neurological populations, it has not been adequately examined in MS. Apathy has been associated with neuroanatomical damage to regions that are often affected by the MS disease process (e.g., prefrontal cortex). In addition, apathy has been linked to neuropsychological deficits commonly found in MS (e.g., in working memory, executive functions). The proposed study will demonstrate how apathy, when separated from other factors traditionally associated with depression, can serve as a key marker of

28 Depression

cognitive dysfunction in persons with MS. Subjects will consist of 80 MS patients. Apathy will be measured with the Apathy Evaluation Scale and the Apathy subscale of the Neuropsychiatric Inventory. Subjects will complete a battery of cognitive tasks focussed on executive functioning and working memory. It is hypothesized that apathy will correlate negatively with performance on tests of executive functioning and working memory, and that apathy will significantly add to the explanation of variance in such performance beyond that accounted for by other neuropsychiatric variables measuring depression, fatigue, pain, and sleep disturbance. Empirical support for the initial hypotheses will lay the foundation for further rehabilitative research designed to improve both apathy and cognitive functioning in persons with MS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: APOE, DEPRESSION AND COGNITION IN LATE LIFE Principal Investigator & Institution: Gallo, Joseph J.; Associate Professor; Family Practice and Cmty Med; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 15-MAR-2000; Project End 29-FEB-2004 Summary: (Adapted from Applicant's Abstract): This study takes advantage of the primary care setting to consider whether we can identify presentations of depression in older adults that are characterized more by motivation disturbance (e.g., anhedonia, executive function disturbance and cognitive content related to physical illness (e.g., hopelessness, anxiety) rather than by mood disturbance (e.g. sadness). The specific aims of this proposal to be carried out in the primary care setting are: o to systematically describe and validate a depressive syndrome, apathetic depression, that does not meet standard criteria for Major Depression in older primary care patients; o to assess how physical illness, cognitive impairment, anxiety, and hopelessness among older primary care patients alters the course of depression and associated functional impairment over time; and, o to evaluate the clinical presentation of depression and associated symptoms in late life in relation to the assessment and treatment decisions of primary care physicians. An age-stratified sample of 3000 adults aged 65 years and older who have visited one of 30 participating primary care physicians will be interviewed with a revised version of the CES-D in the physician's office. Patients above a threshold will be asked to participate in a home assessment and follow-up study. Approximately 300 patients will have significant depressive symptoms and will be asked to participate in a longitudinal, observational study with a 10% random sample of persons without depression. The main study will include a baseline in-home assessment, a 3-monthly telephone follow-up, and a 12-month in-home follow-up evaluation of depression, function, and other factors. Information on assessment and treatment of depression will be obtained from participating physicians. We seek to identify, in primary care, an anhedonic depression syndrome which appears to be associated with physical illness and significant functional limitation and for which misidentification of depression could be avoided if the syndrome were better understood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BARRIERS TO MENTAL HEALTH TREATMENT IN PRIMARY CARE Principal Investigator & Institution: Sirey, Jo A.; Psychiatry; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2001 Summary: The proposed study of Barriers to Mental Health Treatment in Primary Care requests one year B/Start funding to investigate the prevalence and impact of

Studies 29

psychological barriers to mental health treatment, to treatment behaviors and to clinical outcome in older adults with depression in primary care. Inadequate treatment on major depression among older remains a significant public health concern, even though there is ample evidence that major depression can be effectively treated with pharmacotherapy in most elderly adults with depression (Hirschfeld et a., 1997 Schneider, 1996). Preliminary investigations suggest that psychological barriers, such as minimizing the need for treatment and perceived stigma, reported at the beginning of outpatient psychiatric treatment for depression can be important factors in predicting treatment behaviors such as medication recommendation, antidepressant adherence and treatment discontinuation (Sirey, et a., 1999, in press). The primary aims of this study are : 1) to assess the prevalence depression seen in primary care; 2) to examine the impact of psychological barriers on treatment initiation (either pharmacotherapy or nonpharmacologic interventions); and 3) to explore the relationship between psychological barriers and improvement in depressive symptoms. To address these aims the funding would be used to support the primary care (Prevention of Suicide in Primary Care Elderly: Collaborative Trial, PROSPECT; MH 59366; PI George S. Alexopoulos, M.D.). The proposed study would assess the psychological barriers reported by 60 Cornell site of the PROSPECT Study). A part of (PROSPECT) sample is re-interviewed four months later to assess: 1) treatment behaviors (e.g. initiation of treatment, services used); 2) depressive symptoms; and 3) review criteria for depression. Analyses examine the of barriers on treatment initiation, controlling for intervention status. Additional analyses will explore the impact of barriers on clinical status at follow-up. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIORAL INTERVENTION FOR DEPRESSION IN NURSING HOMES Principal Investigator & Institution: Meeks, Suzanne; Associate Professor; Psychology; University of Louisville University of Louisville Louisville, KY 40292 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2005 Summary: (provided by applicant): The risk for depression is nearly twice as great among nursing home residents as it is for community-residing elders, with up to 50 percent of nursing home residents affected by significant depressive symptoms. Although we now have a good understanding of the epidemiology and manifestations of depression in late life, and are beginning to apply effective treatments to some groups of elders, the benefits of the past decade of research have yet to reach the frailest elders living in nursing homes. Depression in long-term care is a significant public health issue. The health and cognitive multiple comorbidity of this population makes treatment, and treatment research, extremely challenging. The broad goal of this proposal is to adapt an efficacious psychosocial intervention for depression to the nursing home setting, using the public health model of intervention research and the exploratory/development mechanism provided by NIMH for implementing such work. There are 3 specific aims: (1) To use a collaborative treatment development process involving nursing home staff to adapt a behavioral intervention for treating depression in elders with cognitive impairment to nursing home residents with a range of physical and cognitive abilities; (2) to conduct a pilot effectiveness study on the adapted intervention, using a replicated, single-subject design, in 2-3 nursing homes other than the one in which the initial treatment development process took place, and (3) as a part of the effectiveness study, to collect data on staff outcomes and cost effectiveness. The treatment has a behavioral theoretical basis, and focuses on increasing opportunity for pleasant events to increase levels of activity and positive affect. Treatment is

30 Depression

implemented primarily by existing nursing facility staff, with supervision from a licensed psychologist, making ultimate dissemination of this treatment practical and affordable. Standardizing the treatment collaboratively with staff insures a high level of staff acceptance and maximizes feasibility in the nursing home setting. The treatment evaluation design employs a replicated, multiple-baselines-within-subjects design and Hierarchical Linear Modeling, optimizing features from single-case and group research. Each participant will be observed for a minimum of a two-week baseline, followed by six weeks of active intervention, four weeks of maintenance, and a three-month followup. Measures include comprehensive psychiatric evaluation and diagnosis, depression and mood rating scales, observed affect and activity participation, behavior problems, and staff burden. The end-product of the work will be a standardized treatment protocol ready for formal multi-site intervention trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIORAL DEPENDENCE

THERAPY

FOR

DEPRESSION

IN

DRUG

Principal Investigator & Institution: Nunes, Edward V.; Associate Professor of Clinical Psychiat; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001; Project Start 25-SEP-1999; Project End 31-AUG-2003 Summary: Depression is the most common comorbid psychiatric disorder in opiate dependent patients along with antisocial personality disorder. Depression has been associated with both severity of addiction and poor treatment outcome. This suggests that effective treatment of depression would improve outcome for opiate addicts. However, standard antidepressant medication trials in depressed methadone maintenance patients have yielded mixed results indicating that antidepressant medication treatment by itself is limited in this population. Several reasons for poor treatment response include: 1) poor compliance; 2) ongoing substance abuse; 3) ongoing stresses with which patients do not cope effectively; and 4) the absence of pleasurable, satisfying activities in patients' lives. A high rate of aversive circumstances and a low frequency of positive reinforcement are classic components in a behavioral model of depression. This suggests that a behavioral therapy could be an alternative or a complement to antidepressant medication treatment in this population. We propose a Stage I development project to design and pilot test a Behavioral Therapy for Depression in Drug Dependence (BTDD) that is based on behavioral model of depression. The primary goals of BTDD are to decrease depressive symptomatology by increasing the frequency of response-contingent positive reinforcement and to build a base of behaviors that can compete with illicit substance use. Aspects of three operant conditioning based treatment programs demonstrated to be effective for treating depression or reducing illicit substance use in other drug using populations will be incorporated in BTDD. These programs include: the Coping with Depression Course, the Community Reinforcement Approach and Treatment-plan contingency management. The latter techniques will be adapted so that reduction in depression is the primary goal. The specific aims over the four years of proposal are: 1. To develop a preliminary BTDD treatment manual through the treatment of 20 depressed methadone maintained patients in an uncontrolled trial. 2. To explore the efficacy and acceptability of BTDD with a randomized controlled pilot trial. 3. To test the theory that an increase in response-contingent reinforcement will produce an improvement in depression and reduced drug use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BIOBEHAVIORAL MECHANISMS OF DEPRESSION IN WOMEN Principal Investigator & Institution: Cyranowski, Jill M.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 20-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): This Mentored Research Scientist Development Award (MRSDA) is designed to promote the Candidate's long-term goal of becoming a women's health researcher with expertise in the etiology and treatment of depression in women. The training and research activities described in this MRSDA will facilitate the Candidate's training in the methods of acute stress research and neurohormonal assessment techniques, and the integration of these techniques within her own background in depression intervention research. This interdisciplinary training will provide the Candidate with the skills and experience needed to pursue an independent program of research testing biobehavioral mechanisms of stress sensitivity, depression vulnerability, and ultimately, depression treatment outcomes in women. Post-pubertal females are twice as likely as males to experience a lifetime episode of major depression, and are particularly likely to become depressed when faced with stressful life events. This gender-linked health disparity persists throughout women's reproductive lives, carrying deleterious consequences for both the woman herself and the children under her care. We (Cyranowski et al., 2000) have theorized that women's sensitivity to interpersonal life stress is mediated, in part, by the hypothalamic neurohormone, oxytocin. Oxytocin is known to play a key role in female reproductive processes. A growing body of animal research indicates that oxytocin is critically regulated by female reproductive hormones, and that oxytocin serves to facilitate female affiliative behaviors and down-regulate the hypothalamic-pituitary-adrenal (HPA) stress axis. The proposed pilot study was designed to provide a preliminary examination of the role of oxytocin in women's stress sensitivity and depression vulnerability. Twenty-two normal cycling, depressed females aged 21-40 and 22 age-matched never-depressed controls will be recruited to participate in a 3-hour laboratory experiment designed to stimulate, measure and compare peripheral oxytocin release and basal oxytocin concentrations within and between groups, and to examine whether peripheral oxytocin release is associated with a down-regulation of the HPA stress axis following an acute stress task. Subjects will also complete self-report measures of depression, anxiety, interpersonal function, trauma history, and recent life stress. Subjects will then be retested with the laboratory paradigm at 18 weeks follow-up, or for depressed subjects, following a course of interpersonal psychotherapy (IPT). The skills, training, and pilot data obtained from this MRSDA will subsequently be used to support the Candidate's development of an R0l application in Years 03-05 of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BRIEF ALCOHOL INTERVENTION WITH DEPRESSED PATIENTS Principal Investigator & Institution: Ramsey, Susan E.; Rhode Island Hospital (Providence, Ri) Providence, RI 02903 Timing: Fiscal Year 2003; Project Start 05-SEP-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Heavy alcohol consumption is common among patients seeking treatment for depression. Heavy drinking is associated with a variety of medical and psychosocial problems. Heavy drinking is particularly problematic among depressed patients, increasing the likelihood of poor depression treatment outcomes. While methods for reducing alcohol use in this population have been unexplored to date, brief interventions to reduce heavy alcohol use have been well-

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validated in numerous patient populations and offer the promise to reduce heavy drinking among depressed patients and to improve depression treatment outcomes. We hypothesize that adding a brief alcohol intervention to standard psychiatric care, relative to standard psychiatric care alone, will reduce overall drinking volume and heavy drinking days among heavy-drinking depressed patients. Furthermore, we expect patients who receive the brief alcohol intervention to have better depression outcomes than patients receiving standard psychiatric care alone. We also expect that reduced alcohol consumption will mediate the effect of the brief alcohol intervention on depression outcomes. In addition, we will examine individual difference variables as predictors of change in alcohol use. The proposed study is a randomized, two-group design with repeated measures over time, comparing a brief, motivationally-focused alcohol intervention plus standard psychiatric care to standard psychiatric care alone. For this study, we will recruit a sample of 240 psychiatry clinic outpatients meeting structured diagnostic criteria for major depressive disorder who drink heavily but are not alcohol dependent. We expect that the results of this study will improve depression treatment outcomes for the significant sub-population of depressed patients who drink heavily and are likely to do poorly in depression treatment in the absence of a change in their drinking behavior. The intervention proposed in this study represents a novel approach to reducing heavy drinking among depressed patients that, if effective, can be readily integrated into depression treatment in a variety of treatment settings. In addition, this study will provide valuable information on the association between alcohol use and depression outcomes and on the mechanisms of change in alcohol use among heavy-drinking depressed patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BUPROPION IN ADOLESCENTS WITH COMORBID ADHD & DEPRESSION Principal Investigator & Institution: Daviss, William B.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2003; Project Start 06-DEC-2002; Project End 30-NOV-2007 Summary: (provided by applicant): Attention deficit hyperactivity disorders (ADHD) in youth occur comorbidly with other psychiatric conditions approximately two thirds of the time. Major depressive disorder and dysthymic depression are common, occurring in as many as 40% of youth with ADHD. The comorbid occurrence of ADHD and depression (ADHD + Dep) may cause substantial long-term morbidity. While psychopharmacology is widely used to treat juvenile ADHD and/or depression, no research has established an efficacious treatment for ADHD + Dep, or for most other comorbid ADHD disorders. This five year Mentored Patient-Oriented Research Career Development Award (RCDA) will provide the candidate, a board certified child and adolescent psychiatrist, training to undertake pharmacological trials of youth with ADHD and comorbid disorders. The candidate has had extensive previous clinical experience and some research experience in the pharmacological treatment of juvenile ADHD + Dep. The RCDA will provide the candidate formal training in pharmacology, clinical trial design, and statistical analyses as well as the empirical assessment of juvenile ADHD, depression, and other comorbid psychopathology. The candidate will also receive training in ethical issues germane to juvenile psychopharmacology studies. Training will occur through a combination of formal coursework, guided readings, and consultation with mentors having relevant expertise. This training will be applied in a pharmacologic study of adolescents with ADHD and depression (major depression, dysthymia). The protocol will consist of a 2-week washout/observational period, then

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an 8-week randomized, placebo-controlled trial (RCT) to determine the efficacy of bupropion SR. Then a 24-week open label continuation phase will be used to determine if treatment response and tolerability persist. Exploratory analyses will assess correlations of initial treatment response with both pharmacological variables (plasma levels of bupropion and its metabolites; noradrenergic and dopaminergic effects as estimated by reuptake blockade of rat synaptosomes) and psychosocial variables (baseline psychopathology and psychosocial impairment). The candidate' s training and research experiences during the RCDA will enable him to pursue larger, more scientifically rigorous pharmacologic trials of youth with ADHD and depressive or other comorbid psychopathology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CALCIUM FOR PREVENTION OF POSTPARTUM DEPRESSION Principal Investigator & Institution: Hatton, Daniel C.; Behavioral Neuroscience; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2002; Project Start 08-FEB-2002; Project End 31-JAN-2005 Summary: (provided by applicant): Post-partum depression causes maternal suffering and can have a lasting negative influence on the child's cognitive and emotional development. Interventions that prevent or reduce the incidence of post-partum depression would be of significant value to society. Preliminary studies indicate that dietary calcium supplementation during pregnancy may provide an inexpensive, safe, and effective protection against postpartum depression while at the same time providing a number of other health benefits for the mother and child. We will conduct a rigorous test of the hypothesis that supplemental calcium during pregnancy reduces the incidence of post-partum depression in a randomized, double-blind, placebo-controlled clinical trial of a 2 g/day oral calcium supplement in 238 women at risk for postpartum depression as a consequence of a positive history of depression. Supplementation will begin between weeks 16 and 20 of gestation and continue through 12-weeks post partum. Women will be recruited by newspaper advertisements and clinic referrals. Prior to randomization, a computerized version of the SCID followed by a psychiatric diagnostic interview will be used to determine baseline clinical status. Those currently suffering from major depression, active substance abuse, active psychosis, schizophrenia, bipolar disorder or are on antidepressant medication, will be referred for treatment and will not be included in the study. Prior history of postpartum depression and parity will be controlled for during randomization. The antenatal version of the Edinburgh Postnatal Depression Scale (EPDS) will be used to screen for depression at 26, 32 and 38 weeks of gestation and the postnatal version will be used at 6 and 12 weeks postpartum. Those with a positive change score of 30 percent or a score greater than 16 on the EPDS at any screening visit will be evaluated using a psychiatric interview. Those suffering from major depression will be referred for treatment. The proportion of women in the calcium supplemented group who experience a first episode of major depression since entry into the study in the postpartum period, either at 6 or 12 weeks, will be compared to the proportion in the placebo condition. A significantly smaller proportion in the calcium group will be taken as evidence in support of the hypothesis. Positive results from this trial will provide a strong foundation for a multicenter intervention trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CBASP AUGMENTATION FOR TREATMENT OF CHRONIC DEPRESSION Principal Investigator & Institution: Gelenberg, Alan J.; Professor and Head; Psychiatry; University of Arizona P O Box 3308 Tucson, AZ 857223308 Timing: Fiscal Year 2002; Project Start 24-SEP-2002; Project End 30-JUN-2006 Description (provided by applicant): Chronic depression affects approximately 5 percent of adults in the United States and is associated with significant functional impairment and high health care utilization. Recent work supports the efficacy of established antidepressant medications with chronic depression. However, only a minority of patients with chronic depression attain full remission in these trials: approximately 50 percent do not respond, and an additional 20 percent achieve only a partial response. A recent multi-site study demonstrated that the combination of medication and psychotherapy produced a significantly better response than either monotherapy. Unfortunately, combination treatment is expensive. It may be more efficient to employ a stepped approach, in which patients first receive medication, and only non-responders and partial responders receive adjunctive psychotherapy. We propose to conduct the first large-scale study of adjunctive psychotherapy in chronic depressives who fail to respond, or respond only partially, to an initial trial of medication. This multi-center trial will compare 12 weeks of adjunctive treatment with the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), the form of psychotherapy with the best evidence for treating chronic depression, with adjunctive treatment with Supportive Psychotherapy (SP) and continued pharmacotherapy alone, in patients with chronic forms of major depression. Separate trials will be conducted in patients who fail to respond to an initial open trial of serotonin reuptake inhibitor (SSRI) and in patients who achieve only a partial response. In addition, we will conduct naturalistic follow-up assessments at 6- and 12-months post-treatment. The specific aims of the project include: (1) comparing the efficacy of adjunctive psychotherapy to continued SSRI alone; (2) determining whether adjunctive CBASP is specifically efficacious compared to adjunctive SP; (3) testing the hypothesized mechanism of action of CBASP, as well as exploring potential moderators of response, and (4) comparing the cost-effectiveness of the three treatment conditions for treatment resistant chronic depression. The outcomes examined will include both symptomatology and psychosocial functioning. In addition, we will conduct exploratory analyses comparing the effect of the three treatment conditions on relapse and post-treatment service utilization. This would be the first large-scale study ever to test the efficacy of any therapy for treatment resistant chronic depression, and to study the value of psychotherapy augmentation in medication non-responders with any form of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CBT FOR HIV MEDICATION ADHERENCE AND DEPRESSION Principal Investigator & Institution: Safren, Steven A.; Assistant Professor, Harvard Medical Sch; Fenway Community Health Center 7 Haviland St Boston, MA 02115 Timing: Fiscal Year 2003; Project Start 01-DEC-2002; Project End 30-NOV-2005 Summary: (provided by applicant): Introduction: This is an amended application to develop a cognitive-behavioral therapy for HIV medication adherence and major depression. Depression is prevalent in HIV and is associated with poor self-care behaviors including poor adherence to antiretroviral medications. Patients with HIV and depression are at risk for poor health outcomes and possibly increased morbidity.

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Cognitive-behavioral therapy is the most widely studied and efficacious psychosocial intervention for depression. Overview of project goals and conceptual model of intervention: The main goal of this project is to complete NIH-defined stage 1 activities in developing a cognitive behavioral intervention for depression and ART medication adherence. We propose to estimate the effect size of the intervention on improved depression, improved adherence to medications, and improved health status as defined by a clinically significant reduction in HIV viral load. Following the goals of the R21 mechanism, this will allow for the collection of the necessary pilot data to conduct a fullscale intervention study. We hypothesize that the psychosocial intervention will achieve improved health status in two ways: by directly increasing adherence to antiretroviral medications using the adherence skills training, and by treating the depression which otherwise makes it difficult for patients to acquire or use these adherence skills. Overview of research plan: Patients with a detectable viral load who have a diagnosis of major depressive disorder will be randomized into either: (1) "CBT," the combination of CBT for depression and HIV medication adherence or (2)"Enhanced Clinical Management," a single-session adherence intervention (Safren et al., 1999, 2001). Those who are assigned to Enhanced Clinical Management will be re-assigned to CBT after the acute phase of the study (4 months) if they have not improved on key outcome variables. Eligibility requirements at this stage of treatment development were selected to maximize the chances of finding an effect with a circumscribed sample (and minimizing the possibility of a type-II error). This will allow for an adequate power analysis for a full-scale intervention trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHILDHOOD DEPRESSION--PHYSIOLOGICAL CORRELATES Principal Investigator & Institution: Armitage, Roseanne; Professor; Psychiatry; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105 Timing: Fiscal Year 2001; Project Start 15-JUN-1999; Project End 31-MAY-2004 Summary: This study will establish whether sleep EEG dysregulation (low inter- and intrahemispheric coherence) is a reliable feature of childhood and adolescent depression, contrasting symptomatic and remitted children and adolescents with ageand gender-matched normal controls. The long range objective of identifying reliable biological features of depression is to improve on differential diagnosis, prognostication, and treatment selection. Of particular relevance to this application is the additional potential to identify patients prior to the clinical expression of the illness in order to ultimately intervene to prevent the onset of illness. The specific aims are: 1) To establish which sleep EEG coherence measures are significantly lower in those with childhood depression (n=50) compared to age- and gender-matched health controls (n=50). 2) To establish which sleep EEG coherence measures are significantly lower in those with adolescent depression (n=50) compared to age- and gender-matched healthy controls (n=50). 3) To fully explore gender differences in sleep EEG coherence measures in the total sample of depressed (n=100) and control (n=100) and control (n=100) subjects. Equal numbers of males and females will be included in the total sample. We expect that gender differences will be evidence in adolescents with MDD. 4) To explore state-train characteristics of low-inter and intrahemispheric coherence in depressed children and adolescents. 5) A sub-aim is to evaluate the developmental time course of sleep EEG coherence in the 100 healthy controls as a means of determining how high inter- and intrahemispheric coherence measures are influenced by brain maturation. 6) To establish the relationship between sleep micro- and macro- architecture in childhood and adolescent MDD.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHILDREN AT HIGH AND AT LOW RISK FOR DEPRESSION Principal Investigator & Institution: Weissman, Myrna M.; Professor; Psychiatry; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2003; Project Start 01-JUL-1987; Project End 31-DEC-2007 Summary: (provided by applicant): The overall aim of this study has been to understand the long term temporal sequence and familial patterns of mood and other disorders from childhood to adulthood in offspring at high and low risk for depression. This study has had 4 waves of assessments. The last wave began in 12/98, 17 years after the initial assessment. This application is for Wave 5. The sample now includes 3 generations (grandparents, parents, and grandchildren). The basic design is one of families at high and low risk for depression based on the depression status of the original sample (1st generation -- the grandparents). Our previous findings in the offspring (2nd generation -- now the parents) showed both cross-sectionally and longitudinally that the offspring of depressed grandparents were at high risk (3-fold increase) for major depression. Their depression began early, often at puberty, and was preceded by prepubertal onset anxiety. The results for the 3rd generation (the grandchildren) again shows that the grandchildren in the high risk group (i.e., at least one depressed grandparent) are at increased risk of mood and anxiety disorders. These consistent findings across the generations lead directly to this new application which focuses on understanding the brain based correlates of familial depression. These results support the use of the original high and low risk classification which guide this renewal and its hypotheses. A new aim of the current application is to define the neural correlates of familial risk for depression in subjects in the 2nd and 3rd generations of this cohort using anatomical and functional MRI. This sample is uniquely valuable for identifying the neural correlates of familial risk because the study of high-risk populations prior to the onset of illness is likely to be the best way to distinguish cause from compensatory effect in neurobiological studies, and because psychiatric diagnoses established prospectively and across generations will provide the greatest possible confidence in the assessment of multi-generational familial risk. In addition, the availability of MRI data will provide us with the opportunity to understand better the underlying basis, in terms of brain structure and function, of the electrophysiological abnormalities identified in the last cyclic of funding. Our specific aims for this renewal are (1) to complete data analyses of the 4th wave assessment; (2) to acquire and analyze both anatomical and functional MRI in 214 subjects (118 second and 96 third generation) of this cohort; and (3) to conduct data analysis integrating findings of the clinical, psychophysiologic and neuroimaging studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CHRONIC DRUG USE, DEPRESSION, AND LABOR SUPPLY Principal Investigator & Institution: Alexandre, Pierre K.; Epidemiology and Public Health; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2003 Summary: (Applicant's Abstract) The University of Miami Health Services Research Center recently collected extensive community-based information on chronic drug users (CDUs) and non-drug users (NDUs) to examine differences in health services utilization, access, and cost. The survey instrument contains information on demographics, health status, lifestyle behaviors, and labor market activities. It also includes the 20-item Zung

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Self-Rating Depression Scale (SDS). The primary objective of the proposed small grant application is to use this unique set of data to analyze the relationships between drug use and depression among CDUs and NDUs, and the effects of these conditions on labor market decisions. Some researchers have examined the relationships between drug use labor market problems, but no study has used community-based data to investigate the co-occurring and confounding effects of depression and drug use on labor market behavior. This research project will pursue the following specific aims: 1. Examine the prevalence of CDU, depression, and the comorbid conditions of CDU and depression in a community-based sample of individuals. 2. Estimate the main and interaction effects of CDU and depression on the probability of employment. 3. Conditional on being employed, estimate the main and interaction effects of CDU and depression on the number of weeks worked during the past 12 months. The proposed study will provide support for the investigators (including Dr. Alexandre, an African American health economist who qualifies as a newer, less experienced investigator) to use a unique set of data to examine the relationships between drug use, depression, and labor supply. Since employers and policymakers are not well informed about the co-occurring and confounding effects of drug use and depression on the labor market, the research and policy importance of this application is immediate and widespread. CDUs as a group have been singled out for intervention and extended study by the Office of National Drug Control Policy. Moreover, mental health problems in the United States have become a challenge to communities, health and social service agencies, managed care organizations, employers, and families. The resulting findings will help policy makers and employers make decisions regarding the allocation of scarce resources between workplace drug control programs and other alternatives such as improving employees' mental health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL IMPLICATIONS OF DEPRESSION-BASED STIGMA Principal Investigator & Institution: Miranda, Martha J.; Research Professor; Psychiatry & Biobehav Sciences; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): This grant examines stigma as it relates to depressive illness. Depressive disorders are among the most significant contributors to disability and reduced quality of life worldwide, but most patients don't receive appropriate care. This is particularly true of ethnic minorities and the poor. In this grant, we examine the extent to which stigma related concerns explain failure to receive appropriate care for depression. Specifically, we examine the extent to which concerns about depression-related stigma, such as fears about losing a job, insurance, or friends due to other people's awareness of illness or treatment, explain unmet need for depression care. We will also investigate if efforts to provide treatments or improve rates of treatment predict outcomes for both persons with and without stigma concerns. We use two existing data sets: (1) Partners in Care, a randomized, controlled trial of improving quality care for depression in primary health care settings and (2) We Care, a randomized controlled trial of providing access to guideline care (either CBT or paroxetine) for disadvantaged, young minority women. These studies allow us to examine the impact of stigma related concerns on acceptance and outcomes of depression care and include large samples of poor and ethnic minorities. Finally, we include stigma items in a nationally representative community study, Healthcare for Communities, funded by the Robert Wood Johnson Foundation that will allow us to

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estimate rates of depression-related stigma in a nationally representative sample. The specific aims of this grant are: 1) to assess rates of concerns about depression-related stigma in a nationally representative community sample; 2) to determine the impact of concerns about depression-related stigma on use of mental health services, controlling for need, predisposing, and enabling factors known to affect access to care; 3) to examine whether interventions to increase the use of guideline-concordant primary care treatments for depression are effective at improving the quality of care for both persons with high and low levels of concern about depression-related stigma; 4) to examine whether use of guideline-concordant treatments for depression (as opposed to quality improvement programs that promote access to those treatments) improve outcomes for both persons with high and low concerns about depression related stigma. Within each of the aims, we will explore the extent to which the findings vary by ethnicity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICIAN MANAGED INTERPERSONAL PSYCHOTHERAPY Principal Investigator & Institution: Stuart, Scott P.; Associate Professor; Psychiatry; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2001; Project Start 28-SEP-2001; Project End 31-AUG-2006 Summary: (Adapted from the Applicant's Abstract): Empirical studies evaluating the effects of acute psychotherapeutic treatment have provided invaluable data demonstrating the efficacy of such treatments for major depression. Under controlled conditions, time-limited manual-based psychotherapies are efficacious in bringing about remission of depressive symptoms. Such efficacy studies, however, have several limitations. First, though the treatments are efficacious in laboratory settings, the effectiveness of such treatments, efficacy studies are limited by their lack of external validity. Second, though the acute effects of time-limited treatments for depression are impressive, the improvement is often not maintained, and recurrence of symptoms is common. Our proposed research project is an empirical investigation of the effectiveness of Clinician-Managed Interpersonal Psychotherapy (CM-IPT) for postpartum depression, a treatment based on the manual of Klerman et al (1) and refined for a community setting. Timing and frequency of sessions will be determined collaboratively by the therapist and patient rather than arbitrarily specified by manualized directives. We will evaluate the effectiveness of 12 sessions of CM-IPT delivered over the course of a year compared to "standard" IPT for postpartum depression, a treatment which we have previously demonstrated to be efficacious compared to a waiting list control condition. Standard IPT will require that 2 sessions of IPT be delivered in the first 12 weeks after treatment assignment. The first major aim of this research application is to evaluate the longitudinal effectiveness of CM-IPT for postpartum depression compared to standard IPT. We predict that CM-IPT will be associated with lower cumulative levels of depressive symptoms and lower rates of depression over the first year than standard IPT. The second major aim of this research application is to demonstrate the acute effectiveness of CM-IPT for postpartum depression. We will compare CM-IPT and standard IPT at 12 weeks after treatment assignment (the conclusion of standard IPT treatment), at which time we expect the two treatments to be clinically equivalent. Our study, which uniquely combines the best elements of both efficacy and effectiveness research, will lead to more effective treatment for depressed postpartum women in the community. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COGNITIVE AND AFFECTIVE NEUROSCIENCES OF DEPRESSION Principal Investigator & Institution: Siegle, Greg J.; Assistant Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2002; Project Start 15-MAY-2002; Project End 30-APR-2007 Summary: (provided by applicant) Disruptions of emotional information processing (e.g., attention to, memory for, and interpretation of emotional information) have been implicated in depression. The emerging field of affective neuroscience suggests there are distinct physiological correlates of emotional information processing styles. The proposed research integrates basic research on affective neuroscience with conclusions from cognitive-clinical research regarding depressive information processing to understand brain mechanisms associated with disruptions of emotional information processing in depression. The applicant, Dr. Greg Siegle, Ph.D., has examined information processing in depressive disorders for eight years, and has developed a computational neural network model that suggests a convergence of specific cognitive, environmental, and biological factors are associated with depression. Further training is necessary for the next step in this research, which involves clearly linking observed cognitive phenomena and model behaviors to underlying biological mechanisms. Shortterm goals include using cognitive, physiological, and neuroimaging assessment to test predictions, generated using the model, regarding interactions of factors that could lead to distinct profiles of depressive emotional information processing. Long-term goals involve using this research to direct depressed individuals to focused treatments that target their particular cognitive and physiological profiles, thus improving speed and efficacy of depression interventions. The proposed research involves assessing depressed individuals' pupil dilation and brain activity (via functional magnetic resonance imaging; fMRI) during emotional information processing tasks to create profiles of emotional information processing disruptions in depression. Computational neural network modeling of interactions between relevant brain structures will be used to generate and refme hypotheses and experimental design throughout the study. This research will allow development and refinement of a formal theory of psychobiological mechanisms underlying individual differences in depressive information processing biases. It will lead to an R01 proposal involving understanding changes in brain activity associated with treatment for depression. Research will be conducted at the Western Psychiatric Institute and Clinic, a world center for research on the psychobiology of depression. Researchers who are expert in depression as well as the proposed assessment technologies will serve as mentors and preceptors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COMMUNITY LTC SERVICE AND OUTCOMES--BURDEN OF DEPRESSION Principal Investigator & Institution: Morrow-Howell, Nancy L.; None; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 15-JUN-2000; Project End 31-MAY-2004 Summary: (Applicant's Abstract): This study addresses fundamental concerns in community long-term care: ensuring appropriate service in response to a broad range of client needs and understanding factors associated with service outcomes. It is expected that a disproportionate number of public CLTC clients have mental health service needs due to depression, given that depression is associated with both physical dependency and low income. Yet virtually no research has addressed the extent of depression among elders in CLTC nor the impact of depression on CLTC service use and outcomes.

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Further, little is known about the attitudes of CLTC clients regarding mental health services nor the potential role of CLTC in meeting mental health needs. Study aims are to 1) estimate the extent of depression among elders first entering public CLTC and identify factors associated with depression; 2) determine the service demand in CLTC attributable to depression; 3) determine whether depressed elders experience less benefit from CLTC than do non-depressed elders; 4) examine how CLTC responds to the mental health needs of its clients. The proposed research will survey elders at entry to and through one year of service in Missouri's publicly funded, community long-term care system. Study participants will be 60 years of age or older and eligible for public CLTC services because of low income and functional disabilities. Through a telephonescreening interview, we will assess 1,500 new CLTC clients, documenting the extent and type of depression. We will follow 300 depressed elders as well as a random sample of 300 non-depressed elders though one year of CLTC service use. Subjects will be interviewed and service records will be abstracted to determine the service demand attributable to depression and the extent to which CLTC serves as a gateway to mental health services. Outcomes of CLTC (maintenance in community care, quality of life, life satisfaction, and consumer satisfaction with home care) at six months and one year will be compared for depressed and non-depressed clients to determine the extent to which depression affects the outcomes of CLTC services. Community long-term care is a rapidly growing service sector, and the expansion of home and community care is a priority in the development of long-term care policy. This project has the potential to influence program and policy developments in CLTC. Findings will inform the next step testing interventions that integrate CLTC and mental health services. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COMMUNITY SOCIOECONOMIC CONTEXT, DEPRESSION AND ANXIETY Principal Investigator & Institution: Muntaner, Carles; Professor; None; University of Maryland Balt Prof School Baltimore, MD 21201 Timing: Fiscal Year 2002; Project Start 12-MAR-2002; Project End 28-FEB-2004 Summary: (provided by applicant): Socioeconomic position is a key determinant of individual mental health, including depression and anxiety disorders. Depression and anxiety disorders inflict major social and economic burden on families and communities. Recent studies suggest that the community socioeconomic context, in particular its degree of income inequality, contribute to a person's morbidity and mortality, even after individual socioeconomic position has been taken into account; a disturbing finding as income inequality has grown in the US during the last three decades. The proposed analyses will expand this research program on socioeconomic context to include psychiatric disorders. We will examine the relationship between socioeconomic residential context and the prevalence of major depression and anxiety disorders in Baltimore neighborhoods using the Epidemiologic Catchment Area- Follow Up survey sample, and in US counties, using the National Comorbidity Survey sample. In addition to income inequality, we will examine the relationship between alternative contextual socioeconomic indicators at the county and neighborhood levels (i.e., absolute income, poverty and social capital) and major depression and anxiety disorders. This will be the first population-based analysis to examine the association between residential socioeconomic context in relation to the prevalence of depression and anxiety disorders in the US. Our analysis will also make important methodological contributions to the field of psychiatric epidemiology. Socioeconomic context will be measured at the individual, neighborhood (FCA-F) and county (NCS) levels, and we

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will apply innovative statistical methods that are appropriate for the simultaneous analysis of two levels of data and interactions between contextual and individual-level variables. Testing hypothetical mechanisms that may relate contextual and individual socioeconomic attributes (e.g., age, gender, race/ethnicity, socioeconomic position) will be an area of concentration of this analysis, as it has been overlooked in most multilevel studies to date. The results of these analyses will have implications for local health policy in urban neighborhoods and counties across the US that have the potential to reduce the social costs associated with depression and anxiety disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONSUMER INFLUENCES OF TREATMENT OF DEPRESSION Principal Investigator & Institution: Kravitz, Richard L.; Professor and Director; Medicine; University of California Davis Sponsored Programs, 118 Everson Hall Davis, CA 95616 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): By 2005, the pharmaceutical industry will spend $7.5 billion annually on direct-to-consumer advertising (DTCA) of prescription drugs. Proponents of DTCA say it encourages productive discussions between patients and physicians, while critics charge that it increases unnecessary prescribing, raises costs, and strains the patient-clinician relationship. Empirical evidence for policymaking in this area is lacking. This study will examine the clinical impact of DTCA by conducting an experiment using standardized patients (SPs) who present with depressive symptoms (representing either major depression or adjustment disorder) and make either: 1) an ad-driven request for a brand-name antidepressant, 2) a generic request for treatment, or 3) no request. Our focus on depression is justified by the high prevalence and costs of this condition, its relevance to general medical practice, the ubiquity of depression-related DTC ads in both broadcast and print media, and the broadening indications for the use of antidepressant medications. The application has 3 specific aims: 1) to estimate the effects of DTC ad-driven requests on physicians' prescribing of antidepressants for patients with depressive symptoms; 2) to determine whether DTC ad-driven requests are associated with better or worse quality of care in primary care settings; and 3) to describe differences in physicians' communication behaviors when they are confronted by patients making ad-driven requests, generic requests, and no specific requests. In this randomized trial, 144 primary care physicians in 3 U.S. cities will each see 2 unannounced SPs. The SPs will be trained to portray 6 different roles, generated by crossing 2 clinical presentations (major depression and adjustment disorder) with 3 request conditions (DTCA activated, generically activated, and no request). Visits will be audio-recorded, and SPs will record physicians' clinical behaviors. Using multi-level mixed effects models, data will be analyzed to assess the influence of DTCA on antidepressant prescribing and the clinical process of care. These analyses will be supplemented by qualitative and quantitative analyses of physician communication behaviors across experimental conditions. The results will address a pressing policy question (i.e., should DTCA be further regulated?) while also contributing to our understanding of the social influences on diagnosis and treatment of depression in primary care settings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

42 Depression

•

Project Title: DEPRESSION

CONTROLLED

TRIAL

OF

HYPERICUM

FOR

JUVENILE

Principal Investigator & Institution: Weber, Wendy J.; None; Bastyr University 14500 Juanita Dr Ne Kenmore, WA 98028 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: The candidate, Wendy J. Weber, seeks funding for a Mentored PatientOriented Research Career Development Award to obtain the skills of an independent clinical researcher. During the five year training period, Ms. Weber will conduct an eight-week double blind placebo controlled clinical trial of Hypericum perforatum (St. John's Wort) for the treatment of depression in children and adolescents aged 6 to 17. Childhood and adolescent depression is a major public health concern affecting 2 to 8% of this population and is a significant cause of morbidity and mortality. Numerous clinical trials of Hypericum for the treatment of adult depression have found that it is superior to placebo and nearly equivalent to pharmaceutical anti-depressants. The side effects of Hypericum are adolescent depression, and therefore a placebo- controlled trial is warranted. The proposed trial will determine the efficacy, safety, and response pattern of Hypericum for the treatment of mild-to-moderate depression in children and adolescents. The response to treatment will be determined by th Hamilton Depression Rating-Scale, safety will be determined by measuring adverse event rates, and response pattern will be evaluated by collecting and examining data at weeks one, two, four, six and eight of the clinical trial. Her proposal includes completion of a MPH Degree from the University of Washington School of Public Health's Epidemiology Department. This didactic training will give Ms. Weber the knowledge to design and conduct epidemiological studies in neuropathic medicine. In addition, the research skills we will develop by completing the research plan will give her the expertise to conduct clinical trials that evaluate efficacy of naturopathic therapies individually and in combination for juvenile mental health problems. Ms. Weber has assembled a highly qualified, interdisciplinary team of co- sponsors to ensure the success of her training. These mentors include: Joseph Biederman, MD, Professor of Psychiatry at Harvard Medial School and Chief of the Joint Program in Pediatric Psychopharmacology, who will provide expertise in pediatric psychopharmacology research; Leanna J. Standish, ND, PhD, Director of the Bastyr University Research Institute, who will provide guidance in the development of Ms. Weber's academic career; and Jon McClellan, MD, Associate Professor in the Department of Psychiatry and Behavioral Science at the University of Washington, who will provide guidance in the field of child psychiatry and psychiatric services in western Washington. At the end of the grant period, Ms. Weber will have obtained a MPH degree in epidemiology, conducted the first placebo controlled trial of Hypericum in childhood and adolescent depression, and become a well-trained naturopathic, clinical researcher, which is of critical importance to the field of complementary and alternative medicine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONTROLLED TRIAL OF SERTRALINE FOR DEPRESSION AFTER TBI Principal Investigator & Institution: Bombardier, Charles H.; Rehabilitation Medicine; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 20-SEP-2000; Project End 31-MAY-2005 Summary: Persons with traumatic brain injury (TBI) experience high rates of depression, especially during the first six months following their injuries. Neurological

Studies 43

and psychosocial factors appear to contribute to depression in this population. Depression following TBI is associated with poor cognitive, behavioral, and functional outcomes. Preliminary studies suggest that people with TBI and major depression may not respond to antidepressant treatment in the same way as depressed persons without TBI, post TBI depression may respond well to selective serotonin reuptake inhibitor (SSRI) antidepressants, that and effective antidepressant treatment is associated with improvements in health status, neuropsychological function, and post-concussive symptoms. No large randomized placebo-controlled studies have been conducted and basic questions remain about the treatment and outcomes of major depression among persons with traumatic injury. As a consequence, depression is not usually assessed after traumatic brain injury, and optimal rehabilitation guidelines for identifying and treating depression have not been established. To address this gap, the proposed study would follow a large consecutive sample of persons hospitalized for moderate to severe TBI to identify those who develop major depression. With those who develop major depression, a 12-week, randomized, double-blind, controlled trial of sertraline would be conducted. The trial would test the hypothesis that sertraline reduces depression related symptoms, as measured by the Hamilton Rating Scale for Depression. Secondary hypotheses to be tested include whether sertraline leads to greater improvement in neuropsychological test performance, post-concussive symptoms and self-reported health status as measured by the SF 36. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

CONVENIENT,

AUTOMATED,

OBJECTIVE

MEASURE

OF

Principal Investigator & Institution: Mundt, James C.; Healthcare Technology Systems, Llc 7617 Mineral Point Rd Madison, WI 53713 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): This research is aimed at demonstrating the feasibility of obtaining measures of depression severity using interactive voice response (IVR) technology that are equivalent or superior to clinician-administered Hamilton Depression Rating Scale (HAMD) interviews. Physicians will refer forty patients beginning treatment for a new episode of depression to the naturalistic, open-label study. Clinician HAMDs will be obtained at baseline and Weeks 2, 4 and 6. Beginning at baseline, subjects will call an IVR system daily to provide severity ratings of eight symptoms frequently associated with depression and a rating of clinical change since their last call. Beginning at baseline, and weekly thereafter, subjects will complete a validated IVR version of the HAMD, an IVR implementation of the Quick Inventory of Depressive Symptomatology (QIDS), provide a rating of clinical change since baseline enhanced by personalized recording of their experiences at baseline, and will provide speech samples elicited by a standardized protocol for subsequent acoustical analysis by Dr. Peter Snyder. Principal axis factoring will be used to define a statistically constrained, theoretically interpretable multivariate factor of depressive severity. Derived factor scores will be analyzed for between- and within-subjects variance related to clinician HAMD assessments and compared to depression metrics derived from the Daily Questions on Depression (DQD), the Memory Enhanced Retrospective Evaluation of Treatment (MERET), the IVR HAMD and QIDS, and speech characteristics extracted from the speech samples collected by IVR and analyzed in Dr. Snyder's laboratory. Improving the quality of assessment instruments used in depression treatment research might reverse the currently increasing rates of placebo response in randomized clinical trials, reduce the number of failed trials, provide more accurate measurement of

44 Depression

therapeutic onset, and provide a more level playing field for comparing efficacy between compounds. Ultimately such efforts may decrease the drug development cycle at lower developmental costs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CORE--MEDICAL Principal Investigator & Institution: Williams-Russo, Pamela; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001 Summary: Geriatric depression is rarely found without at least some medical comorbidity and/or impatient in physical functioning. Not only do these conditions complicate the study of geriatric depression, but evidence from the Developing CRC suggests that they are important indicators of heterogeneity in late life mood disorders and contribute to their outcomes; for example in depressed CRC subjects, medical burden predicts chronicity of depression and delayed recovery is associated with increased mortality. The Medical Core is newly added to the CRC and developed from collaborative relationships between investigators in the Departments of Psychiatry and Internal Medicine at Cornell. Addition of the Medical Core uniquely contributes to the CRC's investigation of heterogeneity of late life mood disorders by rigorous and extensive study of medical illness, functional impairment and depression course and outcome. The Medical Core expands the CRC's resource by providing: 1. funded medical investigators with extensive experience conducting longitudinal studies of comorbidity in medical setting patients and having central roles in the CRC; 2. access to a large population of elderly medical patients accustomed to receiving care in a research environment; 3. training and supervision in the administration of carefully selected instruments to assess longitudinal variation in medical morbidity and functional performance; (4) investigations of depression in post-operative depression in subjects enrolled in funded longitudinal studies of coronary bypass surgery and hip fracture repair. The Medical Core will work with the Clinical Core in screening and recruiting elderly patients from primary care settings for assessments and longitudinal follow-up, including subjects with major depression (N=50), minor depression (N=50) and nondepressed. These patients will contribute to the overall CRC database, yielding a sample of depressed elderly subjects ranging widely in severity and type of medical comorbidity and functional status, and followed longitudinally with extensive clinical, neuropsychological and psychosocial ratings. As part of its mission, the Medical Core will take advantage of these data to test cross-core hypotheses concerning the reciprocal relationships of depression and medical illness over time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: COUPLE THERAPY AND PHARMACOTHERAPY FOR MAJOR DEPRESSION Principal Investigator & Institution: Denton, Wayne H.; Psychiatry and Behavioral Med; Wake Forest University Health Sciences Winston-Salem, NC 27157 Timing: Fiscal Year 2003; Project Start 22-JUL-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Depression is a serious public health problem facing our society. Although there is a variety of generally effective treatments non-response, partial response, and relapse continue to be problems and there is a need for improved treatments. There are reasons to believe that couple therapy might be a beneficial treatment of depression for some people. The purpose of this K23 Award application is

Studies 45

to prepare the candidate to become an independent investigator in psychiatric clinical trials and to conduct a research study on the combination of pharmacotherapy and couple psychotherapy. On-site mentorship at the Wake Forest University School of Medicine will be provided by Dr. David Goldston (Sponsor), Dr. Curt Furberg (Mentor), Dr. Vaughn McCall (Consultant), Dr. Beverly Melton (Biostatistician) and through coursework that is part of an NIH K30 Clinical Research Curriculum Award. Off-site mentorship will be provided by Drs. Donald Baucom and Robert Golden (both at the nearby University of North Carolina at Chapel Hill). Additional guidance will be provided by Dr. Susan Johnson, Dr. Steven Beach, and Dr. David Miklowitz (External Consultants). Short term goals will include: 1) development of a treatment manual for a couple therapy of depression based on emotion focused therapy for couples (EFT), 2) development of a therapist adherence and competence rating for the new intervention, and 3) collection of pilot feasibility data on the new intervention through a small clinical trial of sertraline plus couple therapy to sertraline plus an attention control. The primary hypotheses of this clinical trial will be that depressed individuals treated with the combination of sertraine and couples therapy will have 1) more improvement in levels of depression (and better maintenance of gains) and 2) more improvement in relationship adjustment scores (and better maintenance of gains) than individuals treated with sertraline and an attention control condition. Long term goals include: 1) becoming an independent investigator in psychiatric clinical trials, with skills in couple therapy, pharmacotherapy, and comparative trials, 2) successfully preparing a funded R01 grant application by the conclusion of this award that will consist of a larger clinical trial using pilot feasibility data and other materials developed from the present research, 3) developing a program of research on the role of couples interventions in the treatment of depression to eventually include effectiveness studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

CULTURALLY

RELEVANT

PSYCHOTHERAPY--PERINATAL

Principal Investigator & Institution: Grote, Nancy K.; Social Work; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Depression during the perinatal period has adverse effects on the mother, on the development of her newborn infant, and on her family relationships. The purpose of this proposed mentored Patient-Oriented Research Career Development (K23) Award is to promote the Candidate's long-term goal of conducting clinical trials of culturally relevant, psychosocial interventions for perinatal depression in low-income, African American and White Ob/Gyn patients to ameliorate their depression during pregnancy and prevent postpartum depression. The training and research activities described in this application will take place in the cross-disciplinary environment of the School of Social Work and the Department of Psychiatry, University of Pittsburgh. Training will enable the Candidate to assess perinatal mood disorders, develop culturally relevant strategies to effectively engage and retain Ob/Gyn patients in multi-session psychosocial interventions, conduct randomized clinical trials of psychosocial treatments, and collaborate with health services researchers to enhance the public health value of the intervention. Interpersonal psychotherapy (IPT) addresses both depressive symptoms and problematic interpersonal relationships and is an efficacious treatment for depression in general (Weissman, Markowitz, & Klerman, 2000), as well as for depressed African American and White primary care patients (Brown et al, 1999). The first phase of this research plan consists of employing an 8-

46 Depression

session form of IPT 0PT-B; Swartz, Frank, & Shear, 2002) and modifying it to be more culturally relevant to poor, African American and White Ob/Gyn patients by incorporating a number of engagement strategies to minimize practical and psychological practical barriers to care. The second phase of the research plan consists of a small, randomized pilot trial comparing treatment as usual to culturally relevant IPT-B (followed by monthly maintenance IPT up to 6 months postpartum) in a sample of depressed, pregnant, low-income African American and White patients in a public care Ob/Gyn clinic. Participants will be assessed at baseline, posttreatment, and 2 months and 6 months postpartum. The skills, training, and pilot data obtained from this award will support the development of an RO1 application in Years 03-05 of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CULTURALLY SENSITIVE TREATMENT FOR DEPRESSED ASIANS Principal Investigator & Institution: Yeung, Albert S.; Staff Psychiatrist; Massachusetts General Hospital 55 Fruit St Boston, MA 02114 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 30-JUN-2008 Summary: (provided by applicant): This is a resubmission of an application for a mentored patient-oriented K-23 award, designed to enhance clinical training and research expertise in the area of treatment of depression among Asian Americans. This application differs from the original one in that face to face interviews will be used for screening of depression in primary care clinic instead of using telephone interviewers; hypotheses are added to assess if degree of acculturation and illness beliefs predict treatment outcomes; and involvement of patients' family members for psychoeducation and family counseling will be provided if necessary. Preliminary studies from the candidate and the Depression Clinical and Research Program at the Massachusetts General Hospital have shown that depression is prevalent among Asian Americans and many of these patients are unfamiliar with the concept of depression. Depressed Asian Americans frequently do not complain about their mood symptoms leading to underrecognition of their illness. Recognition of depressed Asian Americans in primary care alone does not result in adequate treatment by primary care physicians. We are proposing a comprehensive approach: Culturally Sensitive Collaborative Treatment (CSCT) for treating depressed Asian Americans in primary care. CSCT includes Cultural Consultation to depressed patients by a psychiatrist trained in cultural sensitivity to introduce the concept of depression, treatment of depression by primary care physicians based on established guidelines, and Care Management by a bilingual and bicultural Care Manager under the supervision of a psychiatrist. The goal of this project is to evaluate the effectiveness of this innovative approach compared to usual care. The proposed study will be based at the Massachusetts General Hospital in the Depression Clinical and Research Program, under the mentorship of Dr. Maurizio Fava, MD, and will include consultation from experts in this research area. There will also be a didactic component to the project, include coursework in the cultural aspects of mental illness, methodology of health service research, cost-effectiveness analysis, and ethics. The development of a larger scale R01 project involving different sites and different groups of Asian Americans will be started during the last 2 years of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: CYTOKINE INDUCED DEPRESSION Principal Investigator & Institution: Miller, Andrew H.; Professor; Emory University 1784 North Decatur Road Atlanta, GA 30322

Studies 47

Timing: Fiscal Year 2003; Project Start 11-AUG-2003; Project End 30-JUN-2008 Summary: Depression in the medically ill occurs 5-10 times more often than depression in the general population and has a significant impact on treatment adherence, quality of life, and morbidity and mortality. New developments in the conceptualization of depression in the medically ill have focused on the potential role of immune activation/inflammation and the associated release of proinflammatory cytokines. Proinflammatory cytokines have been found to influence neurobiologic function and induce a depressive syndrome that has overlapping features with major depression. The long term objective of the proposed work is to further understand the pathophysiology and treatment of this cytokine-induced depression as it relates to depression in the medically ill. To accomplish this goal, we plan to develop an animal model of cytokineinduced depression using rhesus monkeys administered the cytokine, interferon (IFN) alpha. IFN alpha is a potent inducer of proinflammatory cytokines (especially interleukin 6) and leads to depressive symptoms in 30-50% of patients depending on dose. In addition, IFN alpha activates corticotropin releasing factor (CRF) pathways and has been shown to lead to monoamine depletion in laboratory animals (including rhesus monkeys). In addition, IFN alpha has been shown to alter fronto-striatal neurocircuitry in humans and induce REM sleep changes (decreased REM latency, increased REM percentage) consistent with depression in both humans and rhesus animals. Thus, IFN alpha treatment provides a unique model system to further understand the pathophysiology and treatment of cytokine-induced mood disorders. The specific aims of the proposed work are 1) to characterize neuroendocrine, monoamine, immune and behavioral responses of rhesus monkeys to IFN alpha and 2) to examine the therapeutic efficacy (capacity to reverse IFN alpha-induced neuroendocrine, monoamine, immune and behavioral changes) of pharmacologic compounds that antagonize activation of the cytokine network (NK-1 antagonists), antagonize CRF, or increase the activity of neurotransmission in monoamine neurocircuits. Relevant techniques to be used to accomplish these aims will include repeated blood and CSF sampling, telemetric polysomnography, microPET, and behavioral analysis of fear potentiated startle and social interactions. Results from these studies will identify novel targets as well as pharmacologic strategies for treatment of mood disorders in the medically ill. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION & MORTALITY FOLLOWING MYOCARDIAL INFARCTION Principal Investigator & Institution: Carney, Robert M.; Professor of Medical Psychology; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2003; Project Start 01-SEP-1997; Project End 30-APR-2006 Summary: (provided by applicant): This is a competitive renewal application for a study of cardiovascular autonomic dysregulation as a mechanism linking depression to mortality after acute myocardial infarction (MI). Pinpointing the mechanism is an important goal because it is one of the key steps in developing a treatment for post-MI depression that improves the chances for cardiac event-free survival. During the first 4 years of the study, a cohort of 356 depressed and 411 non-depressed post-MI patients were recruited and followed for up to 30 (mean = 24) months, during which time 47 deaths and 57 recurrent non-fatal MIs were documented. This cohort includes far more depressed patients than any other study of depression and mortality after MI, is highly diverse (40% women, 25% minorities), and very well characterized medically, with 100% follow-up. The original hypotheses were that both depression and low HRV predict

48 Depression

mortality in post-MI patients, depressed post-MI patients have lower HRV than do nondepressed patients, and low HRV mediates the relationship between depression and mortality. The findings provide robust support for the first two hypotheses and partial support for the third. The proposed renewal will extend the follow-up of this unique cohort in order to increase the number of endpoints and derive new, state-of-the-art measures from the existing Holter monitor tapes, including QT interval measures and nonlinear and wavelet indices of HRV. These variables have recently been shown to be highly sensitive to specific components of cardiac autonomic modulation, and there is growing evidence that they are better predictors of mortality and other cardiac events than the traditional HRV indices. The specific aims of the study are (1) to determine whether novel nonlinear and wavelet indices of HRV and QT interval variability are associated with depression and with mortality after acute myocardial infarction, (2) to determine whether they mediate the effect of depression on mortality after acute MI, and (3) to determine whether nighttime cardiovascular autonomic dysregulation in depressed post-MI patients is a stronger predictor of mortality than is daytime dysregulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATMENTS

DEPRESSION

AND

ANXIETY--REFINING

EFFICACIOUS

Principal Investigator & Institution: Moras, Karla K.; Assistant Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 15-JUL-1997; Project End 30-JUN-2002 Summary: An Independent Scientist Award is sought to enable the applicant to devote major effort to mental health treatment research, specifically to the identification, development, and refinement of efficacious and efficient treatments for the most common presenting problems of adult outpatients (e.g, depression, comorbid anxiety and depression, interpersonal problems). The award also is sought to augment the applicant's expertise in treatment research with training in mental health services research, cost-effectiveness evaluation, and advanced statistical techniques. The specific research aim f the award is to conduct two treatment development projects, each on a patient group that is poorly or incompletely responsive to existing treatments that have been found to be efficacious for patients with similar disorders and symptoms. One group is referred to as having "drug resistant depression" (DRD), the other group has a specific pattern of DSM-IV Anxiety and Mood Disorder comorbidity. The ultimate aim of the DRD work is to develop an effective combined cognitive therapy (CT) + drug treatment for DRD. Three immediate aims are to: (1) Extend CT to the treatment of DRD by integrating three existing forms of CT: CT for depression, CT for personality disorders, and CT for anxiety disorders; (2) develop a treatment manual for conducting CT + drug treatment that will optimize the efficacy of combined treatment for DRD, and (3) obtain outpatient pilot outcome data on the combined CT + drug treatment to determine if it merits further investigation in a controlled clinical trial. The second project extends the applicant's prior developmental research on a psychotherapy that integrates cognitive-behavioral anxiety control techniques (ACT) with Interpersonal Psychotherapy for Depression (IPT) for patients with DSM-IV Generalized Anxiety Disorder (GAD) and an independent Major Depressive Episode (MDE). Two central aims are to: (1) Evaluate the effects of two alternative strategies for sequencing the components of ACT + IPT on symptoms of anxiety and depression, and (2) obtain pilot data on ACT + IPT to compare with outcomes of diagnostically and symptomatically matched patients who receive CT at the University of Pennsylvania Center for Cognitive

Studies 49

Therapy to evaluate the treatment's potential to have enhanced benefit for GAD + MDE, compared to existing standard treatments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND AUTONOMIC CONTROL IN POST-MI PATIENTS Principal Investigator & Institution: Watkins, Lana L.; Duke University Durham, NC 27706 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2007 Summary: (provided by applicant): Approximately one out of four medically ill patients have depression, and the prevalence is projected to increase during the twenty-first century. Depression independently predicts mortality and considerable evidence suggests that depression may increase risk through lowering parasympathetic (PSNS) control of the heart and increasing sympathetic nervous system (SNS) activity. Depression may be especially harmful following an acute myocardial infarction (MI), where clinical depression is associated with a 2- to 4-fold increase in mortality. In the acute phase following an MI, there is a transient denervation of the PSNS and a marked increase in SNS activity. During this period, low PSNS control and high SNS activity are strongly predictive of subsequent fatal cardiac events. Because depression itself is associated with reduced PSNS and increased SNS activity, the presence of depression may exacerbate the impaired PSNS control and increased SNS activity observed after an MI. The purpose of this study is twofold: (1) to examine the effects of depression on PSNS control and SNS activity after MI; and (2) to examine the biobehavioral pathways involved in the altered PSNS and SNS control associated with depression by evaluating the contribution of anxiety, physical activity, and medical comorbidity to this relationship. The effects of depression, anxiety, physical activity, and medical comorbidity on PSNS and SNS control and recovery will be determined in 360 post-MI patients, assessed at two weeks, six weeks, and thirteen weeks post-MI. At the time of each assessment, depression will be measured using a diagnostic interview and anxiety will be measured using the Spielberger state-trait anxiety inventory. SNS activity will be determined by the excretion of urinary catecholamines over 24-hours, and PSNS control will be measured from baroreflex sensitivity and 24-hour heart rate variability; each of these measures are prognostic of mortality. Physical activity will be estimated using 24hour wrist actigraphy. We believe that the study findings will further our understanding of the biobehavioral pathways that link depression to altered autonomic nervous system control, and provide the basis for developing evidence-based treatment programs to improve prognosis in depressed patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION AND BRAIN STRUCTURE IN TYPE 1 DIABETES Principal Investigator & Institution: Jacobson, Alan M.; Senior Vice President; Joslin Diabetes Center Boston, MA 02215 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2006 Summary: (provided by applicant): There is growing evidence that type 1 diabetes leads to an increased prevalence of depressive disorders and preliminary data suggesting that the metabolic disturbances associated with diabetes, both severe hypoglycemia and persistent hyperglycemia, lead to changes in brain structure and cognition. These findings, together with research on structural changes in the brain among depressed patients without diabetes, suggest that diabetes could cause structural changes in the

50 Depression

brain that lead to depression. No studies have evaluated mechanisms underlying the etiology of depression among patients with type 1 diabetes. Using a cross sectional research design, we propose to study six groups of subjects: All subjects (N = 180) will be ages 30-40, right-handed and matched according to age, gender and SES. Diabetic patients will have between a 15-25 year history of types of diabetes. There will be three groups of diabetic subjects without psychiatric history: 1. Well controlled (0-1 episodes of severe hypoglycemia; mean HbA1c over history of diabetes equal to or 3 episodes of severe hypoglycemia; mean HbA1c over time equal to or 9.0%; 0-1 hypoglycemic episodes). A fourth group of diabetic subjects with a history of unipolar major depression and who equally represent the glycemic control characteristics of the other three diabetic groups will also be studied. In addition, two non-diabetic control groups (history of depression; no psychiatric history) will also be studied. We will assess these patients as to brain structure, using Magnetic Resonance Imaging (MRI); depression, using the Structured Clinical Interview for DMS IV (SCID); and cognition using the Wechsler Adult Intelligence Scale III (WAIS III) and other neuropsychological tests of memory, psychomotor speed and mental efficiency. We will also evaluate medical factors (e.g., glycemic control-HbA1c; and history of severe hypoglycemia). We will examine whether: 1) structural abnormalities are more common in diabetic subjects compared to the matched community controls; 2) there is a relationship between diabetes specific medical variables, such as long-term glycemic control, and brain structure abnormalities; 3) structural abnormalities are more common in diabetic patients with a history of unipolar major depression than diabetic patients without a history of depression; and 4) the frequency of structural abnormalities in the brain among diabetic patients with a lifetime history of unipolar depression differs from the depression control group. The proposed research will, for the first time, provide evidence regarding the linkage between structural changes in the brain and depressive disorder in diabetes, and evidence about the relationship of type I diabetes and its attendant metabolic disturbances to structural changes in the brain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND CHILD ASTHMA: EFFECTS OF FAMILY RELATIONS Principal Investigator & Institution: Wood, Beatrice L.; Associate Professor of Psychiatry; Psychiatry; State University of New York at Buffalo 402 Crofts Hall Buffalo, NY 14260 Timing: Fiscal Year 2003; Project Start 01-DEC-2002; Project End 30-NOV-2007 Summary: (provided by applicant): Depression and family dysfunction have been implicated as factors complicating childhood asthma. Direct psychobiologic links have been proposed, but previous studies were limited by lack of integrative models and research methods capable of investigating specific pathways and mechanisms. Wood's 3iobehavioral Family Model (BBFM) proposes specific family relational patterns and child psychological "processes which interact so as to influence physiological processes affecting physical disease in the child. Miller's Autonomic Nervous System (ANS) Dysregulation Model of Emotional Influence in Asthma proposes vagal bias as mediating the effect of depression on airway function. A hypothalamic-pituitaryadrenal (HPA)-immune mechanism is also postulated. The proposed project integrates these two conceptual models to test a family-depression-airway pathway. A controlled laboratory protocol will be used to elicit family interaction in synchrony with physiological measures. Structural Equation Modeling will assess the primary hypotheses: 1)Negative family emotional climate, parental conflict, triangulation of child

Studies 51

in conflict predict depression/hopelessness in the child; 2) The family-depression effect is moderated by parent-child relationship security; 3) Depression predicts airway compromise, which is mediated by vagal bias and/or hypo-HPA function. Children with asthma (N= 320, age 7-12; about 60% boys) and their families will be recruited from the Emergency Department at Children's Hospital of Buffalo. Four weeks later they will have a clinical asthma evaluation and participate in Wood's Family Problem Solving Interaction Tasks (FPSIT). Throughout the protocol, cardio-impedance methods will be used to measure sympathetic and vagal branches of ANS function to index vagal bias in the child. Salivary cortisol response will examine a possible (HPA) pathway. Pulmonary function tests will assess airway compromise. Family interactions will be rated using a reliable and valid instrument (SCIFF). Questionnaires and interview will provide convergent data. This work will lay the foundation for controlled intervention studies, ultimately leading to the reduction of morbidity and mortality in childhood asthma. It will also fill a gap in understanding relationships between family patterns of relationship and the co-morbid conditions of emotional disorder and physical disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND CHRONIC PAIN IN MARRIAGE Principal Investigator & Institution: Cano, Annmarie; Psychology; Wayne State University 656 W. Kirby Detroit, MI 48202 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The principal investigator (PI) is requesting five years of funding through the Scientist Development Award for New Minority Faculty (K01). The career development goals described in this application include testing an integrative model of depression and chronic pain developed by the applicant and training in theoretical and conceptual issues, advanced longitudinal statistical methods, objective interview assessment of life events, observational research methods with couples, and the responsible conduct of research with ethnic minorities. These activities are expected to build on the Pl's strong research and clinical background in marriage and enhance her ability to produce sophisticated scholarly work. Major depression and chronic pain are costly public health problems in the United States that are highly comorbid with each other. Although research suggests that marital variables may contribute to depression, researchers have yet to integrate existing theory and empirical findings into a comprehensive model that accounts for the interrelationships between marital functioning, chronic pain, and depression. Building on the career development activities described in the application, the PI will test an integrative model of the comorbidity of chronic pain and depression in which marital functioning plays a key role. The long-term objective of the study is to develop marital treatments for individuals experiencing both depression and chronic pain. The specific aims of the study include examining how changes in general marital functioning (e.g., marital satisfaction, affect expressed in a marital interaction, marital stressors), pain-specific marital functioning (e.g., spouse responses to pain, affect expressed in a marital interaction related to the impact of pain on the couple), and pain factors (e.g., pain severity, disability) relate to changes in depression over time. Participants will be 160 married couples in the community in which one spouse has a chronic musculoskeletal pain problem. Participant couples will complete surveys, a diagnostic interview for major depression, a life events interview, and two videotaped marital interactions. Participants will also take part in 6- and 12-month follow-ups in which they will complete the same instruments. Participants will be paid upon completion of each phase of the study.

52 Depression

Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND DISABILITY IN PATIENTS WITH HEART FAILURE Principal Investigator & Institution: Turvey, Carolyn L.; Psychiatry; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: Description (adapted from investigator's abstract): In this application for a Mentored Research Scientist Development Award, Carolyn L. Turvey will obtain expertise in the relation between physical disability and depression in late-life. Dr. Turvey will study the relationship between physical disability and depression in elder patients with congestive heart failure (CHF). Heart failure is a major source of disability in the elderly because patients experience fatigue and breathlessness when performing even minor activities of daily living. Accordingly, there are high rates of depression in heart failure patients, ranging from 17-26 percent. Disability is strongly associated with depression for this group. Dr. Turvey aims to identify how patients with CHF can cope successfully with their illness and with physical disability. She will compare CHF patients with and without depression on their level of disability, how they cope with the illness and disability, and the degree and quality of social support they receive. She will then determine which of these factors predicts time to remission of a depressive episode. She will use the information gathered in this study to develop interventions designed to reduce depression in CHF patients. She will develop a brief intervention that teaches CHF patients cognitive and behavioral skills for coping with their illness and the most effective ways of engaging social support. Dr. Turvey proposes a training and research program making use of the diverse resources at the University of Iowa the Departments of Psychiatry, Psychology, Epidemiology and the Aging Studies Program. Dr. Turvey seeks training in gerontology and the design and implementation of outcomes research. As part of this training, she has arranged visits to other sites that specialize in the treatment of late-life depression and the relation between depression and disability in the elderly. Her long-term career goal is to develop interventions that promote healthy aging amongst elders faced with functional decline. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION AND HEALTH BEHAVIOR IN LATE LIFE Principal Investigator & Institution: Kaplan, Mark S.; School of Community Health; Portland State University Box 751 Portland, OR 97207 Timing: Fiscal Year 2001; Project Start 01-DEC-1999; Project End 30-NOV-2002 Summary: (Adapted from the Applicant's Abstract): The overall purpose of this study is to expand the health behavior-health status model to include depressive symptoms and related psychosocial factors as components, thus capturing a more comprehensive conceptualization of the role behavioral factors play in the health of older adults. An understanding of these interactive and dynamic relationships between psychosocial resources, depression, and health behavior may lay the foundation for developing more effective public health interventions. The specific goals of this research are (1) to assess the effects of depression and psychological distress on health behaviors among older adults. (2) To examine the role of depression and depressive symptoms (including their psychosocial antecedents) among older men and women who engage in behaviors which are harmful to their health, and (3) to initiate a longitudinal study to identify and assess the directionality of the causal relationships between general risk factors

Studies 53

(including deficits in psychological and social resources and life event-related stress), depression, and health behaviors. The proposed study will utilize cross-sectional and panel data derived from the Canadian National Population Health Survey (NPHS). The NPHS data are especially attractive for the analyses of depression and health in late life. The survey contains data on a myriad of factors for analytic studies that will assist in understanding the determinants of physical and mental well being. Also, with regard to forecasting the impact on U.S. health policy formulation and analysis, the NPHS has several attractive features. First, the sample is representative of the entire population [From which it is drawn. Studies also suggest that health behaviors among older adults in Canada can be generalized to the U.S.] Second, the survey is longitudinal. Third, the interview data (including standardized psychiatric instruments) will be linked in the near future with health care utilization information obtained from automated record keeping systems. Fourth, the survey information is recent. Fifth, older adults are well represented. Because recent epidemiologic studies suggest that health-promoting habits appear to augment biologic vitality/host resistance in late adulthood, it is critical to understand the psychosocial factors that affect health behaviors. Although numerous researchers have examined the psychosocial factors associated with late life depression, little evidence has accrued regarding how depressive symptoms and their psychosocial antecedents affect health behavior which in turn might exert a negative impact on longevity and disability in older populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND HEALTH OUTCOMES IN REFRACTORY EPILEPSY Principal Investigator & Institution: Gilliam, Frank G.; Neurology; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 24-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): Epilepsy is the most prevalent disabling neurologic illness, and depression is the most frequent comorbid condition associated with epilepsy. The prevalence of depression is 20-50 percent in patients with uncontrolled seizures. This combination affects between 250,000 and 450,000 people in the United States. Our recent clinical studies have shown that depression is a strong predictor of function and health outcomes in epilepsy. Despite the marked adverse effects and high prevalence of depression in epilepsy, most affected patients are not treated. This complacency toward treatment may result from insufficient use of diagnostic screening, the widespread belief that antidepressants lower the seizure threshold, or lack of demonstrated efficacy in the only controlled trial of antidepressant medications in epilepsy. The broad aims of this study are to define the benefits of antidepressant treatment on mood, compliance, and health outcomes in epilepsy patients with comorbid major depression. Based on our prior clinical and research experience, we hypothesize that 1) pharmacotherapy or psychotherapy will reduce depression and improve health-related quality of life in patients with refractory epilepsy, 2) antiepileptic medication compliance will improve after reduction of depression, 3) seizure frequency will not significantly increase during treatment with a selective seratonin reuptake inhibitor compared to psychotherapy, and 4) depression and antiepileptic medication toxicity are stronger predictors of health-related quality of life than seizure frequency or severity in patients with refractory epilepsy. The hypotheses will be tested through a randomized trial comparing the efficacy of sertraline (n=127) to cognitive behavior therapy (n=127) for mood and health outcomes in patients with refractory epilepsy and depression. Reliable and valid measures will be used to assess depression and health-

54 Depression

related quality of life. Electronic, computer-assisted monitoring will determine compliance. Multivariate repeated-measures analyses will be used to determine the interrelationships of treatment, mood, antiepileptic medication toxicity, seizure frequency and severity, compliance and health-related quality of life. We anticipate that dissemination of the results of a positive study will support the modification of the current model of intervention for epilepsy from predominantly seizure reduction to a more comprehensive approach that includes assessment and treatment of depression Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND CARDIOVASCULAR PATHOLOGY

HEART

FAILURE

ASSOCIATED

Principal Investigator & Institution: Johnson, Alan K.; Associate Professor; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2003; Project Start 21-JAN-2003; Project End 31-DEC-2007 Summary: Depression is both a debilitating psychological disorder and a condition that affects an individual's physical well-being. Depression is a recognized risk factor for heart disease. Research has demonstrated that depression predisposes an individual to myocardial infarction, sudden death, atherosclerosis, thrombosis and arrhythmias. While the behavioral and cognitive aspects of depression have been studied extensively, there has been much less research investigating the mechanisms responsible for the physiological consequences of mood disorders. Exposure of rodents to a series of chronic mild stressors (CMS) generates key behavioral characteristics of human depression that are observable and quantifiable. The CMS model of experimentallyinduced depression (ID) mimics the reduced responsiveness to pleasurable stimuli (anhedonia)which is a pivotal diagnostic criterion seen in depression. In the CMSdD model, anhedonia is induced by presenting mild unpredictable stressors (e.g., paired housing, stroboscopic illumination, white noise) of varying durations. In rats,anhedonia is operationally defined as a decrease in responding for a previously demonstrated reinforcer (reward). Recently, we have begun to characterize cardiovascular function in rats with CMS-ID. We have found that rats exposed to CMS for 4 weeks showed anhedonia along with cardiovascular alterations. Similar to patients with depression and with heart failure,CMSgD rats had elevated resting heart rates and reduced heart rate variability. In addition, rats exposed to CMS have increased susceptibility to experimentally-induced premature ventricular contractions. In other studies investigating the behavioral consequences of heart failure, we have found evidence of anhedonia (i.e., experimental depression) in rats with experimental myocardial infarction. The proposed research program will extend our characterization of the cardiovascular changes that accompany experimentally-induced depression and investigate the role of brain serotonergic mechanisms that are hypothesized to be common in the mediation of cardiovascular alterations that accompany both experimental depression and experimental heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND HIV RISK BEHAVIOR IN AN STD CLINIC Principal Investigator & Institution: Erbelding, Emily J.; Assistant Professor of Medicine; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 15-JAN-2000; Project End 31-DEC-2003 Summary: There is a high prevalence of depression in HIV-infected populations, as well as in some HIV-uninfected populations at risk for HIV. Depressive symptoms

Studies 55

themselves have been associated with behaviors that transmit HIV infection. The aim of the proposed cross-sectional study to define the epidemiology of depression, as well as any substance use disorders that may interact with depression in those attending an inner city STD clinic who are known to be at high risk for acquiring HIV. Those who present with symptoms of a new STD or as an STD contact will be eligible for enrollment. They will undergo (1) screening for depression using the Beck Depression Inventory and General Health Questionnaire; (2) behavioral assessment for HIV transmitting behaviors by confidential computer-based survey; and (3) clinical and laboratory evaluation for STDs. Of the 700 enrolled participants, 200 will additionally undergo a structured clinical interview in order to establish a specific DSM-IV diagnosis. The data generated will allow us to describe (1) the prevalence of major depression and substance use disorders in an STD clinic population at high risk for HIV; (2) the independent association of depression with behaviors that transmit HIV infection; (3) the independent association between depression and biologic measure of risk, an STD diagnosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION AND PRODUCTIVE WORK ACTIVITY Principal Investigator & Institution: Lerner, Debra J.; New England Medical Center Hospitals 750 Washington St Boston, MA 021111533 Timing: Fiscal Year 2001; Project Start 08-SEP-2000; Project End 31-AUG-2004 Summary: (Applicant's abstract): While depression is a leading cause of work disability in this nation, disability reduction efforts remain hampered by a lack of research. This study's long-term goal is to prevent work disability due to depression. A longitudinal study is proposed that addresses on-the-job work disability among employed primary care patients with depression. The sample will include 350 patients who have Major Depressive Disorder (MDD) and/or dysthymia and are employed at baseline, and two comparison groups: 1)) 200 workers with rheumatoid arthritis (PA), a physically limiting condition with one of the highest work disability rates; and 2) 100 "healthy" controls. The study has 3 specific aims: 1) to prospectively assess and compare the rates at which four types of work disabilities (job loss, work time loss, reduced work hours and on-the-job limitations) occur among the groups; 2) to identify variables that contribute to successful and unsuccessful work outcomes among patients with depression; 3) to determine whether the variables that contribute to work disability are the same for depression and RA. The project's health-relatedness is its focus on a major public health problem (work disability due to depression) within an increasingly important segment of the mental health care delivery system (primary care). Subjects will be recruited from primary care practices, 18-62 years of age, employed at baseline and not planning to stop working for at least 2 years. Data will be collected from patient surveys (baseline and months 3, 6, 12 and 18), patient charts and clinic pharmacy records. We will also administer a new validated survey instrument; The Work Limitations Questionnaire, which assesses on-the-job performance and productivity and, thus, captures aspects of work disability not reflected in job loss and absenteeism data. The statistical analysis will: 1) establish the magnitude of the four types of work disability and work productivity costs within the depression sample); 2) identify variables that predict work disability or a sustained ability to work; and 3) determine the differential impact of a mental and a physical illness on work disability rates, the predictors of work disability and productivity costs. Study results will contribute to the design of disability prevention and productivity improvement programs and policies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

56 Depression

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Project Title: DEPRESSION IN ADAPTATION TO OPEN-HEART SURGERY Principal Investigator & Institution: Goyal, Tanya M.; Psychology; Rutgers the St Univ of Nj New Brunswick Asb Iii New Brunswick, NJ 08901 Timing: Fiscal Year 2001; Project Start 01-JUN-2001 Summary: Applicant?s The proposed study will examine the effects of depressive symptomatology on physical and psychological adaptation to open-heart surgery. There is growing evidence suggesting that depression may influence the development and progression of coronary heart disease as well as recovery following cardiac events. While several physiological and behavioral pathways have been proposed to explain these associations, potential psychological mechanisms have rarely been considered. In addition to evaluating effects of depression on adaptation to cardiac surgery, this study will examine the role of social cognitive variables as mediators of these effects. The specific aims of this study are to test the following hypotheses: (1) Lower levels of preoperative depression will predict shorter hospitalizations following surgery; (2) Lower levels of preoperative depression will predict less angina and better physical functioning six months after surgery; (3) Lower levels of preoperative depression will predict less anxiety six months after surgery; and (4) These effects will be partially mediated by outcome expectancies and efficacy expectancies regarding behavioral and social activities associated with recovery. This project seeks to advance theoretical understanding of the relationship between psychosocial factors and physical illness. Additional long-term goals of this research include improving pre-surgical identification of cardiac patients at risk for poor outcomes, the development of psychosocial interventions for this population, and ultimately, the enhancement of surgical outcomes and long-term adaptation to chronic disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION IN ALZHEIMER'S DISEASE STUDY 2 (DIADS-2) Principal Investigator & Institution: Porsteinsson, Anton P.; Psychiatry; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2003; Project Start 10-JUN-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Depression in the context of Alzheimer's disease (AD) is a significant public health problem with serious adverse consequences for patients and their caregivers. There has been little research into the course or treatment of depression associated with AD. This is in part due to the absence of validated operational criteria for defining depression in AD. Recently, NIMH convened an expert consensus panel to develop draft criteria for depression of Alzheimer's disease (dAD) and to establish research priorities in this area. These criteria are intended to facilitate further studies of the course and treatment of depression in AD. The first aim of the proposed multicenter study is to determine whether individuals with dAD respond to antidepressant treatment using the medication sertraline in a 12-week randomized, controlled, double blind trial. The second aim is to establish whether earlier treatment of depression in AD affects critical non-mood outcomes such as cognition, quality of life, activities of daily living and caregiver variables, over 24 weeks. The third aim is to validate the dAD syndrome by evaluating its course and response to treatment in comparison to other diagnostic conceptualizations of depression in AD, over six months. These aims are consistent with priorities articulated by the NIMH expert consensus panel. 130 patients meeting criteria for dAD, and their caregivers, will be recruited into the study at five clinical centers: Johns Hopkins, University of Southern California, University of Rochester, University of Pennsylvania, and Medical University

Studies 57

of South Carolina. The study will be coordinated by the Johns Hopkins Center for Clinical Trials. After detailed baseline characterization participants will be randomized to treatment with sertraline or placebo for at least twelve weeks and followed for up to 24 weeks. All patients and caregivers will receive psychosocial interventions for Alzheimer's and depression. Patient outcomes will include: global improvement of the depressive disturbance, ratings on a depression scale, quality of life, cognitive functioning, activities of daily living, behavioral disturbance, and adverse events. Caregiver outcomes will include: depression, quality of life, and care giving burden. Regarding the first study aim, analyses will compare the two treatment groups on patient mood outcomes in the first twelve weeks. Regarding the second study aim, analyses will compare the two treatment groups on the trajectories of patient critical AD patient outcomes (cognition, functioning, quality of life, behavior) and of caregiver outcomes over 24 weeks. Regarding the third aim, analyses will examine the longitudinal course of depressive symptoms and of depressive syndromes in the context of Alzheimer's using three different syndromic definitions: dAD, DSM-IV, and "Alzheimer's Associated Affective disorder" derived empirically. The predictive validity of defining depression in AD using a symptom scale or each of these syndromes will be assessed longitudinally against the various study outcomes, and against efficacy of response to antidepressant treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION IN ALZHEIMER'S DISEASE STUDY-2(DIADS-2) Principal Investigator & Institution: Katz, Ira R.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2003; Project Start 18-AUG-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Depression in the context of Alzheimer's disease (AD) is a significant public health problem with serious adverse consequences for patients and their caregivers. There has been little research into the course or treatment of depression associated with AD. This is in part due to the absence of validated operational criteria for defining depression in AD. Recently, NIMH convened an expert consensus panel to develop draft criteria for depression of Alzheimer's disease (dAD) and to establish research priorities in this area. These criteria are intended to facilitate further studies of the course and treatment of depression in AD. The first aim of the proposed multicenter study is to determine whether individuals with dAD respond to antidepressant treatment using the medication sertraline in a 12-week randomized, controlled, double blind trial. The second aim is to establish whether earlier treatment of depression in AD affects critical non-mood outcomes such as cognition, quality of life, activities of daily living and caregiver variables, over 24 weeks. The third aim is to validate the dAD syndrome by evaluating its course and response to treatment in comparison to other diagnostic conceptualizations of depression in AD, over six months. These aims are consistent with priorities articulated by the NIMH expert consensus panel. 130 patients meeting criteria for dAD, and their caregivers, will be recruited into the study at five clinical centers: Johns Hopkins, University of Southern California, University of Rochester, University of Pennsylvania, and Medical University of South Carolina. The study will be coordinated by the Johns Hopkins Center for Clinical Trials. After detailed baseline characterization participants will be randomized to treatment with sertraline or placebo for at least twelve weeks and followed for up to 24 weeks. All patients and caregivers will receive psychosocial interventions for Alzheimer's and depression. Patient outcomes will include: global improvement of the depressive disturbance, ratings on a depression scale, quality of life, cognitive

58 Depression

functioning, activities of daily living, behavioral disturbance, and adverse events. Caregiver outcomes will include: depression, quality of life, and care giving burden. Regarding the first study aim, analyses will compare the two treatment groups on patient mood outcomes in the first twelve weeks. Regarding the second study aim, analyses will compare the two treatment groups on the trajectories of patient critical AD patient outcomes (cognition, functioning, quality of life, behavior) and of caregiver outcomes over 24 weeks. Regarding the third aim, analyses will examine the longitudinal course of depressive symptoms and of depressive syndromes in the context of Alzheimer's using three different syndromic definitions: dAD, DSM-IV, and "Alzheimer's Associated Affective disorder" derived empirically. The predictive validity of defining depression in AD using a symptom scale or each of these syndromes will be assessed longitudinally against the various study outcomes, and against efficacy of response to antidepressant treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION IN ALZHEIMER'S DISEASE-II Principal Investigator & Institution: Martin, Barbara K.; Epidemiology; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2003; Project Start 05-JUN-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Depression in the context of Alzheimer's disease (AD) is a significant public health problem with serious adverse consequences for patients and their caregivers. There has been little research into the course or treatment of depression associated with AD. This is in part due to the absence of validated operational criteria for defining depression in AD. Recently, NIMH convened an expert consensus panel to develop draft criteria for depression of Alzheimer's disease (dAD) and to establish research priorities in this area. These criteria are intended to facilitate further studies of the course and treatment of depression in AD. The first aim of the proposed multicenter study is to determine whether individuals with dAD respond to antidepressant treatment using the medication sertraline in a 12-week randomized, controlled, double blind trial. The second aim is to establish whether earlier treatment of depression in AD affects critical non-mood outcomes such as cognition, quality of life, activities of daily living and caregiver variables, over 24 weeks. The third aim is to validate the dAD syndrome by evaluating its course and response to treatment in comparison to other diagnostic conceptualizations of depression in AD, over six months. These aims are consistent with priorities articulated by the NIMH expert consensus panel. 130 patients meeting criteria for dAD, and their caregivers, will be recruited into the study at five clinical centers: Johns Hopkins, University of Southern California, University of Rochester, University of Pennsylvania, and Medical University of South Carolina. The study will be coordinated by the Johns Hopkins Center for Clinical Trials. After detailed baseline characterization participants will be randomized to treatment with sertraline or placebo for at least twelve weeks and followed for up to 24 weeks. All patients and caregivers will receive psychosocial interventions for Alzheimer's and depression. Patient outcomes will include: global improvement of the depressive disturbance, ratings on a depression scale, quality of life, cognitive functioning, activities of daily living, behavioral disturbance, and adverse events. Caregiver outcomes will include: depression, quality of life, and care giving burden. Regarding the first study aim, analyses will compare the two treatment groups on patient mood outcomes in the first twelve weeks. Regarding the second study aim, analyses will compare the two treatment groups on the trajectories of patient critical AD patient outcomes (cognition, functioning, quality of life, behavior) and of caregiver

Studies 59

outcomes over 24 weeks. Regarding the third aim, analyses will examine the longitudinal course of depressive symptoms and of depressive syndromes in the context of Alzheimer's using three different syndromic definitions: dAD, DSM-IV, and "Alzheimer's Associated Affective disorder" derived empirically. The predictive validity of defining depression in AD using a symptom scale or each of these syndromes will be assessed longitudinally against the various study outcomes, and against efficacy of response to antidepressant treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION IN BLACK AND WHITE ADOLESCENT GIRLS Principal Investigator & Institution: Franko, Debra L.; Psychology; Wesleyan University Middletown, CT 06459 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2003 Summary: (provided by applicant): The broad, long-term goal of this research is the development of effective preventive interventions to reduce the prevalence of common mental disorders among adolescent and young adult women. Specifically, the aims of this project are to clarify the risk factors for and consequences of depression and related psychopathology in female Black and White adolescents and young adults. By increasing our understanding of the vulnerabilities for and outcomes of depression, more specific and effective prevention strategies can be developed. The three major aims of this project are: 1) To determine ethnicity-specific prevalence rates of depressive symptoms and syndromes of depression in Black and White females during adolescence and early adulthood; 2) To test a bio-psycho-social model of risk for depression in Black and White girls, by exploring the relationship between risk factors (e.g., coping style, body image, pubertal timing, and stressful life events) and the emergence of depressive symptoms during adolescence; 3) To examine the outcomes of adolescent depression for Black and White women. The following outcome variables will be investigated: obesity and health services utilization, psychosocial factors, and psychiatric comorbidity. Capitalizing upon the availability of extensive data collected prospectively among an exceptionally well-maintained cohort of 2,3 79 Black and White females over a 12-year period (from ages 9-10 to ages 2 1-23), we propose to apply innovative analytic procedures to further the scientific understanding of risk factors, course, and outcomes of depressive symptoms in adolescence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION IN ELDERLY CARDIAC PATIENTS Principal Investigator & Institution: Krishnan, Ranga R.; Chairman and Professor; Psychiatry; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-APR-1994; Project End 30-NOV-2003 Summary: High rates of depression have been reported in patients with neurological disorder, endocrinologic/metabolic disorder, post- myocardial infarction, malignancy, and chronic obstructive pulmonary disease. Studies have documented a clear excess of cardiovascular disorders among older compared with younger depressed patients. Rates of persistent depressive disorder in middle-aged and elderly persons following myocardial infarction have been especially high. Despite numerous studies in the population of patients with coronary artery disease (CAD) and post myocardial infarction, few studies have focused specifically on the prevalence of depression other psychiatric problems and its prognostic effects in patients with chronic heart failure (CHF). CHF is a major public health problem in the United States. Currently, it is

60 Depression

estimated by the National Heart, Lung, and Blood Institute that over 3 million Americans suffer from CHF, and about 400,000 new cases are diagnosed each year. A large number of factors have been found to correlate with mortality in patents with CHF. Clinically, the presence of CAD as the etiology of CHF, an audible S3, low pulse and systolic blood pressure, a high NYHA functional class (greater than 11), and reduced exercise capacity have been shown to be associated with increased risk of death. There is evidence which suggests that the rate of depression may be high in the CHF population, maybe even higher than the rate in CAD patients. With the evidence of higher mortality and morbidity which occur in CAD patients with depression, it is speculated that CHF patients with depression bear higher mortality and morbidity as well. Provided that depression is modifiable and therefore results in a better outcome, studies to learn the prevalence of depression and its association with prognosis in the CHF population are promptly needed and, if the results are similar to what is observed in the CAD population, trials to evaluate therapeutic interventions will be undertaken consequently. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION INTERVENTION FOR POOR PREGNANT WOMEN Principal Investigator & Institution: Zlotnick, Caron; Associate Professor; Women and Infants Hospital-Rhode Island 101 Dudley St Providence, RI 02905 Timing: Fiscal Year 2001; Project Start 27-AUG-2001; Project End 31-JUL-2004 Summary: (provided by applicant): In the postpartum period, approximately 10 to 16 percent of women will become clinically depressed. The impact of major depression in the postpartum period is profound with considerable emotional pain for the new mother as well as disturbances in infant development. Unfortunately, few preventive interventions have been developed or systematically tested to reduce the risk of postpartum depression. An area of even greater neglect is the development of such an intervention for financially disadvantaged women who are at high risk for postpartum depression and for the disturbances associated with postpartum depression. This treatment development application proposes to develop a psychosocial intervention for financially disadvantaged, pregnant women at risk for postpartum depression. and to collect preliminary data on the efficacy of this intervention in reducing the likelihood of postpartum depression. The intervention, "Life at Home with a New Baby," is an interpersonal-oriented intervention that targets those factors that may play a significant role in the development of postpartum depression (i.e., poor social support, role transitions, and life stressors). More specifically, the aims of this project are to: (i) develop the manual for the intervention, "Life at Home with a New Baby" (ii) develop, implement, and evaluate a therapist training program, (iii) develop and test the reliability and validity of competence and adherence rating scales that evaluate the training therapists' ability to perform the intervention and assess the reliable delivery of the intervention, and (iv) conduct a randomized controlled pilot study to evaluate the initial efficacy of the proposed intervention compared to a care as usual condition in a sample of financially disadvantaged, pregnant women at risk for postpartum depression. and to provide an estimate of effect size in comparison to the care as usual condition. This pilot study will lay the groundwork for a larger clinical trial evaluating the efficacy of this new group intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION ADOLESCENTS

PREVENTION

FOR

AFRICAN-AMERICAN

Principal Investigator & Institution: Robinson, W L.; Professor; Psychology; De Paul University 1 E Jackson Blvd Chicago, IL 60604 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 30-JUN-2003 Summary: (adapted from Investigator's abstract) Low income, inner-city, AfricanAmerican adolescents are at high risk for depression, due to the many stressors associated with being adolescent, poor, and minority. This is an exploratory project that will use a controlled randomized design to examine the impact of a 15-session, groupbased, cognitive-behavioral depression preventive intervention adapted for low income, inner-city African-American adolescents. This study will lay the groundwork for a future effectiveness study. Participants will be 1029 freshmen and 765 sophomore African-American students, attending three inner-city high schools located in lowincome Chicago neighborhoods. They will be administered the Center for Epidemiologic Studies-Depression Scale (CES-D) and the Adolescent Health Assessment-2000, a collection of psychometrically sound instruments which assess the various study variables of interest. Those students who are determined to be at-risk for depression, based on elevated CES-D scores (i.e., _24), will be interviewed using the DISCIV. Variables of interest include stress, coping, aggression, socio-ecological factors, and other indicators of emotional/physical well-being and adjustment. Students who are at-risk for depression but who do not have a current Depressive, Bipolar, Dysthymic, Cyclothymic and/or Conduct Disorder will be randomized to either the culturally adapted 15-session, group-based, cognitive-behavioral depression preventive intervention or the "usual care" control condition. Upon completion of the preventive intervention, students in both conditions will be reassessed using the CESD, the DISCIV, and the AHA-2000 and will be tracked for follow-up assessments at 6 months. Students who meet DSM.-IV criteria for the above mentioned disorders will either be treated by on-site school based health center staff or referred for community-based service. The study will employ multiple data sources including: teachers' reports, school archival data and primary health care records. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION PRONE SMOKERS AND CIGARETTE CRAVING Principal Investigator & Institution: Mcchargue, Dennis E.; Psychology; University of Illinois at Chicago 1737 West Polk Street Chicago, IL 60612 Timing: Fiscal Year 2001; Project Start 10-SEP-2000; Project End 31-AUG-2005 Summary: Dr. McChargue's short-term goals are to enhance the theoretical, methodological, and statistical skills that he needs to study the determinants of nicotine self-administration in smokers with comorbid psycohpathology. His long-term goals are to develop an independent laboratory, as well as a network of research collaborators devoted to advancing our understanding of nicotine dependence and training fixture clinical researchers. The proposed studies will evaluate two premises about smokers with a history of depression that have been assumed but not directly tested. The first proposition is that depression-prone smokers experience greater than normal cigarette cravings when exposed to negative affect cues. The second proposition is that the dysphoria-reducing effects of self-administering nicotine are more potent for depression-prone than non-prone smokers. Study 1 aims to compare the reactivity of smokers with and without history of depression to cues involving smoking paraphernalia and negative mood. Reactivity will be measured via self-report,

62 Depression

behavioral and physiological indices of craving. The hypothesis is that depression-prone smokers will show heightened cue reactivity in general, but will be especially reactive to dysphoric mood cues. The aim of Study 2 is to compare the degree to which smoking a nicotinized versus a denicotinized cigarette alleviates experimentally induced dysphoria in smokers with versus without a history of depression. The hypothesis is that nicotine's potency as a negative reinforcer (i.e., its ability dispel dysphoric mood) will be enhanced for smokers who have a history of depression, as compared to those who lack such a history. These studies will be the first to systematically examine craving responses in depression-prone smokers and to quantify the dysphoria-reducing effects of nicotine administration for this population. Results should increase understanding of mechanisms that mediate the high prevalence and persistence of smoking among depression-prone individuals, and may contribute to the development of novel treatments for this recalcitrant group of smokers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION SCREENING & TREATMENT IN OVARIAN CANCER Principal Investigator & Institution: Shinn, Eileen H.; Behavioral Science; University of Texas Md Anderson Can Ctr Cancer Center Houston, TX 77030 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Dr. Eileen Shinn earned her Ph.D. in Clinical Psychology from Ohio University and is a postdoctoral fellow in the Department of Behavioral Science at M.D. Anderson Cancer Center. Dr. Shinn will use the K07 award to train with a mentoring team comprised of medical and psychosocial experts at M. D. Anderson and four national experts in depression and primary care research (Drs. James Coyne, Lynn Rehm, John Williams, James Bray). This project has a longitudinal design with an embedded feasibility study to evaluate an innovative intervention for depression. The revised prospective screening plan has been expanded to include a hierarchical screening strategy for depression, as well as additional questions about timing of screening, quality of care received, and basic psychological processes which may affect depression. On the other hand, the pilot intervention has been scaled down and now offers patients a choice of treatment, reflecting the reality of depression treatment in managed-care settings. The training plan now includes formal coursework and workshops suggested by the 4 co-mentors, as well as annual training trips to Dr. James Coyne at U. Penn, and regularly scheduled face-to-face meetings with Drs. Lynn Rehm and James Bray, and to a lesser extent, Dr. John Williams. Formal agreements and specific roles with the mentoring team have been documented and are presented. The research and training plan will be conducted at M.D. Anderson, which has a commitment to research and training with numerous didactic and collaborative opportunities. The Gynecologic Cancer Center at M.D. Anderson treats 250-300 different ovarian cancer patients per year. Major depression is the most prevalent psychiatric disorder in cancer patients and severely disables patients' quality of life. Yet depression is underdiagnosed and inadequately treated when recognized. The research plan proposes to address many of the barriers that hinder the detection and treatment of major depression in busy oncology practice settings. The screening plan now features a brief 2-phase screening method which may demonstrate positive predictive value well above other screening instruments. The pilot intervention will test the feasibility and acceptability among depressed ovarian cancer patients. It will be delivered in the patient's home by telephone and a structured cognitive-behavioral therapy (CBT) journal. The pilot intervention will last 10 sessions over 3 months and cover a range of cognitive-behavioral skills. Each skill will suggest a choice of applications ranging from

Studies 63

side-effect management and pain reduction, to concerns about losses in functioning. Drs. Rehm and Taylor will co-supervise Dr. Shinn in the CBT administration. This intervention is innovative and has not been done before with any group of cancer patients, including ovarian cancer patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION DISABILITIES

SELF-MANAGEMENT

AND

WOMEN

WITH

Principal Investigator & Institution: Hughes, Rosemary B.; Phys Med and Rehabilitation; Baylor College of Medicine 1 Baylor Plaza Houston, TX 77030 Timing: Fiscal Year 2001; Project Start 18-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Depression is a common secondary condition associated with a primary disability. Disproportionately high among women compared to men, depression appears to be even more prevalent among women with disabilities. Although the risk for depression among all persons with disabilities appears to be higher than that among people in general, women with disabilities may be at even greater risk comparied to their male counterparts, yet the literature fails to report on a therapeutic modality that is responsive to the unique needs of depressed women with functional limitations. The purpose of this project is to develop and test an innovative, targeted, and theory-driven group intervention designed to ameliorate depression in women with physical disabilities. It is hypothesized that (a) women with disabilities who participate in a depression self-management group intervention will report lower levels of depression and higher levels of self- management of depression, self-efficacy, and social connectedness after the intervention and at a three-month follow-up, compared to those who participate in a depression education-only intervention; and, (b) self-management of depression, self-efficacy, and social connectedness will mediate the relation of disability to depression outcomes among women with physical disabilities. This study uses a randomized with-groups and between-groups pre/post-test design with a three-month follow-up. The intervention will be implemented at local public and private chronic care clinics with 154 women with physical disabilities who will randomly be assigned to participate in either the self- management intervention or education-only comparison workshop. The scores of the two groups on measures of selfmanagement of depression, self-efficacy, social connectedness, and depression will be compared. These assessments will be conducted at three time points, before and after the intervention period and at a three-month follow-up. Formative and summative evaluations, using qualitative and quantitative methodologies, will be conducted. This study is designed to be generalizable for clinical practice in physical medicine and rehabilititation, for mental health services for women with disabilities, and for public health policy governing the delivery of mental health services to people with disabilities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION TREATMENT IN MEDICALLY REHABILITATING ELDERLY Principal Investigator & Institution: Lenze, Eric J.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): This application requests a Mentored PatientOriented Research Career Development Award (K23). The candidate is a geriatric

64 Depression

psychiatrist and postdoctoral research fellow at the University of Pittsburgh who proposes to develop research skills for geriatric psychiatry research in medical rehabilitation settings. Funding of this award would provide time and resources necessary for him to develop into an independent investigator capable of conducting depression intervention studies in elderly patients undergoing rehabilitation after disabling medical events such as hip fracture. Studies of elders undergoing rehabilitation suggest that depression is associated with poorer outcomes and an increased likelihood of permanent disability and institutionalization. Therefore, it would be of tremendous public health benefit to determine the most efficacious interventions for late-life depression in the medical rehabilitation setting. However, little such intervention research has been done, in part because not enough is known about depression in this setting, and in part due the difficulty of carrying out psychiatric Intervention studies in this setting. To perform such research, the candidate will develop skills in the areas of psychiatric assessment of patients in medical settings, design of intervention trials, measurement of rehabilitation outcomes, and data management and biostatistical analysis. Proposed research consists of a longitudinal descriptive study characterizing late-life depression in medical rehabilitation settings, leading to a pilot intervention study assessing effects of depression treatment on rehabilitation outcomes. The proposed activities will take place in the NIMH-funded Intervention Research Center for Late Life Mood Disorders, directed by the candidate's sponsor, in the Department of Psychiatry at the University of Pittsburgh. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION, DISABILITY & REHAB IN VISION IMPAIRED ELDERS Principal Investigator & Institution: Horowitz, Amy; Senior Vice President for Research; Lighthouse International 111 E 59Th St New York, NY 10022 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 29-SEP-2003 Summary: The proposed study builds upon current research addressing the interrelationships among chronic impairment, disability and depression in later life and will make several unique contributions. The study's focus is on subgroup of elders experiencing an extremely common age- related disability, vision impairment, in which the rates of both functional disability and depression are particularly high, but which has received relatively little systematic research attention. The longitudinal design will permit an in-depth examination of the course of depression over time, utilizing a stress and coping conceptual model which incorporates key personal and social resources as mediators of the relationship between disability and depression. Most importantly, the focus on a sample seeking rehabilitation permits us to empirically challenge the assumption of inevitable, reciprocal decline in functional and depressive status. By following the natural course of both depression and rehabilitation service use, a primary long-term goal is to examine the extent to which, and mechanisms by which, this non- psychiatric intervention may influence depression status among disabled elders. This knowledge will provide a foundation for future intervention studies. The specific study aims are: 1. to document the prevalence, course, and severity of depression among visually impaired elders over time. 2. to examine the influence of depression on utilization of vision rehabilitation services. 3. to examine the mechanisms by which vision rehabilitation services may affect the severity and course of depression. 4. to test a longitudinal model explicating the interrelationships among vision impairment severity, co- morbid health conditions, functional disability, rehabilitation service utilization and depression, and how such relationships are mediated by

Studies 65

personal and social resources. 5. to examine gender differences relative to aims 1-4 above. 600 elders (300 of each gender) will be sampled from applicants, age 65+, of a vision rehabilitation agency. Subjects will be assessed 4 times (at baseline, 6, 12 and 18 months) in order to examine both short and long-term causal relationships among key variables. Analyses address concurrent associations (cross-sectional) and prospective relationships (longitudinal) using regression and structural equation modeling (SEM) techniques. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION, DUAL DIAGNOSIS AND ANTIRETROVIRAL ADHERENCE Principal Investigator & Institution: Bova, Carol A.; None; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001; Project Start 16-NOV-2000 Summary: The long-term objective of this project is to examine the relationship between depression, dual diagnosis and medication adherence in HIV infected individuals. Understanding adherence behaviors in vulnerable populations is essential to maximizing the clinical effectiveness of highly active antiretroviral therapy (HAART) among all HIV seropositive populations. The specific aims of this study are (1) to describe the prevalence of depression and dual diagnosis (depression and substance abuse) in a cohort of 200 HIV infected individuals currently treated with HAART, (2) to describe the relationship between depression, dual diagnosis and antiretroviral adherence, (3) to examine the relationship between depression, dual diagnosis and response to a home-based nursing intervention to improve adherence to HAART. This is a prospective, descriptive study nested in a randomized clinical trial of a home-based nursing intervention to improve adherence to HAART (Williams, A.). Subjects will be 200 HIV infected individuals enrolled in the parent study. Measures of depression (selfreport, Beck Depression Inventory, 5-item mental health subscale of the MOS Short Form) and substance abuse (self-report) will be added to the parent study data collection instrument and measured at baseline in face to face interviews. Adherence data (measured by self report, unannounced pill counts and MEMS cap data) will be collected at baseline, monthly for 3 months then every 3 months for 18 months. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION, HPA AXIS ACTIVITY, AND NEONATAL OUTCOME Principal Investigator & Institution: Suri, Rita; Psychiatry; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2005 Summary: (Adapted from applicant's description) This revised application proposes Rita Suri, M.D. for a K23 Mentored Patient-Oriented Research Career Development Award for the study of depressive disorders during pregnancy. A limited body of knowledge regarding the impact of mood state on the fetus complicates the management of major depression during pregnancy. The purpose of this prospective study is to examine the effects of maternal depression on the hypothalamic-pituitaryadrenal (HPA) axis during pregnancy and its impact on variables related to neonatal outcome. This will be achieved by studying mood, plasma corticotropin releasing hormone (CRH), salivary cortisol, and neonatal outcome in the following groups of pregnant women: 1) 50 women with major depression who are depressed and not on antidepressants; 2) 50 women with a history of major depression who are treated with

66 Depression

an SSRI and are euthymic; 3) 50 women without a history of major depression who are euthymic and not on antidepressants. Maternal mood state and anxiety will be assessed across each month of pregnancy; an assessment of HPA axis activity will be made in each trimester with measurements of plasma CRH and salivary cortisol. Neonatal outcome measures will include infant birth weight, gestational age, and performance on the Brazelton Neonatal Behavioral Assessment Scale. Information gained from this study will help clinicians and patients better understand the impact of untreated maternal depression versus treatment with antidepressants on HPA axis activity and the neonate and better assess the risks and benefits of treatment versus no medication during pregnancy. During the Award period, Dr. Suri will follow an organized program of inter- disciplinary training and supervised research under the sponsorship of Dr. Lori Altshuler. She will undergo coursework in endocrinology, physiology, embryology, neuroscience, biostatistics, and research design. She will complete a methodologically sound study of mood and endocrinology across pregnancy and effects on neonatal outcome. This research and career development plan will provide a foundation for future independent investigation regarding the management of psychiatric disorders during pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIABETES

DEPRESSION,

SELF-MANAGEMENT

AND

ETHNICITY

IN

Principal Investigator & Institution: Fisher, Lawrence L.; Professor in Residence; Family and Community Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2007 Summary: (provided by applicant): Diabetes affects between 6.5 and 13 million Americans and is associated with an expenditure of over $44 billion in direct health care costs per year. Prevalence rates for Latinos, America's fastest growing minority, are approximately twice that of European-Americans (EAs). Depression occurs as a comorbid condition in 23% of EAs with diabetes, but the rate of depression among Latinos with diabetes is almost 30%. Depression is associated with decreased selfmanagement behavior, poor metabolic control, and increased risk for complications. Explanatory models, based almost exclusively on cross-sectional research, suggest that depression has both direct and indirect effects on metabolic control through selfmanagement. Disease severity, impairment, complications, life stress, personal resources, and social support also affect these relationships. Given the pervasiveness of depressive affect, the variability in self-management among EA and Latino patients with diabetes, and the increased behavioral and biological risk that depression poses for these patients, longitudinal studies with implications for intervention are needed to describe the forms that depression and self-management can take in these patients over time. The proposed 3-wave, 18-month longitudinal project seek to: (1) describe the variation, and sub group patterning of depression and self-management over time in EA and Latino patients with type 2 diabetes; (2) identify the linkages among depression, self-management, and metabolic control, over time, along with factors that moderate these linkages; and (3) determine variations in these relationships based on patient ethnicity (EAs, Latinos). The proposed longitudinal research has major implications for intervention: it will provide a more complete description of the natural course of the full range of major and minor depression and self-management over time, it will identify sub group variations that may warrant specific interventions, it will identify at what point along the continuum of depressive affect linkages with disease self-management

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and metabolic control become evident, and it will highlight differences in these relationships based on patient ethnicity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION, STRESS & HEALTH: ROLE OF ANABOLIC HORMONES Principal Investigator & Institution: Epel, Elissa S.; Langley Porter Psychiatric Institute; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2002; Project Start 05-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): The objective of the proposed Mentored Clinical Scientist Development Award (K08) is to promote the candidate's development as an independent behavioral science researcher, with a focus on neuroendocrine responses to stress, and their effects on mental and physical health. During the five-year career development period, the candidate will engage in formal and informal training in psychoneuroendocrinology and stress and coping, complete three research projects, build collaborations, and address basic questions about relationships between stress, hormones, and risk for depression and cardiovascular disease. Chronic psychological stress contributes strongly to depression and cardiovascular disease, but the mechanisms are unclear. Most research in this area has focused on the deleterious effects of catabolic stress hormones like cortisol. Although hypercortisolemia turned out to be a weak biological marker of depression, it may be more revealing when examined in combination with anabolic hormones, such as dehydroepiandrosterone (DHEA) and growth hormone (GH), which can buffer the damaging effects of cortisol. The long-term goal of the current research program is to examine whether anabolic and catabolic hormones, as well as their levels relative to each other (anabolic balance) serve as a mediating pathway from stress to depression and to risk factors for cardiovascular disease (insulin resistance, visceral fat, and atherosclerosis). Studies 1 and 2 will examine whether history of chronic stress predicts low anabolic balance, depression, and risk for disease in longitudinal cohorts of younger adults (N = 1000) and older adults (N = 1000). Study 3 will assess whether chronic stress alone and with major depression is related to basal and reactive measures of anabolic balance and disease risk in caregivers, who serve as a unique model of chronic stress. If warranted, future research will compare effects of stress reduction and hormonal supplementation on mood and disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION/DESIRE FOR DEATH IN TERMINAL CANCER PATIENTS Principal Investigator & Institution: Breitbart, William; Professor and Chief; SloanKettering Institute for Cancer Res New York, NY 10021 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-MAY-2004 Summary: A clinically important mental health issue in palliative care concerns desire for death and its relationship to depression. Research focused on desire for death provides a link to understanding why patients might want to end their lives or request physician-assisted suicide (PAS) in the face of terminal illness. There have been several recent studies of patients with cancer or AIDS, demonstrating the central role of depression in desire for death and hypothetical interest in PAS. With one exception, these studies have not directly assessed desire for death among terminally ill patients, and no research has attempted to answer the question of whether treatment for

68 Depression

depression has a significant impact on desire for death. This project aims to describe desire for death among patients with end-stage cancer, determine its correlates, and assess the impact of treatment for major depression on desire for death. Specifically, the research would assess the prevalence, severity, stability, and medical/psychosocial correlates of desire for death among terminally ill cancer patients hospitalized in a palliative care facility. It will examine the relationship between desire for death and a clinical diagnosis of Major Depressive Episode. Desire for death will then be monitored in a group of patients who receive a standardized pharmacological treatment for depression, as well as in patients who do not receive any intervention. This study is expected to provide a direct evaluation of desire for death in terminally ill cancer patients, and to ascertain whether a pharmacological treatment for depression influences desire for death. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMERICANS

DEPRESSION-DIABETES

MECHANISMS:

URBAN

AFRICAN

Principal Investigator & Institution: Musselman, Dominique L.; Assistant Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2003; Project Start 18-JUL-2003; Project End 30-APR-2008 Summary: (provided by applicant): African-Americans have increased prevalence of both diabetes and diabetes complications, reflecting combined psychobehavioral and metabolic dysfunction. Depression may contribute to both the genesis of Type 2 diabetes, and difficulties in management; we find that many African-Americans with diabetes also have depression, that depression is a factor in nonadherence, and that nonadherence leads to poor glycemic control- a major cause of complications. (1) To establish the prevalence, socioecoloqic associates, and. qlycemic impact of depression, we will study patients presenting to the Grady Diabetes Clinic; evaluate socioeconomic status, literacy, and access to care; and relate depression to these factors and to metabolic control both at presentation and after one year of care. (2) To define the pathways through which depression contributes to metabolic imbalance, we will study patients exposed to progressive psychobehavioral challenge (depression and/or early life stress), and assess (a) hypothalamic-pituitary-adrenal activation; (b) counterregulatory hormones; and (c) immunoinflammatory cytokines; in relation to (d) insulin resistance. (3) To determine the psychobehavioral and neurohormonal mechanisms of treatment, we will conduct a randomized, placebo-controlled, double-blind trial: patients with depression will receive stress management videotapes and either placebo or the selective serotonin reuptake inhibitor (SSRI) citalopram, and we will assess (a) overall glycemic control (HbAlc levels), and (b) patient adherence -to a prescribed diet/exercise program, to use of medications, and to scheduled return appointments; in relation to (c) depressive symptoms and (d) neurometabolic function as defined in Aim #2. These questions will be addressed by a multidisciplinary team with experience in both neuroendocrine analysis, clinical psychiatry, and diabetes management. The goal of this proposal is to use state-of-the-art psychobiological techniques to define the neurobehavioral and neurometabolic abnormalities and their response to treatment in urban African-Americans with type 2 diabetes and depression, as needed to improve basic understanding of disordered metabolism in this patient population and to help relieve their disparity in health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSION--LOCUS COERULEUS AFFECTS DOPAMINE VIA GALANIN Principal Investigator & Institution: Weiss, Jay M.; Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 31-JUL-2003 Summary: (Adapted From The Applicant's Abstract): The research proposed here investigates a possible mechanism by which noradrenergic neurons in the brain influence dopaminergic neurons to produce behavioral changes seen in depression. These studies address an important issue related to the neurobiology of depression; namely, that while much evidence shows brain norepinephrine (NE) is important in both the pathogenesis and therapy of depression, basic research implicates dopamine (DA) in depression-related responses (motor activity changes, hedonic responses) much more so than NE. The proposed research derives from, and will continue to use, an animal (rat) model of depression that reproduces characteristics of clinical depression by exposing animals to uncontrollable stressful conditions (called "stress-induced behavioral depression"). Behavioral depression in this model has been traced to heightened "burst" firing of locus coeruleus (LC) neurons. The proposed hypothesis, based on recent electrophysiological data, is that the rapid firing of LC neurons releases galanin (GAL) from LC-NE terminals in the VTA, which inhibits activity of DA cells that project to forebrain. Because VTA DA neurons mediate motor activity and reward processes, their inhibition causes changes seen in depression (i.e., psychomotor retardation and anhedonia). In testing this hypothesis, previous work has shown that microinjection of GAL into VTA mimics behavioral depression. Studies proposed here will determine if (1) conversely, blockade of GAL receptors in VTA can reverse behavioral depression, and (2) commensurate changes in extracellular DA (measured by microdialysis) in forebrain also occur. All microdialysis studies use a recently-developed methodology that permits continuous microdialysis sampling for several days, and also sampling from multiple brain regions simultaneously. Next, using an animal model that shows long-lasting behavioral depression, studies are proposed to (1) measure changes in monoamines and metabolites (DA, HVA, NE, MHPG, 5-HT, 5-HIAA) in various brain regions thought to be important in depression, and (2) determine whether therapy for the long-lasting behavioral depression occurs if one blocks GAL receptors in VTA. Finally, studies are proposed to measure the consequences of effective antidepressant treatment (i.e., chronic administration of antidepressant drugs or a series of electroconvulsive shocks) on (i) electrophysiological activity of LC neurons (since GAL is released at high rates of depolarization), and (ii) estimates of GAL synthesis in LC (i.e., by measuring GAL mRNA and GAL concentration in LC cell bodies) and GAL levels in VTA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPRESSIVE DISORDERS IN PRIMARY CARE AND WORK SETTINGS Principal Investigator & Institution: Druss, Benjamin G.; Assistant Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: The proposed K08 Mentored Clinical Scientist Development Award outlines a program of training and health services research studying the impact of depressive disorders outside of the specialty mental health sector. The candidate is an Assistant Professor of Psychiatry and Public Health at Yale University with a clinical background

70 Depression

in psychiatry and primary care internal medicine, as well as postdoctoral health services research training. The career award will allow the candidate to successfully conduct the proposed studies and develop a career as an independent researcher through classes in research design, statistics, economics, and organizational theory at Yale, and via off-site training with experts in the field. Yale University offers a rich source of resources and faculty and a growing breadth of experience in health services research. The career award mentor, Robert A. Rosenheck MD, is a nationally known health services researcher and director of the Health Services Research and Treatment Outcomes Division for the Yale Department of Psychiatry; the candidate and Dr. Rosenheck have developed a close collaborative relationship. The growing importance of purchasers and primary care providers in determining benefits and delivering care for depression has made it an increasing priority to understand the costs of depression in the workplace and general medical settings. The research program seeks to fill gaps in the previous literature studying the impact of depression in these two areas. The first project will seek to provide a better understanding of the causal mechanisms underlying the association between depression and increased use of general medical services. It will examine the role of health beliefs--a person's perception of his or her medical condition, and of the benefits and barriers to treatment--in mediating the relationship between depression and medical utilization. The second project will use a longitudinal database combining work and health claims data for employees of a major US corporation. This project will compare the impact of depression and three chronic medical illnesses on health costs, absenteeism and job performance ratings both cross-sectionally and over time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSOIN IN ALZHEIMER'S DISEASE STUDY-2 (DIADS-2) Principal Investigator & Institution: Mintzer, Jacobo E.; Professor; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, SC 29425 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 29-FEB-2008 Summary: (provided by applicant): Depression in the context of Alzheimer's disease (AD) is a significant public health problem with serious adverse consequences for patients and their caregivers. There has been little research into the course or treatment of depression associated with AD. This is in part due to the absence of validated operational criteria for defining depression in AD. Recently, NIMH convened an expert consensus panel to develop draft criteria for depression of Alzheimer's disease (dAD) and to establish research priorities in this area. These criteria are intended to facilitate further studies of the course and treatment of depression in AD. The first aim of the proposed multicenter study is to determine whether individuals with dAD respond to antidepressant treatment using the medication sertraline in a 12-week randomized, controlled, double blind trial. The second aim is to establish whether earlier treatment of depression in AD affects critical non-mood outcomes such as cognition, quality of life, activities of daily living and caregiver variables, over 24 weeks. The third aim is to validate the dAD syndrome by evaluating its course and response to treatment in comparison to other diagnostic conceptualizations of depression in AD, over six months. These aims are consistent with priorities articulated by the NIMH expert consensus panel. 130 patients meeting criteria for dAD, and their caregivers, will be recruited into the study at five clinical centers: Johns Hopkins, University of Southern California, University of Rochester, University of Pennsylvania, and Medical University of South Carolina. The study will be coordinated by the Johns Hopkins Center for

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Clinical Trials. After detailed baseline characterization participants will be randomized to treatment with sertraline or placebo for at least twelve weeks and followed for up to 24 weeks. All patients and caregivers will receive psychosocial interventions for Alzheimer's and depression. Patient outcomes will include: global improvement of the depressive disturbance, ratings on a depression scale, quality of life, cognitive functioning, activities of daily living, behavioral disturbance, and adverse events. Caregiver outcomes will include: depression, quality of life, and care giving burden. Regarding the first study aim, analyses will compare the two treatment groups on patient mood outcomes in the first twelve weeks. Regarding the second study aim, analyses will compare the two treatment groups on the trajectories of patient critical AD patient outcomes (cognition, functioning, quality of life, behavior) and of caregiver outcomes over 24 weeks. Regarding the third aim, analyses will examine the longitudinal course of depressive symptoms and of depressive syndromes in the context of Alzheimer's using three different syndromic definitions: dAD, DSM-IV, and "Alzheimer's Associated Affective disorder" derived empirically. The predictive validity of defining depression in AD using a symptom scale or each of these syndromes will be assessed longitudinally against the various study outcomes, and against efficacy of response to anti-depressant treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DETECTING DEPRESSIVE SYMPTOMS IN OLDER ADULTS Principal Investigator & Institution: Duberstein, Paul R.; Associate Professor; Psychiatry; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): One consistent and disturbing finding in the suicide literature compels this investigation. Most older adults who take their own lives have an affective disorder, but the potential risk for suicide was unrecognized by family members and health professionals. The central thrust of our symptom detection model is that specific factors deter the detection, diagnosis, and treatment of depression in older adults. ROl funding is sought to test aspects of this model in a demographically and clinically heterogeneous sample of 1000 primary care patients 65 years of age and older. Beginning in August 2001, these patients were recruited into a naturalistic study, "Depression Outcome in Primary Care Elderly" (DPC) (NIMH ROl MH61429-O1A1, J. Lyness, M.D., P.I.). For this proposed ROl, we will collect data from informants who are members of the social networks of participants in the DPC study in order to examine informant detection of depressive disorders and symptoms of depression and anxiety. We will strive to recruit one informant for each subject in that study, and plan to collect data from more than 628 informants. We will ask the informants questions about themselves and the DPC participants' psychiatric symptoms. Specifically, we will examine informant detection of depression as a function of: the severity and history of patients' psychiatric disorders (Aim 1), patients' psychosocial (personality and social support) characteristics and physical health parameters (Aim 2), patients' demographic characteristics (Aim 3), and informants' psychiatric history and self-reported health (Aim 4). We will explore the role of informants' personality traits and attitudes toward mental illness, and differences between African-Americans and Whites will be explored. We hypothesize the detection will be poorer for: disorders that are less severe and first episode (Aim1); patients with certain personality traits (e.g., low extraversion; low openness to experience) or poor physical health (Aim 2); and men and unmarried participants (Aim 3). Detection will also be poorer when informants have no prior history of depression or are in poor physical health (Aim 4). For Aim 2, the mediating

72 Depression

effect of social support will be examined. Confirmation of these hypotheses will indicate needed revisions in current approaches to late-life depression and suicide. Findings will help guide the development of screening instruments, educational and clinical interventions, and surveillance strategies to lessen the public health impact of unrecognized and untreated depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT OF DEPRESSION DURING ADOLESCENCE Principal Investigator & Institution: Hankin, Benjamin L.; Psychology; University of Illinois at Chicago 1737 West Polk Street Chicago, IL 60612 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2004 Summary: (provided by applicant): Rates of depression rise dramatically during adolescence (from 3-17%). Twice as many girls as boys will experience depression starting in early adolescence. Many individuals experience depression first during adolescence, and half of them may have a recurrence of depression later in adulthood. Thus, adolescence is a crucial time to study risk factors and mechanisms for developing depression, especially with girls, so that improved treatment/prevention programs may be created for this public health concern. This study aims to examine particular vulnerability factors and processes based on 3 different cognitive vulnerability- stress models of depression. Cognitive vulnerability to depression--the way in which individuals interpret negative information about the self and explain why negative events happen is an important risk factor that predicts the prospective development of depression. Cognitive vulnerability is actively operating by early adolescence, and negative life events increase throughout adolescence. Thus, the interaction of cognitive vulnerability with more negative events may be a potent explanation for the rise in depression observed during adolescence. This prospective study will test the hypothesis that the dramatic increase in depression during middle adolescence can be explained by a rising number of negative events interacting with higher levels of cognitive vulnerability. Also, cognitive vulnerability, negative events, and their interaction will be examined as an explanation for the emergence of the gender difference in depression among early adolescents. Last, the precise form of the cognitive vulnerability X stress interaction will be examined to see what combination of cognitive vulnerability and stress best predicts prospective changes in depression. Adolescents from 7th and 10th grade (200 in each grade for a total of 400; half girls) will be assessed initially and then at 4-month intervals for a total of 3 waves of data. The adolescents will be assessed for demographics, 3 forms of cognitive vulnerability, negative events, depressive symptoms, and pubertal status. Parents will provide collateral information on their children's symptoms and negative events. Multilevel growth curve analyses will be used to test the hypotheses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEVELOPMENT SYMPTOMATOLOGY

OF

INVENTORY

OF

DEPRESSIVE

Principal Investigator & Institution: Bernstein, Ira H.; Psychology; University of Texas Arlington 301 South Center Street Arlington, TX 76019 Timing: Fiscal Year 2003; Project Start 03-JUL-2003; Project End 30-JUN-2006 Summary: (provided by applicant): This proposal is a collaborative R01 submitted by Duke University, the University of Texas Southwestern Medical Center, and the University of Texas at Arlington. We plan to further develop and evaluate the 30-item

Studies 73

Inventory of Depressive Symptomatology, which is available in clinician-rated (IDS30) and self-reported (IDS-SR30) forms, and to further develop and evaluate a shortened version (the Quick IDS), which is available in a 16-item self-report (QIDS-SR16) and a clinician-rated (QIDS-C16) format. The properties of each of these four instruments as both screens for depression in general medical and psychiatric populations, and as measures of symptomatic change will be evaluated. We will analyze data that have been or that are now being collected from "ongoing" studies. We will also acquire and analyze new data from "prospective" studies to be conducted at Duke and at UT Southwestern. These studies will evaluate the performance of each measure to screen for major and minor depression, defined by a structured interview to render DSM-IV diagnoses - DIS (elderly), by SCID (adults), or by the K-SADS-PL (children/adolescents). We will evaluate concurrent validity with the Montgomery Asberg Depression Rating Scale (MADRS), the 17-item Hamilton Depression Rating Scale (HRSD17), or Children's Depression Rating Scale (CDRS) as outcome measures in adolescent, adult, and older/elderly populations. Classic psychometric properties (e.g., factor analyses, Cronbach's alpha, concurrent validity) will be established for each of these four measures (IDS-SR30, IDS-C30, QIDS-SR16, QIDS-C16). We will determine whether an anxiety subscale of the IDS-C or IDS-SR can be identified and compare the potential items against the Spielberger State Anxiety Inventory. We will create equivalence tables using Item Response Theory analysis to translate total scores on the IDS or QIDS to total scores on the HRSD17, MADRS, and CDRS. We will provide benchmark scores for depressive symptom severity by IDS/QIDS ratings to identify minimal, mild, moderate, and severe levels of impaired daily function, as measured by the Sheehan Disability Scale (DIS), SF-12, SF-36, or Social Adjustment Scale-Self-Report (SAS-SR). The result will be a matched self-report and clinician rating scale to assess only the core criterion symptoms of major depression (i.e., the QIDS-C and SR), and more expanded scales capable of assessing both core and associated symptoms (e.g., anxiety, irritability) (IDSC and SR) that are in the public domain for use with patients across the age spans seen in practice and in research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT OF NEGATIVE ATTRIBUTIONAL STYLES Principal Investigator & Institution: Gibb, Brandon E.; Psychology; Temple University 406 Usb, 083-45 Philadelphia, PA 19122 Timing: Fiscal Year 2001; Project Start 28-SEP-2001; Project End 30-JUN-2002 Summary: (provided by applicant): The primary goal of the current study is to better understand the development of depression by examining factors that may contribute to the development of a cognitive vulnerability to depression. Understanding the development of depression is important given that depression is the second most common psychological disorder, with lifetime prevalence estimates as high as 17.1 percent , and estimates that the economic burden of depression in the United States is $43.7 billion annually. Thus, understanding how vulnerability to depression develops is an important step in targeting interventions to buffer against the development of that vulnerability, thereby reducing the risk of depression onset. In the current study, therefore , the independent, unique, and combined influences of a number of factors hypothesized to contribute to the development of negative attributional styles in children will be examined over a 6-month longitudinal follow-up. These factors will include variables previously identified in longitudinal studies as contributing to the development of children?s and adolescents? attributional styles as well as factors demonstrating cross-sectional relationships with attributional styles but not yet

74 Depression

examined longitudinally. In this way, the current study will seek to both integrate and extend previous findings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMERICANS

DIABETES

AND

DEPRESSION

IN

ELDERLY

MEXICAN-

Principal Investigator & Institution: Black, Sandra A.; Associate Professor & Associate Director; Epidemiology and Prev Medicine; University of Maryland Balt Prof School Baltimore, MD 21201 Timing: Fiscal Year 2001; Project Start 22-SEP-1996; Project End 31-AUG-2004 Summary: The proposed research is a study of the relationship between diabetes, functional disability, and depression in the elderly. Examining the correlates and consequences of a specific disease (diabetes) that is strongly associated with both functional impairment ad high levels of depressive symptomatology, in a specific population (older Mexican- Americans) will provide a unique contribution to our understanding of these relationships. This approach will help to eliminate much of the confounding effects introduced by examining these relationships concomitantly in several chronic diseases and in heterogenous populations. It will also add to our understanding of the more general relationship between compromised health and depression in the Mexican-American elderly. In particular, the study is significant in that it will (1) conduct an extensive examination of the epidemiology of diabetes and its functional and emotional consequences in older Mexican-Americans; (2) compare different profiles of comorbidity of diabetes and other chronic conditions in terms of their association with functional disability, pain, and depression; (3) examine differences in the utilization of health care services associated with depression in this group; and (4) make use of a longitudinal design to identify probable causal paths between diabetes and depressive status, while controlling for the possible moderating effects of personal factors such as sociodemographic characteristics, health-related factors, and cultural factors. These aims will be accomplished by examining data from a population-based longitudinal panel study of Mexican -American elderly, in which a sample of 3050 older adults are administered extensive interviews. Cross-sectional analyses will examine associations between diabetes and other chronic physical health conditions, activity limitations, functional capacity, pain, medication use, depression and moderating factors. Longitudinal analyses will identify the influences of change in disease status, functional disability, and pain on depression, and characterize the mechanisms by which chronic conditions influence the development, chronicity, and exacerbation of depression in the elderly. Findings from this study will provide a unique contribution to our understanding of the functional and emotional consequences of compromised physical health, not only in older diabetic Mexican-Americans, but among older adults in general. These findings will also help to improve the health care of all older adults by enhancing our understanding of the risk factors for depression in the elderly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIFFERENTIAL RESPONSE TO CBT IN TYPE 1 & TYPE 2 DIABETES Principal Investigator & Institution: Surwit, Richard S.; Professor; Psychiatry; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2004

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Summary: (adapted from investigator's abstract): Extensive literature documents increased incidence of depression in patients with diabetes mellitus. However, the degree to which the treatment of depression impacts on diabetes control is not clear. Some investigators have found a strong association between depression and diabetes control, while others have found a weak association. A review of existing literature as well as preliminary data from our laboratory suggest that this discrepancy may be due, in part, from failure of many studies to clearly differentiate type 1 and type 2 diabetes in their patient samples. The strongest association between depression and diabetes control has been reported in studies of patients with type 1 diabetes. Preliminary data from our group suggests that the Beck Depression Inventory (BDI) scores may be more significantly related to hemoglobin A1C (HbA1c) in type 1, than in type 2, diabetes mellitus. Studies assessing the effects of pharmacologic antidepressant therapy on diabetes have been confounded by the combined use of both diagnostic categories as well as by the direct metabolic effects of most antidepressant drugs. An emerging literature on the use of Cognitive Behavior Therapy (CBT) suggests that improving affect through behavioral intervention can improve diabetes control, particularly in type 1 patients. The overall aim of this proposal is to determine if CBT differentially improves glucose control in type 1 and type 2 diabetes patients. We hypothesize that CBT will produce a greater reduction in HbA1c in type 1 diabetes than in type 2 diabetes and that CBT-induced improvement in HbA1c is mediated by an improvement in depression. We will measure the effects of CBT on changes in HbA1c and daily blood glucose in a sample of 150 depressed patients with type 1 and type 2 diabetes over one year. To evaluate the mechanism by which CBT-induced changes in depression affect blood glucose, we will determine the role of cortisol and the role of diabetes self-care behaviors as mediating variables. Changes in cortisol and self-care are predicted to impact blood glucose levels to a greater extent in type 1 diabetes because these individuals are metabolically more sensitive to any variation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DYADIC SOCIAL SUPPORT FOR MEN WITH PROSTATE CANCER Principal Investigator & Institution: Weber, Bryan A.; Adult and Elderly Nursing; University of Florida Gainesville, FL 32611 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2003 Summary: (Applicant's Description) This 2 year study, "Dyadic Social Support For Men with Prostate Cancer," will investigate the effects of dyadic social support on selfefficacy, social support, and depression for men with prostate cancer, which is the leading form of cancer for American men. Improvements in screening and medical management of prostate cancer have prolonged life expectancy for the 180,000 men to be diagnosed this year. The diagnosis and treatment side effects, particularly urinary and erectile dysfunction from radical prostatectomy, are known to lead to depression. Although support groups have been found to reduce depression for cancer patients, few men participate in such groups. One-to-one support with another man as in the proposed dyadic intervention may be more acceptable than support groups to these men. The purpose of the study is to test the effects of a dyadic intervention based on Bandura's Self-Efficacy Theory (vicarious experience, performance and attribute similarity) that links men who are newly diagnosed with prostate cancer with those who are long-term survivors (> 5 years). One hundred men (50 years and older) with prostate cancer and having a radical prostatectomy will be recruited within 100 days of the diagnosis. Excluded will be those with prior history of cancer and death of a loved one within 1 year. Subjects will be randomized to control or experimental groups.

76 Depression

Experimental subjects will be matched according to race with a long-term survivor volunteer who had a prostatectomy for prostate cancer. After training in the study protocol, long-term survivors will meet with subjects 8 times during a 60-day period to discuss feelings, thoughts, and concerns associated with prostate cancer. The investigator will monitor the intervention through weekly telephone calls and weekly logs recorded by the long-term survivors that will be used to assess the quality of the interaction, the number and duration of sessions, and topics discussed. Baseline and post-test measures of self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), and depression (Geriatric Depression Scale ) will be used to determine if the dyadic intervention decreases depression and increases self-efficacy and social support. Comorbidity (Charlson Index), and urinary and sexual dysfunction (UCLA Prostate Cancer Index) are expected to influence depression, hence data will be collected and these factors will be controlled. If dyadic interventions are shown to enhance survival and/or reduce depression among this group, results may be extended to others with cancer. Hence, this may be integrated in the treatment of cancer survivors in the future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DYNAMIC COMORBIDITY AND PREVENTION IN HIGH-RISK YOUTH Principal Investigator & Institution: Aber, J L.; Nat'l Ctr/Children in Poverty; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 20-AUG-2001; Project End 31-JUL-2004 Summary: (provided by applicant): The proposed study proposes to examine longitudinally the dynamic patterns of comorbidity between depression and conduct disorder throughout middle childhood and adolescence. The study capitalizes on an existing unique data set by proposing a follow-up of an evaluation, conducted by the PI, of one of the largest school-based violence prevention programs in the country, the Resolving Conflict Creatively Program (RCCP). The RCCP curriculum targeted socialcognitive and interpersonal processes known to predict later antisocial behavior and psychopathology; the 1994-1996 RCCP evaluation included assessments of children's depressive symptoms, conduct disordered behaviors, ineffective social-cognitive processes, aggressive tendencies, and socially competent behavior. Aim I of the proposed study is to characterize the dynamic nature of comorbidity between depression and conduct disorder across middle childhood and into adolescence. Aim II is to examine whether comorbidity status in middle childhood as well as developmental trajectories of depression, conduct disorder, social-cognitive processes, and competence predict key outcomes in adolescence. Outcomes of academic achievement will be obtained from New York City Board of Education records for the full sample of 2260 students who completed reports of depression and conduct disorder in the original study; of this sample, 48 percent are female, 38 percent are Hispanic, 42 percent are Black, and 15 percent are White. Outcomes of depression, conduct disorder/delinquency, substance use, social-cognitive processes, and social-emotional competence will be assessed through individual interviews with a selected subsample of the original RCCP sample (N = 600), half of which will be strategically selected based on their initial comorbidity status (100 high comorbid, 100 high depression only, 100 high conduct disorder only) and half of which will be non-disordered children matched on demographic characteristics. The proposed study will provide a greater understanding of the role dynamic comorbidity in middle childhood in predicting adolescents'

Studies 77

psychological and social adjustment as well as an evaluation of the effectiveness of a universal intervention in both preventing and mitigating the occurrence of comorbidity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECTS ACTIVATION

OF

DEPRESSION

TREATMENT

ON

PLATELET

Principal Investigator & Institution: Markovitz, Jerome H.; Medicine; University of Alabama at Birmingham Uab Station Birmingham, AL 35294 Timing: Fiscal Year 2001; Project Start 15-SEP-1999; Project End 31-AUG-2003 Summary: (adapted from investigator's abstract): The primary objective of this study is to assess the effects of standard pharmacologic treatments of the clinical depression on platelet activation PA). Increased PA is present in clinical depression, and has been implicated as one mechanism that may explain the link between depression and coronary heart disease (CHD) events. The investigators' preliminary work indicates that platelet secretion in increased in clinical depression, and that pharmacologic treatment with the selective serotonin reuptake inhibitor sertraline attenuates this increase. They also found evidence that depressed patients with a family history of CHD have increased PA. In the present application, the investigators seek to extend these findings by (a) performing a double-blind, placebo-controlled trial of sertraline and (b) assessing the effects of another pharmacologic treatment for depression (bupropion) on PA. As in previous studies, PA will be assessed by state-of-the-art flow cytometric detection, using methods developed and standardized in our laboratory. After initial PA testing, a total of 180 patients will be randomized to receive either sertraline or placebo for 8 weeks, with retesting at the end of this time period. A control group of 70 nondepressed individuals of similar age and gender composition will also be tested twice over 8 weeks. After follow-up measures for PA are taken, the blind will be broken and patients previously on placebo will be given 8 weeks of treatment with bupropion (an antidepressant medication that affects dopamine and norepinephrine pathways without affecting serotonin pathways). A final PA measure will be performed at the end of this 8-week treatment, in order to a) assess the stability of the response to sertraline and b) assess the open-label effects of bupropion. The investigators anticipate that 144 subjects will complete the entire protocol. The hypotheses for the study are: (1) PA is increased in depressed patients relative to controls, with the highest levels found among depressed patients with a family history of CHD; (2) Sertraline decreases PA in depressed patients relative to placebo; and (3) Bupropion, an antidepressant with nonserotonergic mechanisms of action, also decreases PA. This work will contribute to the understanding of mechanisms and treatment for depression so as to diminish CHD risk, particularly among those with a family history of CHD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECTS ON CHILDREN OF TREATING MATERNAL DEPRESSION Principal Investigator & Institution: Riley, Anne W.; Associate Professor; Health Policy and Management; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 15-APR-1998; Project End 28-FEB-2003 Summary: (Applicants Abstract): Maternal depression has devastating effects on the mental and physical health of children. An obvious first step to solving this social and public health problem is to determine the effects of treatment of maternal depression on children. This proposal captures a unique opportunity to study the influence of treating maternal depression on children ages 5-11 by studying children of women taking part

78 Depression

in an NIMH-funded randomized treatment of a depression trial led by the Co-Principal Investigator. Furthermore, this study fills gaps in the literature on the impact of maternal depression in three ways, by studying: 1) children of women screened while obtaining public sector family planning care, a sample more representative of depressed women than previous studies in psychiatric settings; 2) poor women; and 3) equal numbers of Latina, African American and White women so that cultural differences can be examined. Based on a comprehensive model of the mechanisms by which maternal depression may influence child outcomes, we will study 150 elementary-school aged children whose mothers are depressed (50 Latina, 50 African American, and 50 White) and 50 comparable children whose mothers are not depressed. Their mental health and functioning will be assessed by natural raters in their environments over a two-year time period, with five face-to-face interviews, two mother-child interaction assessments, and bi-monthly phone assessments that will link child functioning, symptomatology, and psychiatric disorders to mothers' symptomatology, parenting behavior, and family environment. Mothers, the children, fathers/other caregivers, teachers, and interviewers will contribute to these assessments in a time-series design. This design will enable us to develop sensitive longitudinal models of the way in which changes in aspects of the mother's depression affect the outcomes of the child over time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ELECTROACUPUNCTURE FOR MAJOR DEPRESSION: A PILOT STUDY Principal Investigator & Institution: Mulsant, Benoit H.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2003; Project Start 08-SEP-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Major depression is a common and serious mental illness. It is associated with a markedly lower quality of life, significant functional impairment, and premature death due to suicide or comorbid physical illness. Over the past 50 years, effective and safe treatments for major depression have been developed, including antidepressant pharmacotherapy, psychotherapy, and electroconvulsive therapy. However, many Americans who suffer from a depressive disorder either do not accept to receive one of these conventional treatments or do not complete an adequate course of treatment. A growing number of Americans with depression are choosing to be treated with complementary and alternative therapies. Acupuncture, in particular, is increasingly being used to treat depression even though only limited data support its safety and efficacy. The proposed pilot study builds upon the complementary expertise of a group of investigators of conventional antidepressant treatments and a group of practitioners of alternative medicine. It will use a randomized parallel-group design to compare the safety, efficacy, and tolerability of electroacupuncture (EA) and sham electroacupuncture (SA) for the treatment of major depression. Over a 15-month period, 60 adult outpatients with a major depressive disorder of mild or moderate severity (as defined by the DSM-IV) will be randomized to either 12 sessions of EA or SA to be provided over 6 weeks. Safety and symptomatic improvement (as measured with the Hamilton Rating Scale for Depression) will constitute the primary outcome measures. Tolerability and functional improvement will constitute secondary outcome measures. The data generated by this pilot project will be used to support the feasibility of conducting, and inform the design of, a large multicenter study comparing the efficacy of two forms of acupuncture with a conventional treatment for depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EMORY CONTE CENTER FOR NEUROSCIENCE OF MENTAL DISORDERS Principal Investigator & Institution: Nemeroff, Charles B.; Reunette W. Harris Professor and Chair; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: This revised application seeks support for the Emory Center for the Neuroscience of Mental Disorders (ECNMD) in the Department of Psychiatry and Behavioral Sciences at the Emory University School of Medicine. The major goal of this five year research plan is to characterize the persistent neurobiological consequences of adverse events early in life and to determine the relationship of such long-lived central nervous system (CNS) alterations to the development of affective disorders, particularly depression, in adulthood. Two animal models of early adverse experience, for which pilot data on persistent neurobiological alterations exist, will comprise the bulk of the proposed work. These two models include a particularly well documented rodent model of maternal separation and a non-human primate variable foraging demand model of early stress. Gender-specific effects of early life stress will also be evaluated in these models. All of the preclinical projects will receive CNS tissue and biological fluids from each of these animal models. Neural circuits that have been implicated in both the neurobiology of stress and anxiety as well as the neurobiology of depression-like syndrome will be scrutinized, including corticotropin-releasing factor (Proj l; PI: Plotsky), serotonin (Proj 2; PLC Owens), dopamine and norepinephrine (Proj 3; PI: Kuhar), and signal transduction systems (Proj 4; PI: Nestler), hippocampal neurogenesis and remodeling (Proj 5; PI: Gould) and acoustic startle plasticity (Proj 6; PI: Davis) will be characterized in these models. In addition two clinical research projects will be included. Project 7, conducted both at Emory University (PI: Nemeroff) and Yale University (PI: Bremner), will examine the neurobiological consequences of child abuse by studying women with a past history of child abuse who are currently suffering from an episode of major depression versus a group of women who are currently depressed without a history of child abuse and a group of women with a history of child abuse without major depression. Finally, Project 8 will seek to determine the neurobiological and behavioral consequences of maternal depression during pregnancy or in the postpartum period on their children (PI: S.Goodman, Stowe). These research projects will be supported by an administrative core led by the Center Director, a rodent animal core (PI: Plotsky, Weiss), a primate animal core (PI: Insel, Winslow), an assay core (PI: Bonsall, Ritchie), and an integrated functional brain imaging core (PI: M. Goodman, Kilts). We postulate a model in which genetic vulnerability coupled with early trauma in a critical plastic period of development results in sensitization of neural systems which when exposed to even mild stressors in adulthood responds in a heightened manner, resulting in the neurobiological alterations that underlie the syndrome of depression. These studies have important implications not only for the neurobiology of depression but the development of novel treatment strategies for both depression and child abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EMOTION PROCESSES IN ADOLESCENT DEPRESSION Principal Investigator & Institution: Burwell, Rebecca A.; Psychology; University of Denver Box 101562 Denver, CO 80208 Timing: Fiscal Year 2002; Project Start 01-SEP-2002

80 Depression

Summary: (provided by candidate): Theories of depression have been conceptualized primarily using cognitive, interpersonal, and behavioral frameworks. However, the role of emotion regulation processes in the development of depression has not been adequately addressed despite their association with mental health. Study 1 of the application utilizes a prospective longitudinal design and developmentally sensitive and reliable measures to examine the relative contributions o cognitive versus emotional vulnerability to depression among a community sample of adolescents. Comparing three models (a cognitive vulnerability model, an emotion regulation deficit model and a cognitive-emotional vulnerability model) will allow for a greater understanding of processes associated with depressive symptoms Study 2 will experimentally assess the role of emotion expression in depressive symptoms by assigning adolescents to expression, inhibition, and control conditions and examining resulting declarative (selfreport) and procedural (color naming negative and positive words) negative mood. The proposed project will utilize multiple informants for depressive symptoms, varied methodology, and complementary experimental design, providing an increased understanding of the relative contributions of cognitive and emotional processes to depression. Finally gaining knowledge into the mechanisms by which cognitive and emotion vulnerabilities are linked with depression may inform research and interventions by identifying proximal emotion factors that may be targeted clinically. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ENVIRONMENTAL MODIFIERS OF FAMILIAL RISK FOR MDD Principal Investigator & Institution: Williamson, Douglas E.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2007 Summary: (provided by applicant): The career development and research plans outlined in this Mentored Research Scientist Development Award (K0l) proposal are designed to enable the candidate to independently design and conduct studies that examine the combined importance of genetic and environmental risk factors for the development of depression in children and adolescents. Depression is a chronic condition that often begins early in life and appears to be the result of both genetic and environmental risk factors. Recent studies have suggested that the phenotypic expression of genetic risk for depression emerges during adolescence and appears to be moderated by the presence of behavior-dependent stressful life events. Understanding the pathway(s) by which various stressful environments interact with genetic risk factors to contribute to the onset of depression is crucial for understanding how to successfully treat and/or prevent this debilitating disease. The proposed study will prospectively examine whether the frequency of environmental stressors, particularly behavior-dependent stressors, increases during adolescence and continue to increase thereafter. An important aim of the research plan is to determine whether exposure to specific environmental stressors modifies the familial risk for depression in adolescents at highand low-familial risk for depression. The candidate is formally trained in psychiatric epidemiology and has research experience in the study of familial and environmental risk factors for depression in children and adolescents. Neal D. Ryan, M.D. and Bernie Devlin, Ph.D. will serve as co-mentors. Coursework and didactic readings in genetic epidemiologic methods, quantitative genetics, molecular genetic techniques, and clinical interviewing techniques are designed to complement the candidates research training and prepare him to become an independent investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EPIDEMIOLOGY AND CARE OF COMORBID OBESITY AND DEPRESSION Principal Investigator & Institution: Simon, Gregory E.; Associate Clinical Investigator; Center for Health Studies 1730 Minor Ave, Ste 1600 Seattle, WA 98101 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This application proposes two related studies: A population-based epidemiologic study of obesity and depression among women and a longitudinal study of obesity treatment among two cohorts (one with comorbid obesity and depression, one with obesity only) identified by the epidemiologic study. Study 1 Epidemiologic Study: A population-based sample of approximately 6000 women aged 40-65 will be complete structured telephone assessment of weight, nutrient intake, physical activity, depression, functional impairment, and disability. Women with Body Mass Index (BMI) >30 will be oversampled. Insurance claims data will be used to measure health care costs. Aims of the epidemiologic study include: 1) Examine the association between obesity and depression among middle-aged women 2) Examine the specific contributions of obesity and depression to disability and health care costs. Study 2 - Treatment study: A cohort of approximately 100 women with obesity (BMI > 30) and no current depressive disorder will be enrolled in a 6-month state-of-the-art group weight loss treatment. Approximately 200 women with comorbid obesity and depression will be randomly assigned to either the identical weight loss treatment or to a combined cognitive-behavior group therapy program focused on both depression and weight loss. Aims of the treatment study will include: 1) Examine the effect of depression on success in weight loss treatment by comparing weight loss, diet, and exercise in depressed and non-depressed women enrolled in the identical weight loss program 2) Examine the benefits of a combined weight loss/depression intervention above those of weight loss treatment alone by comparing weight loss, nutrient intake, physical activity, depressive symptoms, functional impairment and disability in the two groups of women with comorbid obesity and depression randomly assigned to the two different intervention programs Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ETHNOGRAPHY OF SELF-CARE AND ALCOHOL USE FOR DEPRESSION Principal Investigator & Institution: Han, Clara Y.; Social Medicine & Hlth Policy; Harvard University (Medical School) Medical School Campus Boston, MA 02115 Timing: Fiscal Year 2001; Project Start 25-SEP-2001 Summary: The long term objective of this research is to investigate how people's understanding of conditions medically defined as depression influence self-care patterns for depression. This study of self-care behaviors will explore: 1) the primary factors involved in the evident treatment gap between a disease model of depression and the practices and knowledge that inform people's attempts at care for their depressive symptoms, and 2) the proposed understanding of alcohol use as a form of self-care rather than only a provoking factor of depression. This research will take place in a poor, urban setting of Santiago, Chile. The overall research design is a case-based, 18-month longitudinal, ethnographic study of the development and utilization of careseeking behaviors for depressive symptoms by community and hospital-based samples of people meeting DSM-IV-R criteria for minor depression, major depression and comorbid depression and alcohol abuse/dependency. It will rely on screening and diagnostic tools for depression and substance use, bi-monthly open-ended interviews

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with subjects, and a general ethnographic study of the social and economic context of mental health care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EXERCISE TRAINING AND DEPRESSION IN OLDER ADULTS Principal Investigator & Institution: Blumenthal, James A.; Professor; Psychiatry; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-APR-1994; Project End 30-JUN-2005 Summary: Aging of the population and the increased prevalence of chronic diseases among the elderly are major challenges facing our society and medical community. More than 20% of Americans will experience an episode of depression serious enough to warrant diagnosis and treatment. Treatment of major depressive disorder (MDD) has focused on reduction of symptoms and restoration of functioning. Although antidepressant medication has been particularly effective in this regard, many patients either fail to respond to medication or suffer from significant side effects. Thus, there continues to be a need to identify alternative approaches for treating depression, particularly in the elderly. There is now good reason to believe that exercise may be one such approach. The study proposed in the application will build upon the applicant's previous work in which they demonstrated the feasibility and efficacy of exercise as a treatment for MDD in older men and women. The major aim of this project will be to test the hypothesis that a program of home exercise is as effective as supervised exercise and medication in reducing depression relative to placebo controls. As a further extension of past work, the Principal Investigator proposes to examine the differential effectiveness of exercise for a significant subgroup of patients identified by Magnetic Resonance Imaging of the brain as having "vascular depression." Two hundred sixteen men and women, aged > 55 years, with MDD will be randomly assigned to supervised exercise, home exercise, drug (sertraline), or placebo. Before and after treatment patients will undergo evaluation of depression and exercise testing, assessment of vascular functioning including endothelial dysfunction and baroreceptor control, and psychometric testing to assess cognitive function and other measures of quality of life. Six month follow-up will assess relapse rates. The data generated from this study will have important practical implications by determining the extent to which exercise may benefit older men and women with MDD. The study also will provide information regarding the relationship between vascular depression and various indices of vascular and neurocognitive function, and the extent to which these indices may be modifiable by treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EXPLORING DIABETES AND DEPRESSION IN YOUTH Principal Investigator & Institution: Mckeown, Robert E.; Graduate Director for Epidemiology; Epidemiology and Biostatistics; University of South Carolina at Columbia Byrnes Bldg., Room 501 Columbia, SC 29208 Timing: Fiscal Year 2002; Project Start 24-SEP-2002; Project End 31-AUG-2006 Summary: (provided by applicant): Exploring Diabetes and Depression in Youth (EDDY) is a response to RFA-DK-02-009: Depression and Mental Disorders in Diabetes, Renal Disease, and Obesity / Eating Disorders. EDDY will focus on depression and diabetes in 10 to 19 year old youth at two ethnically diverse sites: South Carolina and Colorado. EDDY is an ancillary study to SEARCH for Diabetes in Youth, a CDC- and NIDDK-funded, multisite investigation for population-based case ascertainment and

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classification of both prevalent and incident cases of diabetes in youth. This case-cohort will allow investigation of the complex association between diabetes and depression in three major ethnic groups, African American, Hispanic, and Non-Hispanic Whites. Diabetes mellitus (DM) is the third most prevalent severe chronic disease of childhood, and a major cause of morbidity, mortality, and compromised quality of life. Childhood DM is now acknowledged to be a complex and heterogeneous disorder, with increasing rates of type 2 DM. A few smaller studies have found that children with DM are at higher risk for depression and that depressed children with DM may be at increased risk of poor management and complications. Existing studies have been small, and restricted to type 1 diabetes. The overall aim of this application is to explore the complex associations of depression and diabetes, which may differ for type 1 and type 2, in the SEARCH case cohort in SC and CO. We will examine the mutual impact of depression on diabetes management, glucose control, quality of life, and complications, as well as the impact of DM disease burden on the risk for depression. Specifically, we will estimate the prevalence and incidence of depression and related affective and anxiety disorders among youth with DM, and explore the correlates and predictors for depression among children and teens with DM, including parenting, self-efficacy, body image, and self-esteem. We will also investigate the impact of depression on diabetes management, clinical course, and complications in both type 1 and type 2 DM, and examine the extent of effective treatment for depression, and the impact of treatment on DM outcomes. Finally, we will explore the pathways involved in the association between DM and co-morbid depression and recurrent depression, with particular attention to disease burden, self-concept, obesity, and parenting. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FAMILIAL RISKS FOR MOOD DISORDERS IN ADULT OFFSPRING Principal Investigator & Institution: Giles, Donna E.; Professor; Psychiatry; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2003 Summary: (Verbatim from the Applicant's Abstract) The proposed project is a revised new R01 project, MH 60350. We propose to: 1) determine whether EEG sleep abnormalities and early onset independently predict lifetime affective morbidity in the offspring of families identified by depressed probands; 2) estimate the additive effects of early onset and abnormal EEG sleep in lifetime risk for depression; 3) establish cohort of offspring at risk for depression for prospective assessment of predictors of affective morbidity. We have compelling evidence that EEG sleep abnormalities cosegregate in families, are associated with increased lifetime risk for major depression, and double the risk of new-onset depression in at-risk relatives. Early onset of depression in the proband independently conferred increased familial risk for depression. These findings hold for two generations of relatives ascertained through unipolar depressed proband identified as part of MH39531 to the PI. By extending our well-characterized twogeneration pedigrees to include the third generation we will specify, in a definitive and cost-effective manner, independent sources of familial risk for depression and morbidity associated with early onset and with abnormal sleep physiology. Young adult offspring are an ideal resource to evaluate the cumulative or interactive influence of these distinct sources of risk. Lifetime psychiatric disorders and EEG sleep have been studied in parent and grandparent generations. Offspring targeted for this proposal have not been studies as part of MH39531. Unipolar depressed probands who defined our families had onset of depression before age 45 and 63 percent had their first episode by age 25 (early onset). Data on EEG sleep and clinical history in these offspring can be

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critically informative in describing physiological characteristics that cosegregate with the disorder and build on observations from two well-characterized generations to identify pathophysiologically important characteristics in adult offspring. Effects of age, sex, illness and medication will be controlled to generate information that is relevant across generations and across time. The proposed study creates a cohort that spans three generations, provides the framework for longitudinal, prospective predictions and identifies maximally informative families who can then be studied using molecular and/or genetic techniques. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FUNCTIONAL STATUS OF 5HT IN AGING & LATE LIFE DEPRESSION Principal Investigator & Institution: Meltzer, Carolyn C.; Associate Professor; Radiology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 05-AUG-2000; Project End 31-JUL-2005 Summary: (Adapted from application's abstract) Depression in late life, which carries an increased risk of dementia and brittle response to treatment, is a significant public health care concern. Extensive evidence supports a key role of serotonergic dysfunction in the development of major depression. The well-characterized serotonin type 2A receptors (5HT2A) have been among the sites of prime interest in postmortem human studies and animal models of depression, and an effect of age on the density of this receptor subtype has been observed. We recently used a position emission tomography (PET) to demonstrate a marked reduction in 5-HT2A receptor binding with normal aging in vivo in humans, which is consistent with our hypothesis that age-related changes in serotonergic function may predispose the elderly to depression. However, we have found no effect of depression on the 5HT2a receptor in the elderly. This finding suggests that, although the loss of 5HT2A receptors may contribute to changes in mood and 5HT mediated behaviors, it does not directly account for the development of depression in late life. These observations have prompted investigations of other important components of the 5HT system that are strongly implicated in depression and mechanisms of antidepressant pharmacotherapy. The development of several selective markers of aging, including partial volume correction, have made it possible to image two important targets of action for antidepressant medication: the 5HT1A receptors and the 5HT transporter. This proposal will evaluate the interaction of aging and depression on 5HT1A and 5HTT binding. The interpretation of PET data will be addressed by an MR-based method for Late-Life Mood Disorders at the University of Pittsburgh. Subjects will be longitudinally followed to determine the potential predictive value of serotonergic markers identified by the PET study on treatment resistance and dementia risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENDER AND DEPRESSION; TREATMENT, QI, AND OUTCOMES Principal Investigator & Institution: Sherbourne, Cathy D.; Senior Health Policy Analyst; Rand Corporation 1700 Main St Santa Monica, CA 90401 Timing: Fiscal Year 2002; Project Start 10-JUL-2002; Project End 30-JUN-2004 Summary: Little is known about the clinical aspects of depression care received by females, relative to males, in primary care settings. In particular, few studies have addressed whether depressed men and women respond similarly to treatment for depression within usual care primary care settings. Recently, a number of studies have

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examined the efficacy and cost- effectiveness of models designed to improve depression treatment for primary care patients by increasing the number of patients who receive guideline-concordant care. Yet, we do not know whether these quality improvement (QI) efforts have been equally effective for men and women. It is important for policy makers to know whether existing QI programs successfully reduce gender disparities or inadvertently create new disparities. The proposed study will contribute to research knowledge of these issues using a unique, common data base from four quality improvement studies for depression, called QID. This data base includes 1498 primary care patients with major depression plus an additional 500 depressed patients who did not meet QID exclusion criteria from Partners in Care (PIC), an AHRQ-funded PORT II for depression. The proposed study will 1) determine if there are differences in quality of care received, compliance and health outcomes for depressed men and women in usual care; 2) determine whether QI programs for depression reduce existing disparities in quality of care and outcomes for men and women; 3) determine (for PIC only) whether costs and cost-effectiveness of QI programs differ for men and women; and 4) determine whether the effect of appropriate treatment on outcomes differ for men and women. Multiple factors that explain possible gender differences will be explored. Estimates of treatment effectiveness under QID's more naturalistic conditions are the type of data needed to inform policy debates over mental health care coverage. Results from the proposed study will enable policy makers to refine treatment and services interventions to ensure gender-equitable care for this prevalent and disabling condition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENETIC DISTRUPTION IMPLICATION FOR DEPRESSION

OF

MONOAMINE

SYSTEMS:

Principal Investigator & Institution: Caron, Marc G.; Professor and Hhmi Invesitgator; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): Depression is a psychiatric disorder where a disturbance of mood is the prominent feature. Although the etiology of depression is unknown, alterations in serotonergic and noradrenergic function have been clearly implicated in the disorder. The present Center Grant proposes to examine depression from the perspectives of functional imaging, morphometrics, and pharmacological interventions in humans, as well as through the use of a variety of animal models of depression. The overall objective of the mouse studies is to show how the serotonin (5HT) and norepinephrine (NE) systems are interdependent in the development and amelioration of symptoms of depression and to reveal the neural mechanisms that contribute to this reaction. In Aim I, the role of the monoamines will be investigated in the heterozygous vesicular monoamine transporter 2 (VMAT2) animals. Studies will be performed to determine whether antidepressants influence monoamine levels in selected brain regions and whether these alterations are related to responses in several different behavioral models of depression. An inducible VMAT2 knockout (KO) mouse will be developed so that the role of this gene and subsequent alterations in neurochemical and behavioral responses can be readily assessed. In Aim II, the role of the norepinephrine transporter (NET) in depression will be evaluated. Experiments will be conducted in NET-KO mice to examine the effects of antidepressants on brain monoamines and behavior. An inducible NET-KO mouse line will be developed such that the role of this gene in the prevention of depression can be evaluated at any time. In Aim III, effects of 5-HT dysfunction will be studied in mice by selectively restoring VMAT-2 function to catecholaminergic neurons in the VMAT2-KO line. In this case, 5-

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HT and histamine function should be defective. We have generated these mice and plan to create an inducible mouse line for additional studies where disruption of VMAT2 function in 5-HT neurons can occur at the discretion of the investigator. The results from the studies in Project 4 will complement the aims of the other Center projects and they will be coordinated with the clinical Projects to better understand the mechanisms that may underlie depression. Additionally, results from the clinical Projects will be integrated into the mouse Project such that, an attempt will be made to examine some of these same phenomena in mice. From these perspectives, the findings from the mouse studies should be helpful revealing some of the molecular, cellular, and biochemical changes that accompany depressive-like behaviors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GERIATRIC DEPRESSION AND ANTIDEPRESSANT USE Principal Investigator & Institution: Crystal, Stephen; Research Professor; None; Rutgers the St Univ of Nj New Brunswick Asb Iii New Brunswick, NJ 08901 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2002 Summary: Among the elderly, few conditions are more consequential than depression. Rapid evolution in health care systems, new treatment technologies, changing prescription patterns and wider social acceptance of the biomedical basis of depression have created a new context for diagnosis and treatment of depression among the elderly. Such changes make it essential to examine national patterns and trends in the diagnosis and treatment of geriatric depression. In this study, nationally representative data from the Medicare Current Beneficiary Survey, including detailed longitudinal information on use of pharmaceuticals and mental health services, will be used to examine patterns of diagnosis of geriatric depression; analyze trends in and predictors of antidepressant treatment among the elderly; analyze use of specialty mental health services among elderly diagnosed with depression; investigate the extent and predictors of early discontinuation of antidepressant use; model amounts received and duration of mental health services use; and compare observed treatment patterns to those recommended by treatment guidelines. Variations in these patterns by care sector (mental health specialty versus general medical care), payer system (managed care versus fee-for-service), sociodemographic subgroup, insurance coverage, medical comorbidities, and other factors will be evaluated. We will also use data from the National Ambulatory Medical Care Survey, which link physician specialty, assigned diagnoses and medications prescribed during physician visits, to explore the evolving roles of the specialty and general medical care sectors in treatment of geriatric depression, and analyze the relationship between diagnoses assigned and psychotropic treatments prescribed at medical visits. Data from both sources will also be used to study the diffusion of selective serotonin reuptake inhibitors (SSRIs) among the elderly. These analyses will contribute to a better understanding of the process of diagnosis and treatment of depression in the elderly population, so that barriers to optimal care can be identified and addressed. They will also provide important information on trends in treatment patterns and shed light on the impact of health care system changes on the treatment of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GERIATRIC DEPRESSION: RISK FACTORS FOR ADVERSE OUTCOMES Principal Investigator & Institution: Steffens, David C.; Associate Professor; Psychiatry; Duke University Durham, NC 27706

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Timing: Fiscal Year 2002; Project Start 01-JUL-1995; Project End 30-NOV-2006 Summary: This is a renewal of a project in which 375 depressed patients aged 60 years and over will be followed for two to ten years, with a focus on cognition as a primary outcome. 250 patients from the current funding period will continue to be followed, and 125 new patients will be added in the first 30 months of the study. Detailed psychosocial, functional, functional, clinical, psychiatric, medical, neurological, and cognitive assessments will occur at intake and defined points during follow-up. Brain MRI studies will be performed at intake and once again two years later. The principal outcome measures are cognitive decline and dementia. The investigators will continue to examine depression outcomes. The analysis plan focuses on examination of risk for cognitive decline and later dementia using the following independent variables: change in fronto-striatal lesion burden, change in hippocampal volume, APOE genotype, and depression course. The project will preserve past methodological advances by combining and psychiatric assessments with psychosocial and psychobiological perspectives. In a study design that employs carefully defined treatment protocols, we will test specific hypothesis regarding cognitive decline and dementia in depression. While several studies have noted an increased risk of later dementia among depressed elderly, how one may predict incident dementia in older depressed adults is unclear. This application will focus on clinical variables (course of depression), neuroimaging variables (changes in fronto-striatal lesions) and genetics (APOE genotype) as predictors of cognitive decline and dementia in a group of older depressives and a group of elderly controls. Psychosocial factors will be used as co-variates. It is expected that the results from this study will clarify the relationship between depression and dementia in the elderly. It will also add to the literature on the long-term outcome of depression in a clinical setting. Ultimately it should aid in the clinical management of geriatric depression, shedding light on the prognosis for cognitive outcomes of depression in the elderly, as well as for long-term recovery and remission of depression symptoms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GERIATRIC DEPRESSION--NEUROBIOLOGY OF TREATMENT Principal Investigator & Institution: Reynolds, Charles F.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 01-APR-1983; Project End 30-NOV-2003 Summary: In this revised competing renewal of MH37869-16, we propose a randomized, double-blind, placebo-controlled study to test a method for the rapid treatment of geriatric major depression and for probing treatment response variability. We hypothesize that therapeutic sleep deprivation (TSD) will accelerate response to paroxetine (PX), as compared with TSD (+ placebo) or with PX alone. In open pilot studies, we have observed a rapid response rate of 69 percent (9/13 subjects), with Hamilton depression ratings of 10 or less by 14 days, in elderly depressed patients treated with the combination of TSD (one night) and paroxetine (20 mg QHS). By contrast, in other studies of bereavement- related or recurrent major depression, we have observed rapid response rates to placebo of 15 percent, to nortriptyline of 25-32 percent, and to paroxetine alone of 26 percent, suggesting that the use of combined (TSD + medication) may double or triple the rate of rapid response as compared with placebo or drug monotherapy, respectively. With respect to treatment response variability in geriatric major depression, we hypothesize that metabolic activity in cortical areas (prefrontal cortex and ventral anterior cingulate gyrus) will decrease to normal levels in patients showing an antidepressant response to TSD and will remain decreased after recovery sleep in patients responding rapidly to antidepressant treatment. (Data from

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non-depressed control subjects will be collected for comparison.) By contrast, we predict that glucose metabolism will remain elevated in non-responders and unchanged in nonresponders who may be hypometabolic at baseline. Our pilot data show a reduction in cingulate metabolism after TSD in patients but not controls; the reduction persists after successful treatment with paroxetine. We will recruit 108 elderly depressed outpatients with current major depression into a 14-day randomized, placebo-controlled, doubleblind, parallel-group study of TSD + PX, TSD + Placebo, and PX without TSD. All subjects will have pre-treatment MRI scans and twenty of 36 subjects in each treatment condition will also participate in PET studies of treatment response variability, together with 20 normal elderly control subjects. The percentage of patients meeting criteria for rapid response after 14 days of treatment in each of the three conditions will be contrasted in the intent-to-treat sample using contingency table analysis. Measures of subject expectancy, vascular risk factors, cerebral atrophy and white-matter hyperintensity, and cognitive status will be used as covariates in survival analyses of treatment response variability. Correlational analyses will be used to determine the association between changes in depression severity and alterations in regional glucose metabolic rates. Thus, this study aims to develop strategies to accelerate treatment response in geriatric major depression, to improve the early discrimination of nonresponders, to model the functional neuroanatomy of treatment response variability, and ultimately to reduce heterogeneity of treatment response in geriatric depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GERIATRIC DEPRESSION--TREATMENT RESPONSE VARIABILITY Principal Investigator & Institution: Little, John T.; Assistant Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: This is an application for a Mentored Patient-Oriented Research Career Development Award (K23). The candidate is a geriatric psychiatrist who proposes to acquire the specific skills and knowledge necessary to become an independent investigator and leader in geriatric depression treatment research. Among the aged, major depression is a common problem which causes significant morbidity and mortality. While effective treatments exist for major depression, the speed, extent, and permanence of treatment response are unpredictable and vary widely, thus leaving considerable residual symptoms and disability. The candidate proposes to use the tools of functional neuroimaging to examine the underlying biology of treatment response variability in geriatric depression in order to predict and optimize antidepressant treatment response. Career development activities emphasize an integrative approach and focus on treatment research methodology, functional neuroimaging, and geriatric psychopharmacology. The research plan involves a treatment trial for elders with major depression combined with fluorine-18 deoxyglucose positron emission tomography before and after 10 weeks of acute treatment with paroxetine. Reduction in the Hamilton Depression Scale score will be correlated with cerebral metabolism in neuroanatomical regions of interest. It is hypothesized that pretreatment anterior cingulate hypermetabolism will correlate positively with extent of antidepressant response to acute treatment. Possible sources of variance accounting for treatment response heterogeneity (e.g., cerebrovascular disease reflected as white matter hyperintensities on brain magnetic resonance imaging, age of illness onset, and serum paroxetine concentration) will also be examined. As continuation and maintenance treatment will be offered through the Mental Health Clinical Research Center for the Study of Late-Life

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Mood Disorders, regional cerebral glucose metabolism before and after acute treatment will also be examined with respect to long-term clinical outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GLIAL CELL GLYCOGEN AND STRESS-INDUCED DEPRESSION Principal Investigator & Institution: Bonsall, Robert W.; Associate Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): In this exploratory project, we propose to test a new hypothesis that deficiencies in the brain's reserves of energy make it vulnerable to stress and constitute a risk factor in the development of depression. Normal brain function is dependent on the expenditure of large amounts of energy (up to 20 percent of all energy needs in the human) and most of this energy is consumed in maintaining electrical potentials and ionic gradients across neuronal cell membranes. Exposure to stressful conditions induces greatly increased energy consumption in specific areas of the brain, and the ability of a neuron to respond normally to stressors and to survive the excited state that stressors produce is dependent on surrounding glial cells providing energy in the form of glucose and glucose metabolites. The glial cell's ability to provide energy sources to neurons is not only dependent on the transport of glucose from the blood but also on the mobilization of its own glycogen energy reserves. In response to excitatory neurotransmitters, glial cells break down glycogen into glucose and lactic acid and export them to neurons. We will determine if depression results when the brain is exposed to stressful conditions of sufficient intensity and duration as to deplete the glial glycogen reserve in specific regions of the brain. Depleted glial cells would then be unable to provide nearby neurons with sufficient glucose and lactic acid, and neuroprotective responses to the energy deficit would reduce local neural activity and cause symptoms of depression. We present new data using a well-established animal model of depression that support the glycogen hypothesis. These data indicate that stressful conditions sufficient to cause behavioral depression not only deplete cerebral glycogen but also cause a profound metabolic deficit. In the planned experiments, we shall (a) examine the effects of depression-inducing stressors on levels of glycogen in different brain areas, (b) monitor brain glucose and lactic acid release during exposure to the stressor and during the development and recovery from behavioral depression, and (c) examine the neurochemical and behavioral effects of manipulating brain glycogen levels. Results will provide entirely new insights into the mechanisms of stress induced depression and should suggest new approaches to the treatment and prevention of this devastating disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GLUCOCORTICOID RECEPTORS IN STRESS AND DEPRESSION Principal Investigator & Institution: Boyle, Maureen P.; Anatomy and Neurobiology; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Dysregulation of the hypothalamic-pituitaryadrenal axis (HPA), which controls the endocrine stress response, has been implicated in the pathogenesis of stress-related disorders including depression and anxiety. It is believed that at least part of the dysfunction is related to a lack of glucocorticoidmediated negative feedback to the hypothalamus. It has been hypothesized that glucocorticoid receptors (GRs) within the hippocampus (HPC) are important mediators

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of this inhibition. In order to investigate this hypothesis we will take advantage of recent advances in transgenic technology. We have generated mice with a conditional knockout of the GR in area CA1 of the HPC. In addition, we are in the process of generating mice with inducible expression of GRs in the HPC. Analysis of these two lines of mice will allow us to discretely address the role of GRs within the HPC in regulation of the HPA axis. We will examine these mice for changes in basal and/or stress-induced activation of the HPA axis. These mice will also be analyzed for changes in stress/depression related behaviors. Decreased hippocampal GR has been associated with a number of animal models of depression, while increased hippocampal GR is correlated with a decreased susceptibility to depression. We will therefore examine how changes in GR expression in the HPC influence depression related behaviors including anxiety, despair, anhedonia, and learning. We will further examine whether these mutations influence susceptibility to two established models of depression: chronic mild stress and social defeat. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GROUP CBT FOR DEPRESSION IN PUERTO RICAN YOUTH WITH IDDM Principal Investigator & Institution: Rossello, Jeannette M.; Psychology; University of Puerto Rico Rio Piedras Rio Piedras Sta San Juan, PR 00931 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Insulin dependent diabetes mellitus (IDDM) is a serious and complicated medical condition that requires a strict and burdensome regimen for its control. Statistical data suggests that IDDM is more prevalent in Latino populations, particularly in Puerto Ricans. Also, higher rates of complications, hospitalizations and mortality have been registered for Latinos. This population has been traditionally underrepresented in medical and psychological research. Depression symptomatology has been identified in approximately 32.4% of diabetic patients making it a frequent co-morbid condition. Although several studies have demonstrated good outcomes in the treatment of depression in adult diabetes, this has not been tested for youth with IDDM, much less for Latino youth. The main objective of this proposal is to develop and test a culturally appropriate group CBT intervention for depression in Puerto Rican youth with IDDM. The specific aims are to: (1) Develop, adapt, manualize, and refine an empirically based CBT group intervention for the treatment of depression in Puerto Rican adolescents with IDDM and depressive symptoms; (2) To pilot test the CBT for adolescents with IDDM (CBT-IDDM) to assess primary (depression, adherence, and metabolic control) and secondary (cognitions, self-esteem, coping strategies, quality of life, social support, and functionality) outcomes; (3) To evaluate the feasibility and acceptability of the procedures for implementation of CBT-G-IDDM and measures. Data will be collected to estimate intervention parameters such as effect size, attrition and response rate; recruitment of participants and therapists; sample definitions; outcome measures; protocol adherence; therapist competency; and patient acceptance of treatment and measures. Forty Puerto Rican adolescents with IDDM and depression symptomatology will be randomly assigned to one of two conditions: CBT-G-IDDM or a minimal contact (MC) group with close monitoring of symptoms. Multiple measures will be completed by multiple raters (adolescent, parent, and interviewer) at pre, midline and post. The impact of the intervention will be evaluated on primary and secondary outcome targets. Results from this study will permit a large randomized controlled clinical trial to further study efficacy and effectiveness issues. The treatment manual and procedures could benefit other Latino and minority youth with IDDM.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GROUP TREATMENT FOR DEPRESSION IN HEART FAILURE Principal Investigator & Institution: Friedman, Michael A.; Psychology; Rutgers the St Univ of Nj New Brunswick Asb Iii New Brunswick, NJ 08901 Timing: Fiscal Year 2003; Project Start 14-FEB-2003; Project End 31-JAN-2006 Summary: (provided by applicant): The overall aim of this research is to develop an efficacious group psychotherapy for the treatment of major depression among individuals with congestive heart failure. Both major depression and heart failure are associated with severe loss of functioning and increased mortality, and this co-morbid condition is particularly debilitating. While treating depression among heart failure patients has the potential to improve functioning and prolong life in this population, there are currently no empirically-supported treatments for depression among heart failure patients. Among the several well-validated psychosocial treatments, group cognitive-behavioral therapy (CBT) has been proposed as efficacious, and has established feasibility among heart failure patients. Group CBT may be particularly efficacious among CHF patients with depression due to the potential for increasing patient social support. Initial research suggests that there are several ways in which current group CBT could be improved to treat major depression among CHF patients, including: (1) the use of an "open" group format that allows for immediate patient care, (2) integration of individual interventions to individually tailor treatment goals and improve adherence to treatment, and (3) family-based interventions within the group CBT format to mobilize patient social support. The proposed integrated cognitivebehavioral therapy program includes group, individual, and family treatment (GIFT) for depression among individuals with CHF (GIFT-CHF). The current proposal is designed to develop the GIFT-CHF program. The proposal consists of three phases: a Development, Pilot, and Revision Phase. During the Development phase of the GIFTCHF, the goal of the research will be to: (a) develop an integrative group therapy program for depressed patients with heart failure (GIFT-CHF); (b) develop a therapist training program; and (c) develop and test the reliability and validity of competence and adherence rating scales. During the Pilot phase of the GIFT-CHF program, the goal will be to conduct a small pilot trial investigating the short-term efficacy of the GIFT-CHF program in comparison to a Standard Medical Care/Wait-List control group, and determine effect size. Finally, during the Revision phase of the GIFT-CHF program, the goal of the research will be based on the results of the Development and Pilot phases, to revise the GIFT-CHF program and treatment manual. This treatment development grant will lay the groundwork for a large-scale treatment outcome study of the GIFT-CHF program for depressed individuals with congestive heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HIV IN WOMEN: DEPRESSION AND IMMUNITY Principal Investigator & Institution: Evans, Dwight L.; Professor and Chair; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2003; Project Start 25-JUL-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Psychiatric morbidity has been associated with HIV disease since the beginning of the AIDS epidemic. Most of the clinical literature to date has focused on psychiatric issues in men who are HIV seropositive. There has been little data regarding the prevalence of psychiatric disorders in HIV infected women, despite the fact that HIV remains among the leading causes of death for US women between the

92 Depression

ages of 25 and 44. HIV also is the leading cause of death among African American women in this age group. We found that the proportion of women with current major depression was four times higher in HIV positive women compared to HIV seronegative women. This high rate of major depression coupled with the recent and largest epidemiology study to date indicating that depression is associated with increased mortality in HIV-infected women, underscores the need for studies to ascertain the relationship of major depression, immunity, and HIV disease progression in HIV infected women. The potential immune mechanisms by which depression may influence HIV disease progression and mortality remain to be understood. In our studies of HIV infected men, we have found depression associated alterations of immune cytotoxic cells suggesting that killer lymphocytes might mediate the effects of depression on HIV disease progression. Although previous studies have focused almost exclusively on HIV infected men, we have recently found that women with depression exhibit significant reductions in natural killer cell activity as well as increases in activated CD8 lymphocytes and viral load. The proposed study of HIV seropositive women, largely of minority representation, is designed to provide important information on 1) the underlying immune mechanisms by which depression my influence HIV-1 replication and thereby HIV disease progression; and 2) three potential mechanisms of action whereby depression my influence immunity and HIV disease progression. The present study may also help determine whether conventional antidepressants (SSRIs) as well as novel antidepressant pharmacotherapies (substance P antagonists and glucocorticoid antagonists) might benefit HIV-infected individuals and extend survival with HIV infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HMO TREATMENT OF DEPRESSION & SUBSTANCE ABUSE Principal Investigator & Institution: Clarke, Gregory N.; Senior Investigator; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, CA 94612 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 31-MAR-2003 Summary: Previous research has shown that depression is frequently comorbid with alcohol abuse and/or dependence, and that it is predictive of poorer short- and longterm drinking outcomes. Efficacy studies suggest that alcohol and other drug (AOD) treatment outcomes improve when comorbid depression is successfully treated. However, these efficacy studies are limited in their generalizability to real-world clinical settings, and their results require replication in effectiveness trials. Further, little is known regarding the cost- effectiveness of the treatment of depression comorbid with AOD problems. This randomized, controlled trial will test whether concurrent treatment for depression and AOD disorders improves drinking outcomes (percent days abstinent from alcohol, and mean standard drinks per possible drinking day) and depression. Adult HMO members entering an intensive, 5-week outpatient AOD treatment program will be administered a depression screening scale (the Beck Depression Inventory; BDI) as part of their standard intake assessment. Members scoring 16 or greater on the BDI will be contacted and invited to participate in the study. Consenting members will be administered an intensive intake battery, assessing drug, alcohol and psychiatric history, life functioning, and other psychosocial constructs of interest. Two hundred and twelve (212) subjects will be randomized to either: (a) "usual care" AOD treatment, or (b) usual care AOD treatment plus 8 individual sessions of cognitive-behavioral treatment for depression (CBT-D). All subjects will be re-assessed for AOD and depression outcomes at post-treatment, and at 3,6 and 12- months follow-up points. HMO databases will be employed to examine health services utilization and costs outcomes.

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Principal outcomes analyses will examine whether (a) AOD outcomes are better in the CBT-D condition; (b) depression outcomes are better in the CBT-D condition; (c) better AOD outcomes are mediated by improved depression outcomes: and (d) CBT-D is a cost effective adjunctive treatment for AOD with comorbid depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

HORMONE

RHYTHMS:

METABOLIC

SIGNIFICANCE

IN

Principal Investigator & Institution: Rubin, Robert T.; Professor; Allegheny-Singer Research Institute 320 E North Ave Pittsburgh, PA 15212 Timing: Fiscal Year 2001; Project Start 01-DEC-1985; Project End 31-JUL-2006 Summary: (adapted from applicant's abstract) This renewal application, for years 23-27, is to continue studies of the neuroendocrinology of major depression. The studies planned herein build upon more than 20 years of systematic exploration of the HPA axis in major depression, supported by this grant. In previous years, we conducted several large studies of patients with major depression vs normal controls, the results of which have led to our current focus on the hypothalamo-pituitary-adrenal cortical (HPA) axis. This axis is mildly to moderately hyperactive in 30-50 percent of depressed patients, most likely on the basis of increased corticotropin releasing hormone (CRH) and arginine vasopressin (AVP) secretion from the hypothalamus. Our most recent studies have revealed an unexpected and very interesting finding, the HPA axis responds differently to cholinergic challenge not only in depressed patients vs normal controls but also in women vsmen. Our extension of this to the study of laboratory rats has revealed similar findings between female and male animals. This is an emerging area of CNS neuropharmacology, with only a few prior studies that have considered neuroendocrine responses, other than the hypothalamo-pituitary-gonadal axis, by sex. Specific aims include: 1) Continued analysis of data from earlier studies. 2) Continued detailed study of sex differences in cholinergic regulation of the HPA axis in patients with major depression vs normal controls, in depressed patients during illness vsafter successful treatment, and in women us men. This specific aim forms the major thrust of this renewal application. 3) Completion of HPA axis studies at the adrenal and pituitary levels. 4) Continuation of animal studies of sexual diergism of cholinergic regulation of the HPA axis in female and male rats. The human studies will be used to inform planning of the studies in laboratory animals, and vice versa. The significance of the planned studies lies in their furthering our understanding of HPA axis regulation by CNS cholinergic mechanisms in major depression, as well as what we hypothesize to be adaptive changes to increased CNS stimulation of the axis at the pituitary and adrenal levels. In particular, understanding sex differences in cholinergic regulation of the HPA axis may help elucidate biological mechanisms underlying the greater incidence of major depression in women vsmen. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HPA AXIS IN DEPRESSION AND ANXIETY Principal Investigator & Institution: Young, Elizabeth Ann.; Professor; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 30-APR-2006 Summary: (Applicant's abstract) This is a Research Scientist Award Application. I have received 15 years of salary support through the RSDA program and have become a

94 Depression

leader in the area of HPA axis regulation in depression. Future studies proposed in this application will continue to explore hormonal abnormalities in depression and also in related anxiety disorders, panic disorder and PTSD. Current research indicates that depression is accompanied by abnormalities of the HPA axis, while anxiety disorders, particularly Panic Disorder, is accompanied by abnormalities of the central noradrenergic system, as reflected by a blunted growth hormone response to clonidine. Specific research aims in this proposal are I) to determine if abnormalities of central noradrenergic system are present in both pure depression, pure panic disorder and depression plus panic disorder. We will study a group of well characterized pure depressed, pure panic and mixed panic and depressed patients with the clonidine/growth hormone challenge to determine if all depressed patients manifest abnormalities in clonidine stimulated growth hormone release or if only those with comorbid panic symptoms manifest this abnormality. 2) To determine if abnormal activation of HPA axis secretion occurs in Panic Disorder patients. We will examine 24 hr urinary cortisol excretion, collected in 8 hrs segments in pure depressed, pure panic and and mixed panic and depressed patients. 3) To evaluate noradrenergic and HPA axis 'reactivity' to two simple challenges in pure depression, depression plus anxiety, panic disorder patients and normal controls. These challenges include orthostatic challenge and the Trier Social Stress Test (TSST). We hypothesize that panic disorder patients and depressed patients with co-morbid anxiety will demonstrate exaggerated catecholamine response to orthostatic challenge i.e increased reactivity. We hypothesize that depressed patients will have altered HPA axis responses to stress response while Panic Disorder patients will have normal HPA axis response to the TSST. 4 ) To determine if the abnormalities in basal HPA axis dysregulation, exaggerated responses to stress and blunted response to clonidine-growth hormone challenge studies occur in the same individuals and if the results of these biological studies support the nosological distinction between Panic Disorder, pure Major Depression and Major Depression with co-morbid Panic Disorder. Finally we will examine whether HPA axis and noradrenergic dysfunction reflect a common factor, degree of impairment, more than a specific mood and anxiety disorder. With regards to PTSD, we will explore whether decreases in urinary free cortisol and increases in urinary catecholamines are present in epidemiological sample of subjects exposed to trauma both with and without PTSD and normal subjects not exposed to trauma who are free of Psychiatric disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

HPA

REACTIVITY,

PUBERTY,

&

SEX

DIFFERENCES

IN

Principal Investigator & Institution: Stroud, Laura R.; Miriam Hospital Providence, RI 02906 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to allow me to become an independent, transdisciplinary researcher examining sex differences in stress responses and depression over puberty. I am a new Assistant Professor at the Brown University Center for Behavioral and Preventive Medicine with previous research focusing on sex differences in stress responses and depression in adults. Training from this K23 proposal will allow me to re-focus on adolescents and to develop a program of research examining: a) How do HPA responses to stress change across puberty in boys and girls? and b) Do changes in HPA responses to stress over puberty influence the emergence of sex differences in depression? My Career Development Plan includes training in social

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and biological influences on adolescent development, nosology and measurement of adolescent depression, statistical methods and ethics. My research goals include carrying out the K23 study, building a base of publications in adolescent stress responses and depression, and the submission of an R01. Guiding my training and research will be four transdisciplinary Mentors: Raymond Niaura, Ph.D. (sex differences in stress responses); Ronald Seifer, Ph.D. (high-risk children, statistics, ethics); Ronald Dahl, M.D. (puberty, depression, brain stress systems) and Adrian Angold, MRCPsych (sex differences in depression, nosology, statistics). The Research Plan involves a crosssectional investigation of sex differences in stress responses across stages of puberty in adolescents at risk for depression (offspring of depressed mothers). I hypothesize that in the early stages of puberty there will be no sex differences in HPA responses to interpersonal and instrumental stress. In advanced puberty, however, paralleling the emergence of sex differences in depression, girls will show greater responses to interpersonal compared to achievement stress, but boys will show greater responses to achievement compared to interpersonal stress. The K23 study will represent pilot data for a longitudinal study of stress responses and depression over puberty (R01 submission). This work has implications for targeted intervention and prevention efforts to diminish sex differences in adolescent depression. It should also elucidate basic interactions between the gonadal and stress axes over puberty. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HUMAN NEUROENDOCRINE STUDIES Principal Investigator & Institution: Akil, Huda; Gardner Quarton Distinguished University; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001 Summary: This proposal attempts to address the question: is the dysregulation of the Limbic-Hypothalamo-Pituitary-Adrenal (LHPA) Axis observed in depression a result of the stress which either precipitated the depression and/or resulted from it, or does the LHPA axis play a more fundamental role in the biology of depression? If the latter is correct, we would hypothesize that individuals who are prone to depression may respond to psychological stressors differently as monitored by endocrine correlates, and that they may do so not only when in episode, but also when out of episode. It would suggest that information which is laden with negative affect may be remembered differently by depressive individuals, as compared to normal controls. We propose to test these ideas by subjecting depressed patients, in and out of episode, to a social stressor and testing how they respond to it endocrinologically, how rapidly they terminate this response, and how well they habituate to its repeated presentation. We shall also use a newly devised memory test which contrast the ability to remember neutral vs. negative material, and ask whether depressed subjects, be they in or out of episode, show differences from controls in the way they handle emotional material. In addition, we shall test subjects out of episode at the purely neuroendocrine level using some sensitive challenges which we have devised and validated, and which we believe are reflective of the neuronal rather than the peripheral elements of the LHPA axis-these will include a metyrapone test in the evening at the nadir of the rhythm where we observe substantial dysregulation in drive level, and a test of fast feedback in the morning, at the peak of the rhythm, where we have shown a disturbance in glucocorticoid feedback. A complementary approach to addressing this central question is to study a group of subjects undergoing a very stressful life situation ( genetic test for a familial Breast Cancer Gene-BRCA1, to determine whether or not they carry a

96 Depression

mutation which gives them an almost 90% chance of developing breast and/or ovarian cancer); evaluating their neuroendocrine profile at that point; and determining whether it resembles that of individuals with major depression. We shall then ask whether an abnormal neuroendocrine profile is correlated with a personal or a family history of major depression, or with the subsequent occurrence of depression or mood disorders, as determined with a 6 month follow-up. Together, this series of studies should shed light on the extent of the relationship between major depression and the dysregulation of stress responsiveness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMAGING OF SEROTONERGIC AND CHOLINERGIC MARKERS IN SMOKERS Principal Investigator & Institution: Innis, Robert P.; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001 Summary: Prospective studies have shown that smokers whoa re vulnerable to depression are less successful at quitting and have a higher relapse rate than euthymic smokers. Seventy-five percent of smokers with a history of depression develop depression during smoking cessation, even if they are not depressed prior to quitting Nicotine, a principal component of cigarette smoke, has been suggested to have rapidacting antidepressant effects in non-smokers. These effects of nicotine are mediated through its initial actions on a central nicotinic acetylcholine receptor (nAChR) and the downstream enhancement of serotonin (5-HT) neurotransmission. In addition, a unknown byproduct of tobacco smoke is a potent monoamine oxidase inhibitor which further enhances 5-HT function. Since cigarette smoke has potent effectors on 5-HT, synaptic markers for this transmitter may by differentially regulated in smokers versus non-smokers. Also, the emergence of depression during smoking cessation in vulnerable smokers may be a consequence of adaptive changes in 5-HT markers. In vivo imaging using radiotracers regionally selective for the 5-HT transporter and 5-HT2A receptor have demonstrated reduced numbers of these pre- and post-synaptic 5-HT markers in living depressed patients. We hypothesize that heavy cigarette smoking will induce adaptive changes in 5-HT markers in living depressed patients. We demonstrated reduced numbers of these pre- and postsynaptic 5-HT markers in living depressed patients. We hypothesize that heavy cigarette smoking will induce adaptive changes in 5-HT transporter and 5-HT2A receptor number in smokers, and that these 5HT markers will down-regulate during smoking cessation in the subset of smokers vulnerable to depression. To test this hypothesis, we propose the following specific aims: 1) to determine the effects of smoking on 5-HT transporters and 5-HT2A receptors in euthymic smokers and non-smokers between genders 2) to determine if 5- HTtransporters and 5-HT2A receptors undergo adaptive changes during smoking cessation in smokers that develop depression; and 3) to develop a radiotracer for in vivo imaging of the nAChR, so that its potential role in nicotine dependence and depression may be studied in living smokers. The results from these studies will determine if there is a difference in pre- and postsynaptic 5-HT in smokers and if adaptations in key 5-HT markers during withdrawal are correlated with the emergence of depressive symptoms in vulnerable smokers. Furthermore, these studies may elucidate a neurochemical marker which will identify a subgroup of smokers who would benefit from antidepressant treatment during smoking cessation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IMAGING OF SEROTONIN TRANSPORTERS IN DEPRESSION Principal Investigator & Institution: Parsey, Ramin V.; Assistant Professor; Psychiatry; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 29-MAY-2001; Project End 30-APR-2006 Summary: (Provided by Applicant): Structural and functional imaging studies have suggested a neurocircuitry of mood disorders that involves a limbicthalamic-cortical circuit (amygdala, thalamus, prefrontal cortex) and a limbic-striatal-pallidal-thalamiccortical circuit. Abnormalities in a component of these circuits may affect the regulation of mood. Serotonin has been implicated in the pathophysiology of depression. Reports of fewer platelet serotonin transporters in major depression have rarely been extended to postmortem brain studies and neuroreceptor imaging studies in vivo. Serotonin transporter binding in the brainstem of depressed patients measured by SPECT is reportedly lower. ["C]McN5652 is a PET radioligand with high affinity for the serotonin transporter. Our group has developed kinetic modeling methods with this ligand that allow quantification of the serotonin transporter in subcortical and to a lesser extent in some cortical structures. We propose an in vivo study of the neurocircuitry of the serotonergic system in major depression. We predict that transporter binding will be decreased in depressed subjects in the midbrain, thalamus, putamen, hippocampus, and amygdala. Symptoms of depression have been correlated to serotonergic measures, including suicidal ideation, psychomotor retardation, and anxiety. We will correlate these measures of psychopathology with ["C]McN5652 binding. Correlations will help refine the neurocircuitry model of depression. Several lines of evidence suggest that serotonin dysfunction in depression may be a trait marker. Consequently, we will study both currently depressed (n=40) and remitted depressed subjects (N=20) while off medication, and compare both groups to healthy volunteers (N=20). We predict remitted depressed will not differ from currently depressed subjects. These results will greatly enhance our knowledge of the pathophysiology of major depression and help in our diagnosis, treatment, and design of future studies. This application for a Mentored Clinical Scientist Development Award has been submitted with the goal of supporting the development of the applicant's career as a psychiatric researcher. This research plan is intended to build on the candidate's prior work with neuroreceptor imaging in mood disorders. This application delineates plans for training and mentoring in the areas of the neurobiology of depression, cell and molecular physiology, pharmacology, neuroanatomy, statistical analysis, clinical diagnosis and ratings, teaching, brain imaging, and mathematical modeling necessary to enable the applicant to pursue an independent career of scientific inquiry in psychiatry. These goals will be met by a combination of didactic I course work and supervision. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IMIDAZOLINE RECEPTORS IN DEPRESSION--CLINICAL STUDIES Principal Investigator & Institution: Halaris, Angelos E.; Psychiatry and Human Behavior; University of Mississippi Medical Center 2500 N State St Jackson, MS 39216 Timing: Fiscal Year 2001; Project Start 01-MAR-1998; Project End 28-FEB-2003 Summary: (Adapted from applicant's abstract): For the last twelve years the investigator's laboratory has attempted to identify a specific and readily obtainable biological marker for depression. Platelet a2-adrenergic receptors (a2AR) were of theoretical interest because brain a2AR modulate monoamine output. In the wake of over 60 studies or the platelet a2AR in depression, the investigator noted a high degree of consistency only with an elevation in radioligand binding amongst those studies

98 Depression

which utilized imidazolines (principally 3H-clonidine) in their "a2 assays". After thoroughly characterizing the imidazoline-receptive sites on human platelets, the investigator concluded that platelets possess a nonadrenergic imidazoline receptor (IR1) binding site, in addition to an a2AR. In four studies of depression, and one of dysphoric PMS, the investigator has consistently observed an elevation of IR1 on platelet plasma membranes of depressed patients compared to matched controls, suggesting that the earlier literature might be explained by IR1 sites. The investigator also found that treatment of patients with either desipramine (DMI) or fluoxetine for 6 weeks leads to normalization (i.e., down regulation) of platelet IR1, suggesting that the platelet IR1 site might be a state marker for depression. These alterations were not correlated with changes in catecholamines. After transferring the grant from Case Western Reserve University the investigator replicated his findings in depressed patients with a demographically different population. Furthermore, he has developed a selective antibody assay for the IR1 protein, which is 100-fold more sensitive than the older IR1 radioligand binding assay. Using IR1-selective antiserum, depressed patients continue to display a marked elevation in the platelet IR1 density. The density of this single band (33 kDa), as detected on Western blots, is linearly correlated with the IR1 Bmax values of platelet samples. Recently the investigator has also observed an increase in 33 kDa/IR1 in hippocampi of depressed victims of suicide. Thus, in our search for an a2AR marker, he uncovered a novel nonadrenergic receptive protein which in five pre-treatment and 3 post-treatment studies of depression (and as assayed by two independent techniques) appears to be a marker for depression. The investigator's specific aims will determine: a) the extent to which IR1 elevation is observed throughout brain regions of depressed suicide victims, b) whether depressed patients also exhibit a functional IR1 alteration in hypothalamic growth hormone (GH) and prolactin responses to moxonidine infusions (as assessed under an a2AR mask), c) whether the potential platelet IR1 marker is sensitive to the severity of depressive illness, and d) whether the IR1 neurotransmitter candidate, agmatine, is also altered in depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMMUNOLOGICAL ASPECTS OF HEMORRHAGE Principal Investigator & Institution: Chaudry, Irshad H.; Professor, Vice Chairman & Director; Surgery; University of Alabama at Birmingham Uab Station Birmingham, AL 35294 Timing: Fiscal Year 2003; Project Start 01-APR-1988; Project End 31-MAR-2007 Summary: (provided by applicant): A major feature of trauma is immune depression. Studies demonstrate immune depression is severe in aged and ovariectomized (OVX) females and adult males, as opposed to maintained immune functions in proestrus females, after trauma-hemorrhage and resuscitation (T-H). Administration of 17betaestradiol (E2) in OVX females and males, or prolactin or steroid enzyme activity modulators (SEAM) in males after T-H restores immune functions. Moreover, survival rate of proestrus females subjected to sepsis after T-H is significantly higher than agematched males or OVX females. Studies also show that increased 5alphadihydrotestosterone synthesis in T cells is the likely cause for immune depression in males, while continued E2 synthesis maintains immune functions in proestrus females, following T-H. Similarly, hypoxemia also causes immune depression in mice. Recent studies show that in males, (a) pattern recognition receptors TREM 1, 2 and 3 are expressed in CD11b+ macrophages from bone marrow, PBMC, spleen and liver, in the absence of LPS stimulation, and their expressions are enhanced following T-H, and (b) there is a Th1 to Th2 shift in T cell cytokine release following T-H, implying that the

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depression in immune function may be due phenotypic changes in MPh and T cells. Since immune response following T-H is gender-dimorphic, phenotypic changes occurring in the immune cells early following T-H may be different in males and proestrus females. Therefore, the hypothesis is that the sex steroid hormonal milieu prevailing at the time of injury induces phenotypic changes in macrophages and T cells whose altered functions, evidenced in the release of mediators, lead to either depression or maintenance of immune functions after T-H. Since macrophages and T cells express receptors for sex steroids, and T cells synthesize active steroids in situ, it is also hypothesized that modulation of immune functions early following T-H with sex steroid receptor-specific antagonists/agonists or SEAM will lead to restoration and maintenance of immune functions and decrease mortality from subsequent sepsis in both genders. The specific aims are to: characterize phenotypic changes in macrophages and dendritic and T cells in the inflammatory microenvironment early following T-H; delineate the mechanism(s) for the release of inflammatory mediators by immune and endothelial cells; determine the contribution of hypophysis-pituitary-adrenal-gonad axis to immune depression; and evaluate the effects of steroidogenic enzyme and sex steroid receptor-specific modulators for restoring immune functions in males and estrus cyclespecific females after T-H or hypoxemia. Detailed analysis of phenotypic changes in immune cells and understanding their functions in T-H induced milieu, using recent cellular/molecular biological techniques, delineating sex steroid immune functions and assessing how they can be modulated by exogenous steroidal/ nonsteroidal modulators to improve immune responses should lead to innovative approaches for preventing immune depression and reducing mortality from sepsis in trauma victims with low E2 levels. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPACT OF DEPRESSION & FUNCTION ON HEALTHCARE USE & COST Principal Investigator & Institution: Friedman, Bruce; Community and Prev Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): The purpose of this Mentored Research Scientist Career Development Award (KO1) is to become an independent researcher prepared to make a unique and significant contribution to our understanding of the impact of depression and functional impairment on health services use and expenditures among older adults (age 65+). Three themes characterize my background: (a) work-related positions with an exclusive or major focus on the aged; (b) exposure to and involvement with late life mental health; and (c) expertise in crosssectional analysis of healthcare use and expenditures. My past scientific history has focused on innovative intervention studies of elderly patients. I will receive the needed training and conduct mentored research at the University of Rochester, with additional study at the University of Michigan and training and mentored research at Cornell University. Presently little is known about the impact of depression and functional impairment on healthcare use and expenditures among most categories of elderly patients (e.g., primary care patients, home care patients, and community-dwelling high users of medical care). The Training Objectives of my Research Career Development Plan are to: (1) Improve my knowledge base in relation to affective illness, cognitive dysfunction, and chronic illness comorbidity and disability in elderly persons; (2) Increase my knowledge of mental health oriented community-based interventions and public health models; (3) Add to my knowledge and skills in longitudinal data analysis; (4) Become more familiar with

100 Depression

the requirements for responsible conduct of research involving human subjects; and (5) Plan, organize, and carrying out a systematic research program adding knowledge of geriatric mental health and function to my expertise and skills in Health Services Research and community-based geriatric interventions. The Specific Aims of the Research Plan are: (Aim 1) To better understand the impact of major and subsyndronml depression on certain specific types of healthcare use and expenditures; (Aim 2) To better understand the effect of functional impairment (deficits in activities of daily living, instrumental activities of daily living, and ambulation/-mobility) on certain specific types of healthcare use and expenditures; and (Aim 3) To study the role of depression as a mediator between functional impairment and use/expenditures, and functional impairment as a mediator between depression and use/expenditures. The Analytic Plan consists of (a) bivariate associations, (b) regression analyses, (c) an examination of direct and indirect effects, and (d) longitudinal analyses applied to data from 3 studies: (1) the Medicare Primary and Consumer-Directed Care Demonstration (2) the Depression Outcome in Primary Care Elderly study, and (3) the Depression in Elderly Medical Homecare Patients study. Given the expected continuing rise in healthcare costs and the high prevalence of depression and functional impairment among the chronically ill aged, understanding the impact of depression and functional impairment on healthcare use and expenditures is of particular public health importance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPROVING ANTIDEPRESSANT ADHERENCE IN OLDER ADULTS Principal Investigator & Institution: Sirey, Joanne; Associate Professor; Psychiatry; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2002; Project Start 23-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This proposal is for a K23 Mentored PatientOriented Research Scientist Award. The applicant is a clinical psychologist and a developing investigator in the Cornell Intervention Research Center for Geriatric Mood Disorders. The goal of this application is to provide further interdisciplinary training and research opportunities to transition the applicant to become an independent investigator in interventions research. The career goal of the applicant is to develop interventions to improve adherence to antidepressant treatment among depressed older adults in primary care. The career development objectives of this application are to learn: 1) the theories underlying behavioral change interventions: 2) the design and evaluation of interventions in late-life depression; 3) assessment of older adults' attitudes and beliefs; and 4) factors that affect treatment adherence across illnesses. This training will provide the knowledge and skills to assess and to address negative attitudes and beliefs about: 1) depression and the usefulness of treatment efficacy, 2) stigma, and 3) treatment self-efficacy. The research proposed will pilot the usefulness of a brief, individualized intervention to improve adherence to SSRI antidepressant therapy by older adults prescribed by Primary Care Physicians. The intervention is designed to improve adherence by addressing the negative attitudes and beliefs that are obstacles to adherence for adults with late-life depression. Although the intervention is not a therapy to reduce depression; but because depression itself can contribute to negative attitudes and beliefs, one of the goals of the intervention is to buffer the effect of depression on adherence. The intervention targets obstacles to adherence and if proven useful, would be a manualized and feasible way to reduce the personal and public health costs of under treatment of late-life depression in older adults seen in primary care.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OUTCOMES

IMPROVING

DEPRESSION

TREATMENT

ADHERENCE

&

Principal Investigator & Institution: Flynn, Heather A.; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001; Project Start 31-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): This application seeks support for a Mentored Patient-Oriented Research Career Development Award (K23). The award would provide me the opportunity to transition to a successful independent research career focused on improving treatment adherence and outcomes for women with depression. I have had a thematic clinical and investigational interest in identifying factors that maintain depression, determining effective prevention and treatment strategies to overcome them. I have followed a career trajectory to develop a research focus in this area. The K23 mechanism will continue this trajectory, allowing me to: 1) obtain additional knowledge and skills in targeted areas pertaining to treatment adherence and transition to an independent research career in this area, 2) expand research methodology and grant-writing skills sufficiently so as to become competitive for extramural funding in this adherence/outcome arena, and 3) obtain support to pursue these academic and research goals under the mentorship of successful researcheracademicians in a multidisciplinary academic environment. Specifically, the educational and research endeavors for the proposed career development period will focus on developing incremental skills in 3 areas: I) theoretical/conceptual models (and associated methodological skills) of etiology, maintenance and treatment of depression in women, 2) exploration of how to incorporate selected psychological theoretical/conceptual models to improve treatment adherence, and 3) clinical and health services projects to objectively assess changes in treatment adherence and effectiveness of treatments for depression in women in naturalistic settings. To achieve these goals, I propose specific mentoring, coursework, didactic training, visits to national consultants, and participation in national meetings. The research plan aims to examine the underlying mechanisms and processes of psychotherapeutic approaches (Interpersonal Psychotherapy; IPT) and other psychological and interpersonal factors that might enhance treatment adherence and improve outcomes in women with depression. The first study proposed will examine the effectiveness of IPT in improving adherence and depression outcomes in pregnant women with depression. A second proposed project will examine the role of a number of factors hypothesized to affect treatment adherence in a more heterogeneous group of women (i.e. pregnant and nonpregnant) with depression in primary care. At the later stages of the proposed career development period, I will have achieved the training, mentoring and research experiences to permit independent formulation and execution of competitive ROl applications. This research has potential to meaningfully improve medication adherence, enhance outcomes and quality of life, and minimize the terrible morbidity burden experienced among women with depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPROVING DEPRESSION TREATMENT/OUTCOMES IN PRIMARY CARE Principal Investigator & Institution: Adler, David A.; New England Medical Center Hospitals 750 Washington St Boston, MA 021111533 Timing: Fiscal Year 2001; Project Start 15-SEP-1997; Project End 30-APR-2003

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Summary: (Adapted from applicant's abstract): This randomized clinical effectiveness trial will test the ability of a pharmacist intervention to improve the outcomes of treatment of depressive disorders in primary care. Numerous treatments are available; however, all require compliance to be effective. Approximately 30% of depressed primary care patients stop using antidepressant medications within the first month of treatment, while only 40% reach the recommended therapeutic dosage of antidepressant medication. Participation in care by clinical pharmacists has been proposed as a way to ensure the safe and effective use of drugs and to improve compliance. However, their specific clinical and economic contributions to the care of patients with depressive disorders are unknown. This study will evaluate the impact of standardized pharmacist interventions on the clinical, therapeutic, health status and financial outcomes of care, and on patient satisfaction with care. Specifically, we aim to (1) Compare, between the intervention and control group: a) the optimality of drug therapy for depressive disorders as defined by AHCPR guidelines; b) patient compliance with and knowledge of antidepressant medications; c) the number of drug-related problems; d) the resolution of clinical symptoms of depression and health status outcomes; and e) patient satisfaction; (2) Estimate the economic consequences (e.g., utilization of health resources, work functioning) and cost-effectiveness of the intervention. Consecutive patients (n=27,000) from 3 primary care practice settings will be screened. Patients meeting DSMIV criteria for major depression or dysthymia (n=710), based on a validated two-stage screening process, will be randomized to either an intervention or control group. Four pharmacists will participate in the primary care physicians' (PCP) care of each patient in the intervention group by: conducting an initial evaluation; following a standardized protocol to monitor drug therapy; assessing compliance and recommending strategies to correct non-compliant behavior, and educating and counseling patients about drug use. Patients in the control group will receive usual care from their PCP. All groups will be assessed at 3, 6, 12, and 18 months. By doing this study, we hope to elucidate whether participation of a clinical pharmacist in primary care treatment of depression improves the process of patient care, improves health outcomes and patient satisfaction, and decreases the economic costs of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INCREASING THE DETECTION OF MAJOR DEPRESSION--VIDAS Principal Investigator & Institution: Gonzalez, Gerardo M.; Professor; California State University San Marcos 820 W Los Vallecitos Blvd San Marcos, CA 92069 Timing: Fiscal Year 2001 Summary: The specific aims of this project are: 1. To develop a innovative computerassisted voice-interactive screener for accurately detecting major depression in English and Spanish- speakers. 2. To enhance culturally-sensitive depression assessment which provides access to mental health services. 3. To provide a reliable and valid depression screening tool that promotes the prevention of depression. The investigators seek to develop a reliable, valid, and culturally-sensitive computer-assisted voice-interactive screening tool for accurately detecting major depression in English and Spanishspeakers. The investigators intend to design and evaluate an innovative application called the Voice- interactive Depression Assessment System (VIDAS). VIDAS will integrate state-of-the-art speech recognition digital voice analysis, and natural spoken language understanding to overcome the limitations of self-report screening. Computerized speech recognition can conduct a structured clinical interview by verbally presenting each item and recognizing the patient's spoken responses. Digital voice analysis can quantitatively measure the patient's voice characteristics (e.g. speech

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rate, loudness, and tone) to objectively assess the intensity of current depressive mood. Natural spoken language understanding can evaluate depression symptoms through analyses derived from patient speech patterns (e.g. reaction time and pauses). The investigators propose to enhance the early and accurate identification of depression by evaluating the verbal content, speech patterns, and voice characteristics of English and Spanish-speakers. The investigators also seek to broaden the research on culturallysensitive depression because of invalid English language assessment methods. Furthermore, VIDAS is not intended to replace mental health professionals, but will extend mental health services by providing a tool for assessing individuals who would otherwise continue to suffer or develop debilitating depressive disorders. Early detection will also promote access to English or Spanish language services for the prevention of major depression. Ultimately, the investigators' broad long- term objectives are to contribute to the reduction of inappropriate health care practices, undue costs associated with the misdiagnoses of depression, and the incidence and occurrence of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INFORMATION PROCESSING BIASES IN DEPRESSION Principal Investigator & Institution: Gotlib, Ian H.; Professor; Psychology; Stanford University Stanford, CA 94305 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2002 Summary: Depression is among the most prevalent of all psychiatric disorders, accounting for over 20 percent of economic costs for all mental illness. A great deal of theoretical attention has focused on the possibility that negative thinking might represent not only a feature of depression, but a vulnerability factor for this disorder as well. A recent influential research paradigm has operationalized depressotypic cognitions in terms of selective attention to, and memory for, negative emotional stimuli. The overall goal of the proposed investigations is to utilize this paradigm to investigate the role of cognitive biases in onset and course of depression, and to examine neurobiological foundations of cognitive biases in depression. Specific aims include (1) examining the utility of cognitive biases to predict the course of depressive symptoms and diagnostic status over a two-year period; (2) localizing the neurobiological underpinnings of these biases; and (3) examining the breadth of these biases and their specificity to depression. To achieve these aims, standardized cognitive information- processing tasks will be used to identify 30 "high-bias" and 30 "low- bias" depressed patients in psychiatric outpatient clinics. The nature and breadth of these biases in the depressed patients will be compared to cognitive biases among 30 patients diagnoses with generalized anxiety disorder, 30 patients diagnosed with social phobia, and 30 non-patient controls. Each depressed patient will be followed for one year, and the degree of cognitive biases will be reassessed when the patient achieves clinical remission. Hypotheses concerning the neurobiological underpinnings of depressotypic cognitive biases will be tested by conducting functional magnetic resonance imaging (MRI) of depressed (and later, remitted) patients while they are performing informationprocessing tasks. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INSURANCE EFFECTS ON PRIMARY CARE FOR DEPRESSED PATIENTS Principal Investigator & Institution: Post, Edward P.; Medicine; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260

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Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: (Provided by applicant): This application's primary purpose is to provide the candidate with the means and mentorship to achieve the following goals: 1) Immediate goal: to characterize the effect of healthcare financing structure on utilization and quality of primary care services for patients with depression. 2) Long-term goals: to become an independent health services researcher, investigating policy-relevant questions about the effects of insurance structure on care for the chronically ill. The candidate will further develop and utilize research skills in health economics and psychiatric outcomes assessment; develop facility in techniques to analyze the effects of financial and organizational incentives; and acquire advanced training in quality of care measurement. He will master disease-specific skills in mental health services research by working on a multidisciplinary team studying a patient-oriented mental health intervention in a primary care setting. The career development program will incorporate formal coursework; tutorials and workshops with experts in specific methodological issues; site visits to major venues studying mental health services; and attendance and research presentations at local and national conferences. The major goal of the proposed research program is to characterize the effect of insurance structure on utilization and quality of primary care services for patients with depression. This goal will be accomplished through the planning, conduct, and analysis of a research project using data from a study that focuses on treatment for geriatric patients with depression. This study, a five-year multi-site NIMH-funded clinical intervention trial (Charles F. Reynolds, III, P.I., Prevention of Suicide in Older Primary Care: Patients [PROSPECT], is investigating strategies to improve depression treatment in primary care settings. The proposed K23 research will describe the effects of insurance structure on: individual patients' ambulatory service utilization, and the quality of care for depression. In addition, the research will assess the effect of insurance on the intervention to improve depression treatment in a primary care setting. Furthermore, this study will implement, collect, and predictably validate quality of care performance measures for several domains of depression management. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INTERPERSONAL CONTEXT OF ADOLESCENT DEPRESSION Principal Investigator & Institution: Rudolph, Karen D.; Assistant Professor; Psychology; University of Illinois Urbana-Champaign Henry Administration Bldg Champaign, IL 61820 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2003 Summary: Despite recent widespread recognition of child depression as a valid and potentially debilitating clinical phenomenon, controversy remains as to the etiology, significance, and prognostic power of depression in childhood. The primary goal of the proposed research is to identify the antecedents and sequelae of depression during the early course of disorder. A particular focus is placed on understanding the rise in depression during adolescence, especially in girls. The model guiding the research posits that family dysfunction in the form of parental depression and lifetime family disruptions fosters the development of maladaptive conceptions of interpersonal relationships and ineffective coping, which create a vulnerability to depression. Stressful circumstances, including the negotiation of normative developmental transitions, are hypothesized to activate this vulnerability, leading to depression during transition periods. Girls are expected to be most sensitive to these processes due to personal characteristics as well as the experience of unique challenges during adolescence. Finally, depression is expected to induce further psychosocial disruption,

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which increases the likelihood of persistence or recurrence of disorder across adolescence. This proposed multivariate model will be examined using a prospective, multi-informant, multi-method design. Subgroups of depressed, externalizing, and comparison children selected from a community sample will be followed over a period of 2 1/2 years to explore the social-cognitive, affective, interpersonal, and contextual processes underlying onset and recurrence of depression during the early course of disorder. Ultimately, it is anticipated that knowledge from such research can inform the creation of empirically based intervention programs designed to treat childhood-onset depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LATE-LIFE DEPRESSION MASKED BY LOW SADNESS Principal Investigator & Institution: Francoeur, Richard B.; None; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, NY 10027 Timing: Fiscal Year 2002; Project Start 01-JAN-2002; Project End 31-DEC-2003 Summary: (provided by applicant): Only ten percent of older adults with depression are estimated to receive treatment, in part due to low levels of detection by primary care clinicians. There is a growing body of evidence that depression among older adults may present in atypical ways, involving low levels of dysphoric mood, especially sadness. However, there has been little research to identify correlates or risk factors for these conditions of masked presentation. The compelling need for such research is suggested by recent findings that subclinical, intermediate-level symptoms of dysphoria which fail to meet DSMIV diagnostic criteria may be an important risk factor for future stroke episodes. The literature provides evidence that certain physiological conditions that occur with advancing age (vascular diseases, hypotension) are associated with three broad categories of "depression with low sadness": vascular depression, depression related to systolic hypotension, and depression related to diastolic hypotension. Psychosocial factors (chronic life stress, social isolation) are believed to influence expression of depressive symptoms, although it appears that the proposed study would be the first to investigate this. The proposed study is based upon a conceptual model of co-occurrence, or comorbidity, of different forms of "depression with low sadness" associated with underlying physiological conditions. The purpose of the proposed study is to investigate the etiology of these masked forms of depression with the aims of: 1) clarifying distinct patterns of items for depressed affect, low positive affect, and other depressive symptoms; and 2) identifying age-related and depression-specific correlates of these different patterns. A methodologically innovative use of latent trait analysis (MIMIC) will involve interactions between multiple covariates to model the endorsement of specific symptoms by well-focused subgroups, while simultaneously adjusting for the level of overall depression. The proposed study is based on secondary analysis of the first wave from the New Haven site of the EPESE community survey. The empirical model will be replicated on targeted sub-samples (i.e., blacks, white females, white males). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: LIFE STRESS AND COGNITIVE BIASES IN MAJOR DEPRESSION. Principal Investigator & Institution: Monroe, Scott M.; Professor; Psychology; University of Oregon Eugene, OR 97403 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2005

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Summary: Depressed individuals have been found consistently to report a higher incidence of recent severe stress than nondepressed people. Further, compared with patients without a recent severe life event, depressed patients with severe stress may have more severe symptoms, a different clinical course, and different rates of remission. Collectively, these findings suggest that the presence of recent severe stress represents a marker of potentially important individual differences in depression. Because not all people who encounter severe stress develop depression, however, information on other risk factors is required to understand individual differences in vulnerability to depression in the face of life stress. The construct of cognitive biases has been prominent in major theories of depression, and has been postulated to be important in relation to life stress and depression. Despite the obvious relevance of research that integrates information across social (life stress) and psychological (cognitive) domains, such inquiry has proven difficult to undertake. The methodological intricacies within each domain present a number of practical and logistic obstacles. Moreover, there are conceptual difficulties that have hindered this integration. Longitudinal empirical work, guided by theoretical insights and based on state-of-the-art methods from each domain, is required to advance understanding of multifactorial, integrative research. The primary goal of the present project is to investigate life stress and cognitive information processing biases for depression within the conceptual scheme afforded by diathesisstress theory. The present research has three specific aims. First, we test the relationship between life stress and cognitive bias within a well-differentiated conceptual scheme afforded by diathesis-stress theory and informed by attention to the issue of etiologic heterogeneity of depression; state-of-the-art methods will be used to assess life stress and cognitive vulnerability. Second, we test the predictive utility of stress, cognitive bias, and their interaction for clinical features and treatment course of depression. Third, we test differential activation of cognitive biases in remitted depressives as a function of preonset life stress with a laboratory mood priming paradigm to address questions of cognitive vulnerability. Secondary aims include testing: (1) other forms of life stress in relation to cognitive vulnerability; (2) life stress measurement issues; and (3) associations between stress-cognition interactions and other clinically relevant (e.g., attrition, treatment-seeking, post-recovery course) phenomena. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LIMBIC DOPAMINERGIC SYSTEM IN MAJOR DEPRESSION Principal Investigator & Institution: Ordway, Gregory A.; Associate Professor; Psychiatry and Human Behavior; University of Mississippi Medical Center 2500 N State St Jackson, MS 39216 Timing: Fiscal Year 2002; Project Start 14-DEC-2001; Project End 30-NOV-2005 Summary: A vast amount of research reveals that central dopamine (DA) containing systems are neuronal substrates of a broad spectrum of behaviors related to rewardseeking, motivation, and environmental responsivity. Disruption of these behaviors leads to anhedonia, social isolation, and psychomotor retardation that form core symptoms of depression. While there is little debate for a critical role of limbic structures, e.g. amygdala, in the regulation of mood and affect, the role of limbic DA in the pathobiology of depressive illness is not known. Functional imaging studies report involvement of limbic structures in depression, but few have focused on dopaminergic indices. Furthermore, there is a paucity of neurochemical studies of depression that have utilized postmortem brain tissue. Studies using postmortem brain tissue offer much higher anatomical resolution than it is offered by functional imaging. In preliminary studies, we have found lower dopamine transporter (DAT) and up-

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regulation of D2 receptors in the basal and central nuclei of the amygdala, but not in the other nuclei of this complex region, in major depression as compared to psychiatrically normal controls. These and other findings compel us to examine the possibility that there is diminished DA neurotransmission in subjects diagnosed with major depression (who died of suicide or natural causes). The central hypothesis of this proposal is that subjects with major depression have diminished mesolimbic DA activity that can be revealed by neurochemical abnormalities in discrete regions of the mesolimbic dopaminergic system. These neurochemical measures will be performed in discrete regions of the amygdala, (Aim 1), in the nucleus accumbens (Aim 2), and in the ventral tegmental area (VTA, Aim 3), core limbic regions of the brain. We also hypothesize that a distinct constellation of neurochemical abnormalities within limbic structures is specific for major depression (Aim 4), and will differentiate the pathobiology of major depression from that of suicide or schizophrenia. Groups of subjects to be studied will be: a) subjects with major depression who committed suicide, b) subjects with major depression not dying by suicide, c) sudden death non-psychiatric controls, and d) schizophrenics not dying by suicide. The proposed research will be the first focused investigation of potential abnormalities of limbic DA in major depression utilizing psychiatrically characterized subjects. The research will establish the specificity of neurochemical findings with respect to major depression and with respect to regional brain anatomy. Uncovering the potential role of DA in the pathobiology of depression may lead to advancements in the pharmacological, and possibly genetic, intervention of major depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MAJOR DEPRESSION FOLLOWING MINOR INJURY Principal Investigator & Institution: Richmond, Therese S.; None; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant): The cost of injury is considerable, estimated at $260 billion for fiscal year 1995. The primary costs are morbidity costs -- the value of goods and services not produced because of injury. Preliminary findings indicate that psychological distress is a significant predictor of post-injury disability and that symptoms of depression often accompany injury, appearing out of proportion to the severity of physical injury. The purpose of this study is to follow up on these findings, and in particular, to examine the public health impact of the development of major depression following minor injury. The majority of all injuries are minor, defined as injuries of sufficient import that individuals seek urgent medical care in an emergency department, but which do not threaten loss of life or limb. The primary aims of this study are to: determine the frequency of major depression (& related mood disorders) following minor physical injury; and determine the extent to which developing major depression (& related mood disorders) contribute to increased disability and reduced quality of life following minor physical injury. The secondary aims are to: compare the effect of developing depression and related psychiatric disorders (anxiety & stressrelated disorders) on outcomes following minor physical injury; and describe the onset and course of developing depression and related psychiatric disorders in the year following minor physical injury. 250 patients presenting to the emergency department at the Hospital of the University of Pennsylvania with minor injury will be enrolled. Minor injury will be defined by the Injury Severity Score for anatomic severity and the triageRevised Trauma Score for physiologic severity. Intake information includes injury data, pre-injury disability and quality of life. A comprehensive, structured psychiatric

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diagnostic evaluation will be conducted 72 hours after the minor injury has occurred, documenting psychiatric baseline (excluding patients with existing depression at time of injury or major DSM IV Axis I psychotic disorders). Participants will be followed by systematic, longitudinal follow-up evaluations (3, 6, & 12 months) to determine the development of major depression and its effect on post-injury disability and quality of life. The quasi-experimental design, in which each participant serves as his/her own control, will enable an accurate and comprehensive profile of developing major depression (and related mood disorders) following minor injury. Further, this design, using comprehensive psychiatric evaluation, will allow a critical analysis of the influence of major depression and related psychiatric disorders on outcomes following minor injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MARITAL ADJUSTMENT, DEPRESSION AND MYOCARDIAL INFARCTION Principal Investigator & Institution: Gallo, Linda C.; Psychology; San Diego State University 5250 Campanile Dr San Diego, CA 92182 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): Depression and Coronary Heart Disease (CHD) are each prevalent disorders, which frequently co-occur. Approximately 15-23% of individuals recovering from a heart attack (e.g., myocardial infarction; MI) will meet criteria for major depression and up to 65% will experience elevations in depressive symptoms. Yet, history of depression and disease severity are only moderately predictive of this co-morbidity. Importantly, depression is embedded within social context and, in particular, depression is strongly associated with marital adjustment. The primary goal of the current research is to examine if individuals with worse marital adjustment experience higher levels and a more persistent course of depressive symptoms following MI, in a 6-mo, 3-wave, prospective study of 150 men and women. Some research suggests that marital distress and depressive symptoms are more closely linked in women than in men. Therefore, the current research will examine if gender moderates the associations between marital adjustment and level and course of depression, with the hypothesis that associations will be stronger for women than for men. Previous research suggests that depression and possibly marital adjustment represent risk factors for negative physical health outcomes following MI. Further, when psychosocial risk factors occur in combination, the probability of negative outcomes is likely to increase substantially due to additive or synergistic effects. A secondary goal of the study will therefore be to examine the joint and independent effects of depression and marital adjustment on quality of life, functional status, and the probability of recurrent events following Ml. Women may experience worse outcomes following MI, and psychosocial factors could contribute to this trend. The proposed research will therefore examine if gender moderates the relationships between depression, marital adjustment, and health outcomes following CHD, with the hypothesis that effects will be stronger for women than for men. The broader goal of the proposed research is to identify aspects of social functioning that could represent potent, modifiable risk factors for CHD and depression co-morbidity, in the hopes of informing more effective prevention and intervention efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MATERNAL DEPRESSION: AN ADVERSE EVENT FOR INFANTS Principal Investigator & Institution: Goodman, Mark M.; Professor of Radiology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001 Summary: It is now well established that the children of depressed mothers are at increased risk for depression and other psychiatric disorders. The present proposal, the second of the two clinical projects on the CCNMD proposal, takes advantage of these previous clinical observations and scrutinizes the children of mothers who suffer depression during pregnancy or in the puerpurium. We propose to conduct the first longitudinal study of children whose mothers experienced at least one episode of major depression prior to pregnancy, thus placing the children at risk for exposure to depression in pregnancy or during the postpartum period. We propose to obtain behavioral, neurophysiological, neuroendocrine, and neuroimaging measures. Specifically we will test whether fetal exposure to maternal neuroendocrine dysregulation associated with depression, e.g., elevated cortisol, alters infant behavioral and/or endocrine responsiveness. Maternal blood samples will be obtained throughout pregnancy and maternal and umbilical cord blood will be obtained at birth. Subsequent infant measures including salivary cortisol, EEG, heart rate variability, as well as measures of maternal-infant interaction will permit us to test the potential contribution of maternal depressed affect on infant development. The data collected will allow for testing of hypotheses related to maternal depression during pregnancy as an early prenatal stressor and depression postpartum as a neonatal stressor with the resultant novel data on critical periods, severity of maternal depression and its impact on the fetus, as well as the role of genetic factors (family history and genetic analyses). In addition, potential ethnic differences between African-Americans and European Americans will be assessed. Taken together, this study will provide novel behavioral and neuroendocrinological information of the impact of maternal depression in children from birth to one year of age. This project is complementary to the other clinical project (Project 7) on the effects of early life stress on psychiatric and HPA function in adult women, has specific links to the basic science aspects of the proposed Center- through Project 2 and the Functional Brain Imaging Core, and utilizes multiple resources available in the CCNMD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MECHANISMS LINKING DEPRESSION TO CARDIOVASCULAR RISK Principal Investigator & Institution: Vaccarino, Viola V.; Assistant Professor; Medicine; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: (adapted from Investigator's abstract) Although several epidemiological studies pointed out an association between depression and increased risk for cardiovascular (CVD) events, little is known about the mechanisms for this effect. The broad objective of this project is to clarify the role of depression on CVD risk by studying the effects of depression on the cardiovascular system. Using a co-twin study design, 150 monozygotic and dizygotic twin pairs discordant for lifetime diagnosis of major depression drawn from a large national twin registery, the Vietnam Era Twin (VET) Registry will be enrolled. Twin pairs will be compared for 2 indices of altered cardiac function: a) decreased coronary flow reserve, a sensitive indicator of early coronary artery disease, assessed by Positron Emission Tomography (PET) myocardial

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perfusion imaging; and b) decreased heart rate variability, a risk factor for coronary arrhythmias and sudden death, assessed by means of ambulatory electrocardiographic (Holter) monitoring. Since twins share genetic makeup (which is identical if they are monozygotic) and rearing environment while growing up, they are matched on numerous known and unknown potentially confounding factors. Another aim of this project is to determine the relative contributions of genetic and environmental factors (such as life stressors) in the association between depression and abnormal cardiac function, by comparing the size of the intra-pair difference in cardiac parameters between depression-discordant twins. Twin pairs who are free of CVD and discordant for lifetime depression in previous surveys of the VET registry, will be invited to participate. Participants will travel to our institution in order to undergo confirmation of depression diagnosis by means of the Structured Clinical Interview for DSM-IV (SCID), PET myocardial imaging, and 24-hour Holter monitoring. Blood will also be drawn in order to investigate the role of biological mediators such as increase in hypothalamicpituitary-adrenocortical and sympathomedullary activity. Besides extending our knowledge of the mechanisms linking depression to CVD risk, the findings of this project will help in the design of more effective approaches to the primary prevention of CVD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF DEPRESSION AND CARDIOVASCULAR PATHOLOGY Principal Investigator & Institution: Grippo, Angela J.; Psychology; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2002; Project Start 01-APR-2002 Summary: (provided by applicant): This research proposal addresses physiological mechanisms and processes underlying the association between depression and cardiovascular disease. Human studies demonstrate a strong link between depression and coronary artery disease but have not progressed beyond correlational methods. The current proposal will examine the underlying mechanisms in depression and cardiovascular pathology by using a rodent model of depression (chronic mild stress) and a combination of behavioral, physiological, and pharmacological techniques. Rats will be exposed to chronic mild stress to induce the depression-associated sign of anhedonia (a reduced capacity to experience pleasure), and tested for cardiovascular impairments (Aim 1). Autonomic nervous system imbalance will be examined as a mechanism for the cardiovascular dysfunction (e.g., elevated heart rate and reduced heart rate variability) associated with the chronic mild stress model (Aim 2). In addition, central serotonin activity will be examined as a common pathophysiological factor underlying both depression and cardiovascular/autonomic dysfunction (Aim 3). This research will extend our knowledge of the interactions between psychological and physiological conditions, and possibly prompt the development of new treatments for patients with depression and/or cardiovascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MEN AND DEPRESSION Principal Investigator & Institution: Watts, H G.; Vice President; State of the Art, Inc. 4455 Connecticut Ave Nw, Ste B-2 Washington, DC 20008 Timing: Fiscal Year 2002; Project Start 13-SEP-2002; Project End 31-AUG-2003

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Summary: (provided by applicant): The proposed is a multi-media campaign for men with depression, using documentary video, print, and Internet. Campaign targets men with diagnosed or undiagnosed depression, and their significant referents. The project aims to: increase knowledge about depression in men; destigmatize depression; and promote professional diagnosis and treatment. There is a special emphasis on depression in men of color. In Phase I, we interview experts (including our Advisors), men with depression, and referents. We analyze interview content and generate creative plans for a video and companion booklet, and a web module prototype. Advisors review creative plans and prototype, which are revised, then qualitatively and quantitatively tested. Focus groups test validity of content in creative plans and prototype. Testing ensures materials meet the informational, motivational, and supportive needs of men with/at risk for depression, and their significant referents. In Phase II, we will fully produce the video, booklet, and interactive web module based on concepts validated in Phase I. This package is unique in that it examines men's experience of depression with modeling and interactive content. Documentary profiles model seeking professional diagnosis and treatment, web module engages user for education and motivation. The completed documentary video, booklet, and interactive web module will be distributed through counselors, physicians, therapists, clinic, other health professional, and organizations that serve people with depression, as well as Internet health website, and corporate Intranets. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MENTORED DEVELOPMENT AW

PATIENT

ORIENTED

RESEARCH

CAREER

Principal Investigator & Institution: Garlow, Stepheng J.; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-MAY-2000; Project End 30-APR-2005 Summary: PROPOSAL (Adapted from the applicant's abstract): Major depression is a significant independent risk factor for the development of ischemic heart disease and is a potentially lethal comorbid condition in post-myocardial infarction patients. The pathophysiology that links major depression to the occurrence of heart disease is not known. Preliminary observations indicate that platelet reactivity is increased in depression, which implies that depressed patients may be prone to thrombus formation, hence at increased risk for catastrophic cardiac events. There are considerable data indicating that the serotonergic system is altered in depression, both in the central nervous system (CNS) and in the platelets. In the periphery, the most notable and consistently replicated observation of serotonergic alteration is an increased B max for the serotonin-2A (5-HT2A) receptor on the platelets of depressed individuals. The platelet 5-HT2A receptor plays a central role in platelet reactivity and thrombus formation, and may be involved in regulating the expression of platelet specific genes in megakaryocytes, the cells from which platelets are derived. While not tested directly, the overarching hypothesis for this proposal is that major depression adversely increases platelet reactivity, which leads to increased risk of developing heart disease. The principal hypotheses that will be tested are that: 1) Platelets from depressed patients are produced in a "upregulated" state, with increased amounts of a number of transcripts that encode platelet specific genes, the result being the platelets are more reactive and prone to thrombus formation. 2) The platelet serotonergic system, in particular the 5-HT2A receptor, is altered in depression which in turn contributes to the increased platelet reactivity observed in depression, and the relevant alteration may occur in the megakaryocytes. 3) Alterations in the concentration of one or more humoral

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factors (interleukins, cytokines, stress hormones) orchestrate the alterations in platelet reactivity and serotonergic functioning observed in depression. Patients suffering from major depression will be recruited and their condition treated. Their platelets will be sampled before and after treatment and the amounts of transcripts that encode platelet reactivity molecules will be measured. The circulating concentration of three hormones, cortisol, interleukin-1 and interleukin-6 will be measured before and after treatment, and correlated to platelet reactivity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MORPHOLOGIC/NEUROCHEMICAL DEPRESSION IN AD

CORRELATES

OF

Principal Investigator & Institution: Zubenko, George S.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 31-JUL-2003 Summary: (applicant's abstract): Emerging clinicopathological studies of major depression in Alzheimer's disease (AD+D) suggest that the development of this behavioral complication of AD is associated with degeneration of the brainstem aminergic nuclei and the relative preservation of the cholinergic bnM. The neuropathologic and related neurochemical correlates of AD+D appear to be relatively specific for this condition, and may explain aspects of the course and treatment responsiveness of major depression in this context. Family histories of major depression may also be more common for AD+D patients, suggesting an interaction between a preexisting familial vulnerability and key neurodegenerative events in the pathogenesis of AD+D. The Lewy body variant (ADLBV) has been reported to be accompanied by more aggressive degeneration of the brainstem aminergic nuclei and a higher prevalence of major depression than AD alone. If confirmed, the latter observations would strengthen the relationship of degeneration of the brainstem aminergic nuclei to the development of AD+D. We propose to continue our clinicopathologic studies of these relationships and to evaluate their generalizability using autopsy-confirmed AD/ADLBV cases and controls who were prospectively characterized by a consortium of four NIA-funded ADCs/ADRCs. Moreover. we will test the hypothesis that the severity/ chronicity of major depression in AD is correlated with the extent of degeneration of the brainstem aminergic nuclei. To assess the specificity of these findings for depression, we will also explore the morphologic and neurochemical correlates of psychosis and other behavioral abnormalities in AD. In addition to family history studies we will determine whether the emergence of AD+D is influenced by the APOE genotype of AD patients. We will also continue our investigation of the role of apoptosis in neuronal loss from the brainstem aminergic nuclei in AD. Our data suggest that AD+D patients have increased susceptibility to neuronal loss in the LC (and possibly the DR and SN) due to increased vulnerability of these cells to apoptosis. We hypothesize that this enhanced vulnerability to apoptotic cell death results from a reduction in cellular protective mechanisms as reflected by a reduced proportion of neurons that manifest the upregulation of Bcl-2. The long-term goals of the proposed research plan are to better define the biological substrates of AD+D, to facilitate the development of more effective treatments, and to provide additional insight into the clinical biology of depression in the elderly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEGATIVE COGNITION DEPRESSION: ETIOLOGY AND COURSE Principal Investigator & Institution: Abramson, Lyn Y.; Professor; Psychology; University of Wisconsin Madison 750 University Ave Madison, WI 53706 Timing: Fiscal Year 2002; Project Start 01-AUG-1990; Project End 31-DEC-2003 Summary: (provided by applicant): This competing continuation is part of a 2-site collaborative research grant with an identical application submitted concurrently by Dr. Lauren B. Alloy at Temple University. Prior research did not provide an adequate test of the hopelessness theory (HT) and Beck's theory (BT) of depression and may have been misleading about those cognitive theories' validity. Thus, the overarching goal of this project is to provide a more powerful test of HT's and BT's predictions about the etiology of depression and a validation of the Hopelessness Depression subtype. To this end, a large scale, 5.5-year prospective study was conducted at both sites. Initially nondepressed, non-psychopathological Ss (n=349) who were at either high or low cognitive risk for depression were followed prospectively with independent and blind self-report and interview assessments of stressful life events, cognitions, social support, coping, and psychiatric status/symptoms in order to predict onsets and subsequent recurrences of depression. Familial and developmental origins of cognitive vulnerability to depression also were examined, including assessment of the parents (n=335) of highrisk and low-risk Ss. In this renewal, differential predictors of first onsets vs. recurrences of depression, factors that increase resilience among high-risk Ss and promote depression among low-risk Ss, factors that contribute to and moderate change in cognitive vulnerability, and different models of cognitive vulnerability-stress relations also were investigated. This project contributes to: 1) the scientific understanding of the etiology and course of a subset of the mood disorders; 2) a more valid nosologv of the depressive disorders; 3) an understanding of the origins and continuity/change of cognitive vulnerability to depression; 4) an understanding of factors that promote resilience to depression; and 5) the development of interventions for treating and preventing depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEGATIVE COGNITION DEPRESSION: ETIOLOGY AND COURSE Principal Investigator & Institution: Alloy, Lauren B.; Professor; Psychology; Temple University 406 Usb, 083-45 Philadelphia, PA 19122 Timing: Fiscal Year 2002; Project Start 01-SEP-1990; Project End 31-DEC-2003 Summary: This competing continuation is part of a 2-site collaborative research grant with an identical application submitted concurrently by Dr. Lyn Y. Abramson at the University of Wisconsin. Prior research did not provide an adequate test of the hopelessness theory (HT) and Beck's theory (BT) of depression and may have been misleading about those cognitive theories' validity. Thus, the overarching goal of this project is to provide a more powerful test of HT's and BT's predictions about the etiology of depression and a validation of the Hopelessness Depression subtype. To this end, a large scale, 5.5-year prospective study was conducted at both sites. Initially nondepressed, non-psychopathological Ss (n=349) who were at either high or low cognitive risk for depression were followed prospectively with independent and blind self-report and interview assessments of stressful life events, cognitions, social support, coping, and psychiatric status/symptoms in order to predict onsets and subsequent recurrences of depression. Familial and developmental origins of cognitive vulnerability to depression were also examined, including assessment of the parents(n=335) of highrisk and low-risk Ss. In this renewal, differential predictors of first onsets vs. recurrences

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of depression, factors that increase resilience among high-risk Ss and promote depression among low-risk Ss, factors that mediate and moderate change in cognitive vulnerability, and different models of cognitive vulnerability-stress relations are also investigated. This project contributes to: 1) the scientific understanding of the etiology and course of a subset of the mood disorders; 2) a more valid nosology of the depressive disorders; 3) an understanding of the origins and continuity/change of cognitive vulnerability to depression; 4) an understanding of factors that promote resilience to depression; and 5) the development of interventions for treating and preventing depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NET - SELECTIVE LIGANDS FOR THE TREATMENT OF DEPRESSION Principal Investigator & Institution: Johnson, Kenneth M.; Professor; Acenta Discovery, Inc. 9030 S Rita Rd, Ste 300 Tucson, AZ 85717 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): World-wide public health surveys point to an increased global health burden for serious psychiatric disorders, particularly depression. Indeed, by 2020 it is expected that depression may be the second most serious medical condition with respect to global disease burden. It is clear that more effective pharmacotherapies are needed in treating depressive illness. Selective ligands for the norepinephrine transporter (NET) such as desipramine are quite effective in some patient populations, but their use is often limited by side effects, particularly those thought to be mediated by their anticholinergic properties. More selective NET ligands may have considerable application in the treatment of depression. However, currently there are very few NET-selective ligands available. The studies described in this research proposal involve the synthesis and pharmacological evaluation of novel conformationally constrained tricyclic tropane analogues that are designed to be potent NET-selective inhibitors. For the best NET inhibitors identified, we will then screen them in animal models of depression. Additionally, it is reasonable that such ligands could be utilized with positron emission tomography (PET) imaging to assess changes in noradrenergic terminal fields in a variety of human conditions including depression. Thus, these ligands could be a significant addition to the clinical armamentarium available to treat and diagnose psychiatric disease. Within the context of this grant, it is our intention to follow up on our exciting preliminary findings of potent NET-selective compounds by conducting the following studies: 1. Further elaborate the biaryl and thienyl series of conformationally constrained tricyclic tropane analogues based on the SAR information already in hand; 2. Investigate certain phenylacetylene analogues that are derived from our biaryl analogues by the replacement of Ar1 with a triple bond as an aromatic ring bioisostere.; 3. Assay the inhibitory activity of all new ligands at the NET, SERT, DAT and the muscarinic receptor; 4. Scale up the synthesis of the most drug-like NET-inhibitors and study these in animal models of depression. Key words: depression, norepinephrine transporter (NET) inhibitors, conformationally constrained tricyclic tropanes, pharmacotherapy, PET imaging, chemical synthesis, behavioral testing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEUROANATOMY PROCESSING IN DEPRESSION

OF

COGNITIVE

AND

EMOTIONAL

Principal Investigator & Institution: Mccarthy, Gregory; Professor and Director; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The goal of this project is to investigate the functional neuroanatomy of cognitive and emotional processing in humans as it relates to late life depression. This Center has proposed a cerebrovascular lesion model in which small vascular lesions within prefrontal cortex, basal ganglia, and related structures lead to the development of late life depression [1,2]. Here we propose to use functional magnetic resonance imaging (fMRI) supplemented by psychophysiological recording to investigate prefrontal cortical function in emotional regulation during depression. We have adopted as our framework Mayberg?s model delineating the role of prefrontal cortex in depression [3]. Mayberg proposed that three brain systems comprise the neurological substrate of depression: (1) a dorsal attention-cognitive system composed of dorsolateral prefrontal cortex (PFC) (Brodmann areas, BA 9/46,44), the anterior cingulate (BA 24), and inferior parietal cortex (BA 40), (2) a ventral vegetative-somatic system composed of ventral frontal (BA 47) cortex, the amygdala, hippocampus, subgenual cingulate (BA 25), and ventral insula and (3) a rostral cingulate region (BA 24) that integrates the dorsal and ventral systems. A reciprocal relationship between the dorsal and ventral system is believed to regulate mood. Sadness and depression are associated with decreased activity in the dorsal system and increased activity in the ventral system. Remission of depression reverses these relationships. We will test this model in the context of the vascular lesion model proposed above. There are four specific aims: (1) we will investigate the interplay between dorsal and ventral brain systems in-patients with late life depression and MRI-verified prefrontal lesions, and in age-matched controls with no lesions or depression. We will use a target detection task to engage dorsolateral prefrontal cortex with embedded task-irrelevant neutral and emotional distracters to engage ventral prefrontal cortex and the amygdala. (2) We will compare the pattern of functional activation found in patients with late life depression and prefrontal lesions with age-matched controls who have had a sad mood induced by an experimental Relived Emotion procedure. (3) We will compare the pattern of functional activation found in patients with late life depression and prefrontal lesions after treatment. (4) We will investigate the time course of habituation for stimuli with emotional valence and the salience for conditioned emotional stimuli using fMRI supplemented by psychophysiological measurement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEUROBIOLOGICAL BASIS OF DEPRESSION AFTER BRAIN DAMAGE Principal Investigator & Institution: Solodkin, Ana; Neurology; University of Chicago 5801 S Ellis Ave Chicago, IL 60637 Timing: Fiscal Year 2001; Project Start 15-SEP-1999; Project End 31-AUG-2004 Summary: Depression is a serious complication of structural brain injury, and can severely impair physical and cognitive recovery. Of the three million stroke survivors living in the US, more than 65 percent of them will suffer clinical symptoms of depression. Many of these cases can be directly attributable to the stroke, making poststroke depression a serious health problem. The specific aim of this proposal is to study the biological bases of depression as revealed through patients recovering from

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ischemic focal brain injury. These studies of depression will focus on its effects on motor system plasticity after middle cerebral artery infarction. We will test the following hypotheses: Motor cortices in clinically depressed subjects will present neurochemical changes in monoaminergic systems (Serotonin, dopamine and noradrenaline). Recovery of motor skills after frontal ischemic stroke depends on the anatomical reorganization of ipsilateral frontal regions adjacent to the infarcted area, and these anatomical changes will be more pronounced in individuals without depression when compared to cases with post-stroke depression. Functional neuroimaging will corroborate the anatomical findings, demonstrating poorer anatomical recovery in depressed patients than in those without depression. Areas underlying functional recovery as seen with fMRI will show the greatest degree of anatomical reorganization when assessed with direct anatomical methods in non-depressed cases compared to depressed ones. The overriding goal of this research is to investigate the neuroanatomical and neuropharmacological differences between depressed and non-depressed patients following focal ishemic brain damage, and to correlate the findings from studies of autopsy tissue with neuroimaging studies using functional magnetic resonance imaging (fMRI). Since combining both methods will limit the number of cases, in parallel, we will perform the same neuroantomical studies in post-mortem tissue with damage in the equivalent areas (but without fMRI assessment). The detection of the changes in cellular circuitry during recovery in groups with and without post-stroke depression will allow us to understand better the neurobiological substrate of this disorder. In the long run, this information may lead to novel pharmacological treatments in both depression and stroke, but most importantly, in those cases where depression is a concomitant of structural brain injury. At the same time, the current research aims to give the principal investigator necessary mentored experience to achieve independence in biological psychiatry research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DISORDERS

NEUROBIOLOGICAL

PREDICTORS

OF

STRESS-RELATED

Principal Investigator & Institution: Liberzon, Israel; Associate Professor; Psychiatry; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2002; Project Start 05-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Stress-related psychiatric disorders in general, and post-operative depression in particular, constitute a major challenge. Depression, anxiety and post-traumatic stress disorder (PTSD) often develop after various stressors like surgery, serious illnesses, motor vehicle accidents, and natural disasters, and vulnerability factors are likely shared by these disorders. Distinct profiles of hypothalamo-pituitary - adrenal (HPA) abnormalities, are well-established in depression and PTSD, but those alterations which are pre-existing, those which are a response to stress/trauma, and those which are a component of the active illness, remain to be identified. Only prospective study of markers prior to a predictable stressful event will be able to address this question effectively and clarify the role of a neuroendocrine response to stress in the this process prospectively. Studying candidate markers of susceptibility in subjects who undergo a predictable stressful event, such as major surgery, will be important not only for study of post-operative depression but also for study of stress-related disorders in general. Our hypothesis is that postoperative depression develops in patients with pre-stress alteration of neuroendocrine function in concert with specific premorbid risk factors. Our pilot findings suggest that major

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abdominal surgery constitutes a predictable stressful event leading to a de novo depression in a subgroup of postoperative patients. Therefore, we will test the hypothesis that pre-stress markers of HPA axis and catecholaminergic system will predict the development of depressive disorder following predictable stress of abdominal surgery. We predict that hypercortisolemia and DST non-suppression will predict depression. A cohort of 2lO patients undergoing elective endovascular or abdominal aortic operation for aneurysmal or occlusive disease and 70 "control" patients with aortic disease treated conservatively will be studied (4 groups). Surgical patients will be assessed preoperatively, and at three times postoperatively (3, 9, and 18 mo.) to document preoperative and postoperative neuroendocrine function and psychiatric morbidity. Control patients will be assessed to determine frequency of spontaneous onset of psychiatric abnormalities. Using mixed model regression, we will examine the role of psychological and neuroendocrine abnormalities in post-operative depression and determine the stability of specific factors (neuroendocrine measures, psychiatric symptoms and diagnoses) and whether they reliably predict the development of comorbid disorders postoperatively. We will also determine if the ability to terminate neuroendocrine stress response after surgery or in response to dexamethasone predicts outcome, and if this is linked to pre-stress abnormalities. Identification of pre-stress markers of vulnerability clearly has profound implications for our understanding of stress-related dysfunction, the pathophysiology of psychiatric disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEUROIMAGING IN DEPRESSION TREATMENT STUDIES Principal Investigator & Institution: Sheline, Yvette I.; Associate Professor; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Description (provided by applicant): This K24 Midcareer Investigator Award in PatientOriented Research will provide five years of support to enhance a program of research and mentoring for the applicant in Neuroimaging in Depression Treatment Studies. The treatment of major depression in late life is an important health problem with a large and growing number of affected individuals. Many investigators have found that patients with late-onset depression, particularly those with cerebrovascular disease risk factors (VRF), are likely to have a slower and less complete response to antidepressant treatment. It has been proposed VRF may predispose to occult cerebrovascular disease in the form of frontal cortex deep white matter hyperintensities (FDWMH) and subcortical gray matter hyperintensities (SCGMH), collectively referred to as T2H. This may contribute to the development of late life depression by interrupting pathways involved in mood regulation. The overall goals of the applicant's research are 1) to continue the transition from cross-sectional studies to treatment outcome studies investigating brain pathophysiological factors that predict treatment outcome and 2) to train junior investigators from a range of clinical backgrounds in the design and conduct of neuroimaging studies in assessing treatment outcome of depression. The proposal describes the applicant's current research program and the career development and mentoring activities planned for the 5-year duration of the K24. Two NIH grants are ongoing: one will determine if severity of T2H and frontal executive dysfunction predict less antidepressant treatment response; the other will determine if late life depression is associated with abnormalities in 5-HT2A receptor regulation by antidepressants. Career development activities for the PI in MRI diffusion tensor imaging are described to further delineate the prognostic value of T2H and their ischemic nature and a third project is described to use these measures in longitudinal studies of white matter

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ischemic changes. Trainees will engage in these projects, take coursework in neuroimaging and clinical investigation and complete a research proposal over the 2year training period. K24 support will provide the applicant with protected time to carry out depression treatment outcome studies in late life depression and to increase the mentoring of beginning clinical investigators in neuroimaging studies in depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NICOTINE, BIOGENIC AMINES AND DEPRESSION Principal Investigator & Institution: Tizabi, Yousef; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2002; Project Start 01-JUN-1977; Project End 31-JUL-2006 Summary: Because of high incidence of cigarette smoking among depressed individuals, it has been postulated that smoking may reflect an attempt at self-medication with nicotine by these individuals. We have observed anti-depressant effects of nicotine in an animal model of depression. Moreover, the effects of nicotine can be blocked by preadministration of the nicotine antagonist, mecamylamine. There is also a differential expression of nicotinic receptors in depressed rat lines compared to their controls. These findings suggest a role for nicotinic receptors in depressed rat lines compared to their controls. These findings suggest a role for nicotinic receptors in depressive characteristics of animals. Nicotinic receptors are potent modulators of a variety of neurotransmitters including biogenic amines which have been directly implicated in human depression.. Although nicotinic manipulation may constitute a novel intervention in depressive disorders, a clearer understanding of the role of specific nicotinic receptors in depression is critical in developing pharmacotherapies for this devastating mental disorder. Here, we hypothesize that depression is associated with inherent changes in specific nicotinic and/or biogenic amine pathways. Furthermore, we postulate that nicotine would tend to normalize these neurotransmitter systems. These hypotheses will be tested in two rat models of depression by examining the role of nicotinic receptor subtypes as well as the contribution of selective dopaminergic noradrenergic and serotonergic pathways to depressive characteristics in these animals. Specifically, we will: 1) determine the effects of selective noradrenergic and serotonergic neurons in selective pathways implicated in mood regulation; 3) determine the basal function of biogenic amines in selective pathways; 4) determine the effects of nicotine functionality of these pathways; 5) determine central and peripheral bioavailability of nicotine. Behavioral analysis will include measurements of several parameters in the forced swim test as well as locomotor activity. Neuronal densities will be assessed by stereological technique. In-vivo microdialysis will be used to determine the functionality of the neurotransmitter systems. Plasma and brain nicotine and cotinine levels will be measured by gas chromatograph-mass spectrometry. The information provided by these studies will significantly advanced our understanding of biological substrates of depression and can lead to novel pharmacotherapies for this disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ONCOLOGY DEPRESSION PROGRAM--LATINAS WITH CANCER Principal Investigator & Institution: Ell, Kathleen R.; None; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 30-APR-2003 Summary: (Provided by applicant): Despite the high incidence of depression among patients with cancer, detection and treatment of depression in oncology care is

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inadequate with negative effects on patient's functioning, symptoms, quality of life, and even survival. Hispanics under-utilize mental health services and have been underrepresented in depression treatment studies. We propose to conduct a phased developmental pilot study of a socioculturally compatible Multifaceted Oncology Depression Program (MODP). MODP is aimed at reducing symptoms and improving outcomes among Latinas with breast or cervical cancer, reducing demands on family caregivers, and assisting oncologists in caring for their patients. Thus, we aim to: 1) Adapt an existing collaborative care model used in primary care, implement the model, evaluate and further refine the model based on the pilot experience, and produce a detailed manual for use in a randomized trial; 2) determine what treatment is given and what outcomes are obtained with usual care for recognized depression in a separate open trial; 3) evaluate the MODP in an open trial to determine its acceptance by patients and oncologists, adherence, and the size and variability of change from baseline in the primary outcome measures: depressive symptoms, quality of life, and caregiver distress at 4 and 8 months follow-up; 4) estimate the proportion of oncology outpatients having major depression who would meet eligibility criteria for a randomized study; 5) evaluate the use of assessment and outcome measures including direct cost measures; and (6) determine what additional cultural adaptations are needed to optimize acceptance and outcomes of treatment for a low-income Hispanic patient population. The proposed study will address the following specific questions: (i) Can a collaborative model of depression care known to be effective in primary care be effectively adapted and implemented in specialty oncology care, and specifically among low-income Hispanic patients? (ii) What modifications in the intervention model are acceptable, feasible, and appropriate for oncology practice and for Hispanic women? (iii) By implementing enhanced depression management with socioculturally compatible interventions to reduce known barriers to Latinas' access to depression treatment, will recruitment, retention, follow-up, and outcomes of minority women be favorably affected versus modestly augmented usual care? (iv) What would be likely recruitment, necessary sample size and best measures for a randomized trial to compare the effectiveness of the MODP and usual care for patients with identified major depression? Two open trials (of usual care and MODP) will be carried out sequentially on 40 women (a total of 80 women). Women will be screened using the SCL-20 and diagnostically assessed using the PRIME-MD PHQ-9. In addition to screening and physician didactics, MODP intervention enhancements are: onsite case management services to reduce barriers to care; patient and family education on depression treatment; psychiatric consultation; and patient-oncologist shared decision-making in selecting medication treatment or cognitive-behavioral Problem-Solving Treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ONLINE DEPRESSION EDUCATION FOR PRIMARY CARE PROVIDERS Principal Investigator & Institution: Tanner, T Bradley.; President; Clinical Tools, Inc. 431 W Franklin St, #30 Chapel Hill, NC 27516 Timing: Fiscal Year 2001; Project Start 22-SEP-1998; Project End 31-AUG-2003 Summary: Nineteen million adults suffer from depression and it is the leading cause of disability in the United States and a leading cause of suicide. Yet there is clear evidence that primary care physicians --those who treat the majority of depression cases are undertreating depression. During Phase I we developed and implemented a successful Internet based CME course on diagnosing depression. During Phase II we will create a complete continuing education program of 6 Internet-based courses on the topic of

120 Depression

depression diagnosis and treatment in the primary care setting. Courses will be approved by the University of Pittsburgh for CE credit and/or by the American Academy of Family Physicians. The Principal Investigator, Co-PI, and an esteemed group of depression and education consultants will apply an approach used in the development of other CE projects to expand upon the work done in Phase I. The Webbased courses will emphasize learning via a case-based approach. In addition, courses will be enhanced to include unique features possible with web-based courses including support for user control and feedback, discussion/communication, an accompanying news/resource area, patient education materials, and links to other information resources. A standard rapid-prototyping formative analysis technique will utilize consultation with and review by our consultant experts as well as input from potential end-users to produce successively improved versions of each course. If successful, this project will affect improved knowledge, attitude, depression clinical skills, self-efficacy, and awareness of resources. We will evaluate the benefits of the educational experience offered by the courses by using a two-group, pre-post testing design. Over a six-month period, the study group will be required to view all of the web-based courses. The control group will view courses of the same format that are on other clinical topics and do not include any information on depression. We will also assess overall user satisfaction with the online learning experience in terms of course elements, comparison to other learning experiences, and perceived impact. If the courses are successful, this project will produce a new means to educate physicians in depression diagnosis and treatment techniques. The methodology used in this research will serve as a template to guide other Investigators interested in developing other mental health continuing education materials. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ONTOGENY OF DEPRESSIVE SUBSTRATES Principal Investigator & Institution: Feng, Pingfu; Assistant Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 30-JUN-2003 Summary: (Adapted from applicant's abstract): The long-term goal of the proposed work is to determine brain processes involved in the pathogenesis of endogenous depression (ED). In past work investigator found that if neonatal rats were treated with clomipramine (CLI) and other antidepressant drugs they developed signs of depression when they became adults. The investigator's current work concerns the brain substrates of the adult rat depression. The work proposed in this application concerns the processes between neonatal CLI administration and the adult depression. The investigator's question is: what neonatal effect of CLI leads to the adult depression? Evidence suggests that neonatal RSD by CLI (and other antidepressant drugs) produces the adult depression. The investigator has recently developed the first successful technique to produce long-term, instrumental REM sleep deprivation (IRSD). Using this technique, his main aim is to test the hypothesis that in rats neonatal RSD causes adult depression (RSD hypothesis). An unambiguous test of the RSD hypothesis requires that IRSD be administered to neonatal rats over the precise age period (critical period) of depressogenic CLI administration to other rats. The precise critical age period of CLI administration has not been determined. Thus, preliminary to the IRSD study, the investigator's first aim is to determine the precise critical neonatal age period of depressive CLI administration. Also an unambiguous test of the RSD hypothesis requires that IRSD achieve the same RSD as neonatal CLI. The level of RSD by CLI has not been precisely determined. Thus, preliminary to the IRSD study, the investigator's

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second aim is to determine the precise level of daily RSD produced by neonatal CLI during the prior established precise critical period of CLI administration. Using these 2 results, he will administer IRSD to test the RSD hypothesis. Several adult behavior and RS measures related to depression will be the outcome measures. Although it is known from brief (1-3 hour) samples that RS time decreases in the first postnatal month, very little is known about the ontogeny of other RS variables and the interrelationships of their developmental changes. The investigator has recently developed the first successful technique for continuous (24 hour/ day), long-term (weeks) polysomnographic (PSG) recording of sleep/wake states in neonatal rats. With this technique the investigator's preliminary evidence suggests that 7 different RS variables follow parallel developmental courses over postnatal weeks 2-4. Confirmation of this preliminary finding can: a) yield the first systematic data on the ontogeny of several different RS parameters; b) identify the RS markers of the critical period of depressive CLI administration; c) suggest by these RS markers and their known neurophysiology and neurochemistry testable hypotheses about the underlying processes involved in the ontogeny of depressive disposition. The significance of the proposed work is that it may shed light on early developmental processes that contribute to later depression and depressive temperament. In doing so, the proposed work may help in the search for early prevention of ED, and in more precisely targeted treatments of ED. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OPIOID DEPRESSION OF RESPIRATORY NEURONS Principal Investigator & Institution: Lalley, Peter M.; Associate Professor; Physiology; University of Wisconsin Madison 750 University Ave Madison, WI 53706 Timing: Fiscal Year 2001; Project Start 15-JAN-2000; Project End 31-DEC-2003 Summary: (Adapted from the applicant's abstract): Opioid drugs are key adjuncts in the management of acute and chronic pain. However, they depress respiration in therapeutic doses, limiting their effectiveness, and cause fatal respiratory arrest in overdose. At present there is very little information about the cellular and neural network disturbances which underlie opioid respiratory depression. This in vivo investigation will identify mechanisms through which opioids disturb excitability and rhythm in several types of medullary respiratory neurons that control depth and rate of respiration. In adult decerebrate cats of either sex (1), Receptor-selective opioids will be pressure-microinjected into regions of the medulla which are known to influence depth and rate of respiration, and their effects on motor discharges in hypoglossal (HGN), recurrent laryngeal (RLN) and phrenic (PN) nerves will be measured. The results will reveal how these sites contribute to opioid depression of respiratory depth and rate, how they influence upper airway resistance in the presence of opioids, and the functional significance of different subtypes of opioid receptors. (2), Effects of opioids applied by microiontophoresis to medullary Inspiratory, Post-Inspiratory and Expiratory neurons will be measured and analyzed with intra- and extracellular recording methods. Responses related to specific subtypes of opioid receptor will be identified by applying receptor-selective agonists and antagonists to each type of neuron. This research will reveal how opioids and their receptors alter excitability in functionally important cell types and thus contribute to reductions in depth and rate of breathing. (3), A novel approach for reversing opioid-induced depression of the respiratory network based on activating D1-dopamine receptors on respiratory neurons to increase intracellular cyclic AMP will be investigated. In some experiments, A D1dopamine receptor agonist will be applied by microiontophoresis to respiratory neurons to determine whether it reverses opioid-evoked depression of cell excitability. In others,

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receptors on respiratory neurons and network interneurons will be activated by administering the D1-agonist intravenously, and its effectiveness will be judged from its ability to reverse depression of HGN, RLN and PN discharges produced by i.v. injections of opioids. This project will thus identify sites, cells and receptors in the medulla where endogenous opioids modulate respiration and where opiate drugs depress breathing. It will also test a new method that may alleviate opioid-induced depression of respiration without affecting analgesia, and counteract respiratory depression by overdose of opioids. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ORGANIZED SELF-MANAGEMENT SUPPORT FOR CHRONIC DEPRESSION Principal Investigator & Institution: Ludman, Evette J.; Center for Health Studies 1730 Minor Ave, Ste 1600 Seattle, WA 98101 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-DEC-2005 Summary: (provided by applicant): Randomized effectiveness trials demonstrate that organized care programs can significantly improve the process and outcomes of acutephase depression treatment. This application aims to adapt and pilot test two Core elements of an organized care program (systematic telephone outreach and monitoring to improve quality and continuity of pharmacotherapy, and structured psychoeducational group programs focused on patient activation and self-management) in a population-based sample of patients with chronic or recurrent depression. Two forms of group self-management training will be evaluated: a Peer-Led Chronic Disease Self-Management Group (after that developed by Lorig and colleagues) and a TherapistLed Cognitive-Behavioral Therapy Group. Approximately 120 patients with chronic or recurrent depression will be randomly assigned to one of four conditions: 1) usual care; 2) phone care management; 3) phone care management plus peer-led self-management group; or 4) phone care management plus therapist-led CBT group. Blinded assessments will examine clinical outcomes (SCL depression score, depression diagnosis by SCID), functional outcomes (SF-36 Questionnaire, illness intrusiveness, disability/lost productivity), and process variables (self-efficacy for managing depression, use of coping strategies) over 12 months. If patients choose not to participate in treatment, reasons for dropout will be assessed. Computerized data systems and intervention time logs will assess quality of treatment received (prescriptions filled, visits made) as well as direct program costs. The data collected will provide: 1) an evaluation of the feasibility and acceptability (including recruitment, intervention uptake and continued participation) of the intervention programs; 2) preliminary evaluation of effectiveness, i.e., the effects of each intervention on patient outcomes and process of care; and 3) information to inform the design and implementation of a full-scale effectiveness trial (refinement of intervention programs and measurement strategy, necessary sample size). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: PARENTAL DEPRESSION AND INFANT DEVELOPMENT Principal Investigator & Institution: Lewinsohn, Peter M.; Research Scientist; Oregon Research Institute 1715 Franklin Blvd Eugene, OR 97403 Timing: Fiscal Year 2001; Project Start 10-APR-1997; Project End 31-MAR-2004 Summary: (Adapted from applicant's abstract): Research has demonstrated specific impairments in infants of depressed mothers, and in the interactions between these

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infants and their mothers. These impairments include developmental delay, deficits in infant affective and cognitive behavior, poor mother-child attunement, and psychophysiological abnormalities. The participants for this project will be drawn from males and females enrolled in the Oregon Adolescent Depression Project. Females from the sample who become pregnant during a three year recruitment period (n-126). These participants, their partners, and their infants will be assessed on four occasions over the first two years of the child's life. Assessments will include current and past psychopathology amongst the mothers and fathers, marital functioning and familial context, parenting behaviors, parental perceptions of the infant, and observational data pertaining to infant development. The infant will also be observed interacting with each parent in order to examine both parental and infant affect and responsiveness. The three specific aims are to examine: (1) the effect of different aspects of parental depression, including family and personal history of depression on the developmental of infants, (2) the specificity of the abovementioned impairments in infant development of depression, and (3) the role of fathers and the marital relationship in the development of impairments in infants. The results of this study will allow assessment of how history of depression (including family history) influences the development of infants, either through its influence on parental depression in the post-partum period, or as a trait marker that adversely affects parenting independent of current psychopathology. The second aim will be addressed by the inclusion of mothers and fathers with histories of psychiatric disorders other than depression, and the assessment of a wide variety of psychopathology in both. The third aim will be addressed by examination of levels of depression and other psychopathology in fathers, the marital relationship, and observation of their interactions with their child. The public health benefits of this study include knowledge about risk factors that can be used to identify children who are at especially elevated risk, and about specific parental behaviors which are involved in the transmission of risks. This information is important for the design of preventative interventions intended to reduce the deleterious effects of parental depression on children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PARENTAL POSTPARTUM DEPRESSION & THE FAMILY SYSTEM Principal Investigator & Institution: Goodman, Janice H.; None; Boston College 140 Commonwealth Ave Newton, MA 02467 Timing: Fiscal Year 2001; Project Start 13-SEP-2001 Summary: (provided by applicant) Postpartum depression affects between 8 and 28 percent or new mothers, with up to 68 percent of new mothers experiencing some degree of depressive symptoms. New fathers also experience depression, especially if their partner is depressed, and postpartum depression is correlated with decreased marital satisfaction. Parent-infant interaction and attachment are major indicators of the quality of the infant?s nurturing environment. Postpartum depression has significant negative effects on mother-infant interaction and on child development. Little is known about how the infant is affected when a new father is depressed or when both parents are experiencing depressive symptoms. Also unknown is whether or not a nondepressed father may buffer the negative effects of a mother?s postpartum depression on the infant. Using a family systems framework, this study aims to explore the influences of maternal depressive symptoms, paternal depressive symptoms, quality of the couple relationship and parental dyad functioning on the parent-infant interaction and each parent?s attachment to the infant. A mixed-method triangulated design involving quantitative measures at 2 to 3 months postpartum, followed by in-depth

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qualitative interviews and quantitative measurements at 6 to 12 months with a purposive subset of study families will be used. Findings will be interpreted to increase understanding of how postpartum depressive symptoms impact the family, and a family systems model of postpartum depression will be generated. Knowledge gained from this study may be useful in developing nursing interventions that will promote optimal parent-infant relationships in the early postpartum months. This may be especially crucial to child development in families where early parenting is compromised by depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PARTNER PSYCHOPATHOLOGY

VIOLENCE

PREVENTION

&

ADOLESCENT

Principal Investigator & Institution: Ehrensaft, Miriam K.; Psychiatry; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2005 Summary: (adapted from candidate's abstract): This is a request for a Mentored Clinical Scientist Development Award (K08). The purpose of this application is to acquire training and prevention of partner violence in urban adolescents with conduct disorder and depression. Current research suggests that early antisocial behavior, and possibly depression may make unique and substantial contribution to the development of violence between adult romantic partners. Yet, questions remain regarding mechanisms by which these disorders may influence partner violence, especially in urban adolescents. Understanding these mechanisms can inform strategies to prevent partner violence in youth with conduct disorder or depression. The candidate is a clinical psychologist with expertise in adult partner violence and recent postdoctoral training in child psychiatry, especially the study of conduct disorder and depression. This proposal aims to acquire additional training needed for the comprehensive study of the prevention of partner violence in youth with conduct disorder and depression, including: 1) Longitudinal methodology and data analysis used to examine mechanisms mediating the association of conduct disorder, depression and partner violence; 2) Conducting clinical trials of violence prevention programs to target partner violence in conduct disordered and, possibly, mood disordered urban adolescents. Training will be provided via coursework at Columbia, formal tutorials, consultation with a panel of experts, work on longitudinal, epidemiological samples of adolescents, and a Phase I clinical trial of a multiphase prevention program for conduct disordered youth. This Phase I trial will be modified based on results of the longitudinal studies. Training obtained via this award will be used to apply for independent funding to design a controlled clinical trial of partner violence in youth with conduct problems and/or depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATHOBIOLOGY OF HOPELESSNESS, DEPRESSION, SES AND CVD Principal Investigator & Institution: Everson, Susan A.; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001 Summary: (adapted from investigator's abstract): High levels of depression and hopelessness increase risk of cardiovascular disease (CVD) morbidity and mortality. Likewise, CVD prevalence and incidence are inversely related to socioeconomic status

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(SES). Mechanisms by which depression, hopelessness, and low SES increase risk for CVD are not well understood; however, research shows that traditional coronary risk factors cannot account for much of the observed associations. Several studies indicate that depression and hopelessness are associated with abnormalities in serotonin (5HT) function and dysregulation of the hypothalamic-pituitary-adrenal axis, resulting in excess secretion of cortisol, an important stress hormone. Chronic stress exposure and higher levels of psychological stress associated with living in poor conditions also are thought to adversely influence 5HT and cortisol levels. Both 5HT and cortisol have cardiovascular effects and are involved in pathogenesis of CVD. However, to our knowledge, no prior population-based epidemiologic studies have examined whether serotonergic and glucocorticoid mechanisms mediate the well-documented associations between depression, hopelessness, low SES and atherosclerosis. The proposed study takes advantage of a unique opportunity to test these hypotheses within the context of the Kuopio Ischemic Heart Disease (KIHD) Risk Factor Study, the most comprehensive study of biopsychosocial risk factors for atherosclerosis and related morbidity and mortality ever to be conducted. The KIHD study is conducted in Kuopio, Finland, and has been at the forefront of research into psychosocial determinants of CVD. The proposed study will utilize existing data to examine plasma cortisol concentrations and whole blood 5HT and platelet 5HT receptor and transporter binding in relation to depression, hopelessness, SES and athersclerosis. Participants include a populationbased cohort of 800 men and 800 women aged 53-71. The investigators argue that depression, hopelessness, and low SES will be related to decreased levels of 5HT and elevated plasma cortisol; that both 5HT and cortisol will mediate the effects of depression, hopelessness, and low SES on carotid atherosclerosis; that these mediating effects will be evident after taking into account traditional risk factors (although the effects of cortisol also may operate through some of these risk factors); and that 5HT function will be lower in women compared to men. Depression and CVD are expected to be the two leading causes of disability in the next 20-25 years. Moreover, widespread economic disparities and associated health consequences are evident throughout the world. Thus, understanding mechanisms by which psychological states and SES are related to the development and progression of CVD is a critical task and one that will shed light on treatment and prevention strategies for patients with atherosclerotic vascular disease and for patients suffering from depression or hopelessness. Importantly, delineating the mechanisms by which psychosocial attributes influence atherosclerosis also will advance understanding of important mind-body interactions in cardiac disease processes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATIENT CENTERED DEPRESSION CARE FOR AFRICANAMERICANS Principal Investigator & Institution: Cooper, Lisa A.; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2008 Summary: (Provided by the Applicant) Several studies document underutilization of outpatient specialty mental health services by African Americans. However, African Americans with depression are just as likely as whites to receive care in primary care settings. Despite their use of primary care services, African American patients are less likely than whites to be recognized as depressed, offered pharmacotherapy, and to initiate or complete pharmacotherapy or psychotherapy for depression. Compared to whites, African American patients express stronger preferences for counseling and more

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negative attitudes toward antidepressant medication, the most common form of treatment of depression used by primary care physicians. African Americans are also more likely to see depression and its treatment through a spiritual framework. Studies show that African Americans receive less optimal technical and interpersonal health care than whites for many conditions, including depression. Depression is a common chronic condition that results in substantial morbidity, functional disability, and resource use. Despite the proven efficacy of pharmacotherapy and psychotherapy for treatment of depression, many depressed primary care patients of all races and ethnicities still do not receive adequate treatment. Recent quality improvement trials for depression in primary care have shown improvements in outcomes; however, there is room for improvement, particularly for ethnic minority patients. Interventions focusing on patient-centeredness have documented benefits on patient adherence, patient satisfaction, and health outcomes. Yet, only a few recent quality improvement strategies for depression include patient-centered accommodations. We have created a patientcentered adaptation that includes many of the components of recent successful quality improvement interventions for depression in primary care. The proposed study compares a standard depression intervention for patients (delivered by a depression case manager) and physicians (review of guidelines and structured mental health consultation) to a patient-centered intervention for patients (incorporates patient activation, individual preferences, and cultural sensitivity) and physicians (incorporates participatory communication skills training with individualized feedback on interactive CD-ROM). Thirty physicians and 250 patients will be randomized to either the standard interventions or the culturally tailored interventions. The main hypothesis is that patients in the patient-centered, culturally tailored intervention group will have higher remission rates from depression and lower levels of depressive symptoms at 12 months than patients in the standard intervention care group. Secondary outcomes will include patient receipt of guideline concordant care, patient and physician satisfaction with care, patient-physician communication behaviors, patient and physician attitudes toward depression, and self-efficacy in managing depression. This study will add to knowledge about how to effectively engage African American patients in care of depression and serve as a prototype of how to incorporate patient-centeredness in programs to reduce racial and ethnic disparities in health care for common conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATIENT DECISION MAKING ABOUT ANTIDEPRESSANT MEDICATION Principal Investigator & Institution: Wills, Celia E.; Associate Professor; None; Michigan State University 301 Administration Bldg East Lansing, MI 48824 Timing: Fiscal Year 2001; Project Start 15-JUN-2000; Project End 31-MAY-2005 Summary: (Applicant's abstract): The purpose of this application is to prepare the PI for an independent research career focused on primary care mental health services for depression. Depression is a highly prevalent primary care health problem with impact comparable to the burden of major medical illness, and is associated with high morbidity, mortality, diminished quality of life, and health services costs ($44 billion in 1990). Although effective depression treatments including medication are available, a majority of primary care patients who are prescribed antidepressant medication decide to either decline or discontinue medication soon after starting it. Little is known about how people make depression treatment decisions, including key influences on decision making and appropriateness of decision making as related to health status and health system outcomes. Research on patient decision making can provide information that is

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needed to develop patient-focused interventions to improve depression treatment outcomes. The aims of the proposed award are for the PI to: 1) develop knowledge of health services research concepts and methods for primary care and mental health services research; 2) develop and test measurement and analytic strategies for examining relationships between primary care patient decision making, antidepressant medication use, and health services outcomes; and 3) conduct two pilot studies as the basis for a R01 application to test a nurse-implemented patient decision support intervention for depression treatment in primary care. The PI will gain needed health services research skills to carry out these aims through a program of formal course work, directed study, and supervised research field experiences. The goal of research Project #1, a patient decision support intervention for primary care depression treatment will be pilot-tested for feasibility in research Project #2. The PI's long-term goal is to improve the quality of primary care services for depression through implementation of decision support interventions for diverse populations of patients undergoing depression treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATIENT FACTORS IN THE OUTCOME OF DEPRESSION IN PRIMARY Principal Investigator & Institution: Coyne, James C.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2005 Summary: This project examines the role of patient factors and treatment alliance (TA) in the outcome of depression in primary care. The overarching hypothesis is that patients' attitudes about depression, help-seeking, and antidepressant medication, and the quality of their social support influence the TA, treatment adherence, and ultimately the outcome of care for depression. The project involves a mixed method triangulation design in which patients newly identified as depressed are followed for a year with either a quantitative or qualitative methodology. Participating physicians will record all patients they detect as depressed. Following the index visit, patients will be given an initial telephone screening for eligibility. Patients who are deemed incident cases, i.e., who have not received treatment for depression in the previous 6 months, will be scheduled for a comprehensive telephone interview within 2 weeks. A smaller number of subjects will be selected for the qualitative component of the study via purposeful sampling. For the patients assigned to the quantitative arm of the study, this interview will include modules of the SCID and a standardized assessment of attitudes and experiences relevant to depression and its treatment. They will also be provided with a mailback questionnaire and will receive brief assessments at 6 weeks, and 3, 6, and 9 months. A final comprehensive interview and questionnaire at 12 months will reassess symptoms and diagnosis; attitudes, beliefs, and social support; the intervening experience of depression, its treatment and the TA. Relevant physician attitudes and treatment practices will be assessed before patient recruitment commences and at the completion of the study. Patients selected for the qualitative component will participate in unstructured interviews concerning the index encounter, relevant past experiences, and views of their physician, depression and the treatment being offered them, with reassessment at 6 and 12 months. At the end of the 12-month interview clinical diagnosis will be ascertained. Qualitative data analysis will be based on grounded theory methodology. This theoretical model will be compared (triangulated) with the longitudinal structural model developed in the quantitative phase of study. In this way, both quantitative and qualitative results and interpretations will inform an

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understanding of patient depression, adherence, and therapeutic alliance. Results of the project will highlight the need for continued efforts to change lay beliefs concerning the nature and treatment of depression. They will also demonstrate that primary care may not be the optimal setting for treating all patients, and explain why this is so. For the many patients who are treated in primary care, the project will contribute to the development of more collaborative, and, thus, more effective disease management by specifying the themes and barriers that should be addressed in tailored messaging, education, and other patient-oriented treatment strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PET MAPPING DEPRESSION/SUICIDE

OF

5HT

RECEPTOR

IN

MAJOR

Principal Investigator & Institution: Mann, J John.; Chief; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001 Summary: Project 3 will test with PET neuroreceptor imaging techniques one of the central theme of this center, i.e. that alterations in serotonin (5-HT) transmission in key brain regions confers vulnerability to suicidal attempts. Postmortem studies from our group suggest that decreased 5-HT transporters (SERT) and increased 5-HT1A receptor densities in the amygdala and the ventro-lateral portion of the orbitofrontal cortex might be associated with a vulnerability to suicide. The results are consistent with the role of the amygdala and the orbitofrontal cortex in the modulation of aggressivity and impulsivity, respectively. These hypotheses will be tested over five years by studying in vivo the distribution of SERT with [11C]McN 5652 and 5-HT/1A receptors with [11C]WAY 100635 in three groups of subjects. Group 1 will include patients with major depression and a history of a severe suicide attempt. Group 2 will include subjects with major depression, but without any history of suicide attempts. Group 3 will include healthy controls. Each group will include 30 subjects studied over 5 years. Groups will be matched on age, gender, race, socioeconomic background and nicotine smoking. In addition, groups 1 and 2 will be matched for severity of depression (both in terms of the current episode, and in terms of previous history of depression). Alterations associated with vulnerability to major depression are expected to be found in both groups 1 and 2, while alterations associated with suicide vulnerability are expected to be found only in group 1. Thus, this design will test one of the central hypotheses of this Center, i.e. that alterations of 5-HT function confer a vulnerability to suicide attempts per se, over and above alterations of 5-HT function that underlie vulnerability to suicide attempts per se, over and above alterations of 5-HT function that underlie vulnerability to major depression. A similar hypotheses will also be tested in a group of schizophrenic subjects studied in project 4C. Thus, patients with schizophrenia with and without a history of suicidal attempts will be compared, to test if neurochemical abnormalities associated with vulnerability to suicide detected in this study (depressed subjects) are also present in another diagnosis group associated with high suicidal risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSICIANS' DECISIONS FOR THE DEPRESSED MEDICALLY ILL Principal Investigator & Institution: Epstein, Steven A.; Professor and Chair; Psychiatry; Georgetown University Washington, DC 20057 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2004

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Summary: (Applicant's abstract): Depression among primary care patients has been shown to be underrecognized and undertreated. However, previous research has not determined which physicians do not reliably diagnose or treat depression and why they make such errors. Thus, it is critical to address the main objective of this proposal: to determine patient and physician factors that are associated with physicians' quality of care for depression. The specific aims for this project are: 1) To describe primary care physicians' decision-making for depression care in the medically ill; 2) To determine the relationship of patient variables (medical illness comorbidity, attributional style, attitudes toward depression treatment, and demographics) with physicians' decisions for the care of depression; and 3) To determine the relationship of physician characteristics (e.g. specialty, experience with patients with depression, age, and gender) with physicians' decisions for the care of depression. The overall design of the study is the presentation of one videotaped case of a patient with major depression and physical complaints to each physician subject. The study has a 2x2x2x2x2 factorial design with two main effects: medical illness comorbidity (recent myocardial infarction vs. good health); and attributional style (somatic vs. non-somatic). The vignettes will also vary by treatment preference (prefer no mental health treatment vs. accepting of treatment), race (African-American vs. White), and gender. Thus, there will be 32 vignettes, each of which represents one distinct combination of levels. Subjects will be 500 physicians, half general internists and half family physicians. Each physician will complete a semi-structured interview assessing diagnostic, evaluation and treatment decisions for the case vignette. This interview will be followed by a structured interview assessing covariates including physician experience with patients with depression, demographic variables, practice characteristics, and attitudes regarding the care of patients with depression. The direct benefit of this study would be enhanced understanding of patient and physician characteristics that determine whether depression is appropriately treated. The results from this study can guide continuing medical education efforts and be used to improve future intervention studies designed to enhance quality of care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PILOT--DEPRESSION HYPERTENSIVES

&

TREATMENT

ADHERENCE

IN

Principal Investigator & Institution: Rojas, Mary; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: Hypertension is a prevalent disorder. Treatment for hypertension usually requires a patient to take daily medications, reduce sodium intake and lose weight, adhere to routine follow-up visits, and undergo routine monitoring tests. Adherence to such regimens requires a great degree of patient motivation and perseverance, convictions that often require strong feelings of self-efficacy. Hypertensive patients who are also depressed may be less likely to summon the necessary self-discipline to follow such a complex health routine. Depression is also a prevalent disorder; approximately 9.5% of U.S. adults ages >=18 suffer from a depressive disorder in any given year. The relatively high prevalence of these 2 conditions suggest that it is likely that both hypertension and depression will occur concomitantly. Current research is lacking on the extent to which depression complicates hypertension and adherence to antihypertensive treatment regimens. Specific Aims: 1) To describe the prevalence of depression among controlled and uncontrolled hypertensive minority patients; 2) To describe the prevalence of treatment adherence among depressed and nondepressed

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hypertensive patients; 3) To explore associations between depression, treatment adherence, and blood pressure control; 4) To assess the feasibility of recruiting minority hypertensive patients to undergo screening for depression. We will take advantage of an ongoing AHRQ-EXCEED-funded randomized trial among minority patients with uncontrolled hypertension and utilize the recruitment procedures and tools to identify minority patients with diagnosed and treated hypertension. We will assess patients for depression, anti-hypertensive treatment adherence and perceived self-efficacy. We will survey 30 controlled and 30 uncontrolled hypertensive minority patients recruited from the waiting rooms of clinics in East and Central Harlem. This pilot study is an exploration of the relationship of depression, attitudes toward treatment of depression, hypertension treatment adherence, self-efficacy and blood pressure control. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

PILOT--PREVENTIVE

INTERVENTION

FOR

MATERNAL

Principal Investigator & Institution: Lagomasino, Isabel; Charles R. Drew University of Med & Sci 1621 E 120Th St Los Angeles, CA 90059 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: Elevated rates of depressive symptoms have been well-documented among low-income mothers, including Latinas who are at high risk for living in poverty. However, Latinos have consistently been found to underutilize mental health services when these services are needed for such disorders as depression. Despite maternal depression in this group representing a disparity in health and functioning for both Latino mothers and their children, there is a lack of effective intervention strategies to decrease this health disparity. One way to address this disparity is by delivering services through Promotoras, lay health workers who are familiar with the neighborhood, culture, language and social status of immigrant Latinas. This proposal will examine the effectiveness of a preventive intervention for postpartum Latina women in decreasing symptoms of minor depression and will explore how treatment of these mothers may affect their parenting of and attachment to their infants. Teh Promotoras who regularly conduct home visits for postpartum Latinas will be trained in administering a screening instrument for detection of minor depression, the PrimeMD. Four Promotoras will then be trained and supervised in delivering a standardized 12session cognitive behavioral therapy intervention developed to prevent depression in pregnant women and new mothers. 100 postpartum Mexican American immigrant women recently discharged from the hospital following childbirth, will be identified as having minor depression and will be consented to participate in the study. The participants will be randomized to either the intervention group or a control condition. The main outcome variable will be maternal depression symptoms as measured by a structured interview for the Hamilton Rating Scale. Data will also be collected on appropriateness of parenting, attachment, and developmental outcome measures to estimate effect sizes and sample size needed (through power calculations) for a full-scale trial of the preventive intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PILOT--PROVIDE AHRQ GUIDELINES TO AFRICAN AMERICANS WITH DIABETES & DEPRESSION Principal Investigator & Institution: Egede, Leonard E.; Assistant Professor; Medical University of South Carolina 171 Ashley Ave Charleston, SC 29425

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Timing: Fiscal Year 2001 Summary: TITLE: A Pilot Program To Provide AHRQ Guidelines Concordant Care to African-Americans With Type 2 Diabetes Mellitus And Depression ABSTRACT: Despite improved rates of depression recognition in primary care settings, outcomes following treatment of depression in this setting are generally poor. AHRQ guidelines describe the elements of effective depression treatment. Unfortunately, the fast paced nature of primary care interactions makes it difficult for primary care providers to meet these expectations The Diabetes Nurse Educator (DNE) model of diabetes care was designed to address similar problems in the provision of American Diabetes Association minimum levels of diabetes care. We proposed to train the DNA to collaborate with primary care providers to provide AHRQ guidelines concordant depression treatment for African- Americans (AA) with both diabetes and depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: POSTRECEPTOR DYSREGULATION IN DEPRESSION Principal Investigator & Institution: Dwivedi, Yogesh; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, IL 60612 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: This proposal for a Mentored Scientist Development Award focuses on elucidating the role of beta adrenergic receptors (ARs) and the adenylyl cyclase-cyclic cAMP (AC-cAMP) pathway in the pathophysiology of depression and suicide. Several studies suggest that betaAR number is increased in the postmortem brain of suicide subjects; however, the precise mechanism, significance and the cellular/molecular nature of events associated with this increase have not been elucidated. The goals of this study are to examine: 1) if upregulation of betaARs is due to increased rnRNA and/or protein expression of beta1 and/or beta2 ARs; 2) whether this increase is associated with increase transcription rate and/or dysregulated HPA axis; 3) functional consequences of increased betaARs in the AC-cAMP signaling pathway at the level of catalytic and regulatory activities of protein kinase A (PKA) and gene transcription of their specific subunits; 4) functional significance of altered PKA by examining functional characteristics and gene expression of transcription factors and target genes; 5) the localization of these changes at the cellular level in discrete brain areas; and 5) whether these changes are specific to depression.To achieve these goals we propose a series of related human postmortem brain and animal studies. We will study mRNA and protein expression of beta1 and beta2ARs by quantitative RT-PCR, in-situ hybridization and gold-immunolabeling. To examine whether changes in betaARs are associated with alterations in components of the AC- cAMP signaling pathway, we will study [3H]cAMP binding to PKA; total, endogenous and betaAR-mediated PKA activity; mRNA and protein expression of PKA (regulatory and catalytic subunits), CREB, BDNF and phospho-CREB; CREB-DNA binding activity in BAs 8, 9, 10 and hippocampus of suicide victims and age-, postmortem interval-, and gender-matched nonpsychiatric control subjects. We will examine changes in mRNA and protein expression in discrete areas of the brain (layers I-VI of prefrontal cortex and areas CA1-4, dentate gyrus subiculum and area entorhinalis of the hippocampal formation). Further, to examine if the changes in the proposed measures are specific to depression, we will examine the effects of major depression on the proposed measures. To consolidate our human postmortem brain findings, we will study the proposed measures in prefrontal cortex and hippocampus of behaviorally depressed rats. Finally, to examine if these changes are associated with abnormal HPA function we will study the proposed measures in prefrontal cortex and hippocampus of corticosterone-treated rats with and without

132 Depression

adrenalectomy. With this proposal the candidate seeks training in 1) Clinical and psychological aspects of mental disorders and suicide, 2) molecular biology, 3) neuroanatomy, 4) animal behavior, and 5) specialized statistical analyses. The rigorous training plan, which integrates strong didactics and multidisciplinary expertise, and the research plan will advance the knowledge of molecular mechanisms associated with depression and suicide and will provide the candidate with the skills needed to achieve independence in this highly complex field. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREDICTING DEPRESSION OUTCOMES IN MEDICALLY ILL ELDERS Principal Investigator & Institution: Koenig, Harold G.; Associate Professor; Psychiatry; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 15-AUG-1999; Project End 31-JUL-2004 Summary: Older adults with congestive heart failure (CHF) and chronic pulmonary disease (CPD) are increasing in number. Their lives and ability to function are greatly affected by these illnesses, which frequently lead to recurrent hospital admissions to manage exacerbations. We have found that 26 percent of older persons with CHF or CPD fulfill criteria for major depressive disorder when hospitalized. Depression is often prolonged, affects recovery, and increases use of health services. About one-third of these depressed patients, however, will go into full remission within three months of hospital discharge, often without specific treatment for depression. Many of these patients improve because their physical illness improves. The other two-thirds of depressed patients will have persistent depression, whether or not their health improves. Minor depression is even more common than major depression, being present in 32 percent of such patients, and while it may have a better prognosis than major depression, it is nevertheless associated with considerable disability and poorer quality of life. Research Questions: We are interested in studying four conjoint trajectories of depression-physical health outcome in the first six months after hospital discharge: depression and health both improve, depression improves but health does not, health improves but depression does not, and neither depression nor health improves. What proportion of patients follow each trajectory? What psychosocial and health characteristics predict which trajectory they will follow? What are the barriers to effective treatment, how is depression currently treated in these patients, and what are predictors of treatment intensity? Methods: 1000 older patients with CHF or CPD and major (n=500) or minor depression (n=500) will be recruited from the inpatient services of Duke Hospital and two community hospitals and followed for six months after discharge. Detailed assessments of depression and severity of medical illness will be conducted by a research nurse during telephone and in-person evaluations. Significance: Such information is necessary to determine which of the many patients with major or minor depression need specific treatment, and which patients will improve on their own after discharge as their medical illness improves or fails to improve. It will also provide important information to both guide future clinical trials and identify barriers to effective treatment of depression in these patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PREDICTORS OF ANTENATAL AND POSTPARTUM DEPRESSION Principal Investigator & Institution: Rich-Edwards, Janet W.; Harvard Pilgrim Health Care, Inc. 93 Worcester St Wellesley, MA 02481

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Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2006 Summary: (provided by applicant): Antenatal and postpartum depression together affect roughly 15% of mothers, and may have serious consequences for the health and well-being of the entire family. Despite significant advances in understanding major depression, the specific causes of antenatal and postpartum depression remain less understood. Like major depression, antenatal and postpartum depression appear to arise from interacting environmental and biological factors. A large volume of work implicates poverty and lack of social support as environmental determinants of major depression and postpartum depression. However, there has been little investigation into the impact of experiences of personal threat, such as violent abuse or racial discrimination, on the incidence of antenatal or postpartum depression. Among biological factors, disorders of the hypothalamic-pituitary-adrenal stress response have been implicated in depression. During normal pregnancy, cortisol levels are elevated, and the placenta contributes large quantities of corticotropin-releasing hormone (CRH) to matemal circulation. The implications of these high levels of stress hormones for onset of depression during and immediately following pregnancy are poorly understood. We predict that antenatal and postpartum depression are influenced by these endocrine factors as well as by the psychosocial environment. We hypothesize that: 1) Physical and/or sexual abuse in childhood, in adulthood, and/or during pregnancy are associated with antenatal and postpartum depression. 2) Experience of racial discrimination is associated with antenatal and postpamam depression among women of color. 3) Levels of CRH during pregnancy are associated with a history of depression, are correlated with antenatal depression, and predict postpartum depression; 4) Elevated morning cortisol and/or depressed evening cortisol levels in the first three postpartum months are associated with postpartum depression. Few studies have had the size or the data needed to investigate both biologic and environmental predictors of depression before, during, and after pregnancy. Project Viva and Project Access are two ongoing cohort studies of pregnant women and their children in Boston, supported by the National Institutes of Health and the March of Dimes to assess psychosocial and hormonal predictors of pregnancy outcome and child health. To date, they have enrolled over 2800 women; by the end of the project, the proposed project will include 3,500 participants. These ongoing longitudinal cohort studies will provide a cost-effective and unique resource with which to determine factors predicting depression during pregnancy and the postpartum. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREFRONTAL CELL PATHOLOGY IN VASCULAR DEPRESSION Principal Investigator & Institution: Rajkowska, Grazyna; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The project is a direct extension of project 1. The present project will evaluate in the brains of elderly depressed subjects with and without vascular deficits the cellular pathology of cortical prefrontal areas that have been found to be involved in depression. The specific aim of the project is to estimate quantitatively the changes in the morphology and distribution of neurons and glial cells in dorsolateral area 9, lateral orbitofrontal area 47 and medial prefrontal area 12 in postmortem brains from matched depressive subjects with vascular deficits, depressives without vascular disease, and elderly controls. To achieve this objective we will measure morphological features of neurons, glia and blood vessels using Cresyl Violet (Nissl staining) for the study of the general cellular cytoarchitecture and immunohistochemical

134 Depression

methods modified for labeling of cytoskeletal and calcium-binding proteins in neurons and glial fibrillary acid protein in glial cells in celloidin-embedded human brain sections. In addition, similar morphometric parameters will be measured in the homological regions of the prefrontal cortex in the VMAT2 and NET knockout mouse representing an animal model of depression. The measurements will be carried out using a computer-assisted stereological counting method. To understand whether specific pathology is associated with depression in old age with or without vascular diseases is important, because it will contribute to establish specific therapeutic basis for a differential treatment of depression in the elderly with vascular disorders. Alternatively, it may turn out that idiopathic and vascular depression share many pathological characteristics, which will suggest that a common treatment for both would be possible. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREVENTION OF DEPRESSION IN AT-RISK ADOLESCENTS Principal Investigator & Institution: Beardslee, William R.; Psychiatrist-In-Chief; Judge Baker Children's Center 3 Blackfan Cir Boston, MA 02115 Timing: Fiscal Year 2003; Project Start 03-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): This application is one of four interlocking R01's to assess the impact of a group cognitive behavioral program (CBP) on the prevention of depression in adolescents at risk for depression. Eligible teens must have a parent with active depression; teens themselves must have either a past depressive episode or current subsyndromal depressive symptoms. In this 5-year study, 320 at-risk adolescents (80 at each site) drawn from managed care organizations will be randomized to either CBP or usual care (UC) and followed for 32 months post intake to determine the impact of CBP vs. UC on onset of depressive disorders and symptoms, level of functioning, and medical and mental health care utilization. We hypothesize that participants in the CBP intervention will have a significantly lower prospective incidence of first and repeated episodes of depressive disorders and symptoms compared to adolescents in the usual care group. In addition, we will explore whether participants in CBP have a reduced prospective incidence of non-affective symptoms and disorders, and will show improved global functioning relative to the comparison group. Analyses also will focus on the incremental cost-effectiveness of providing the CBP over usual care from the health care perspective. This study builds on previous work by the Portland site (Clarke et al., 2001) showing a nearly six-fold reduction in the incidence of depression in CBP vs. UC, and extends this work in two ways - first, by testing whether the program can be replicated at several different sites, thereby greatly increasing the generalizability of the original findings; and second, by changing the timing and spacing of the intervention to provide continuation sessions to prolong the duration of the effect of CBP. This program of research is significant for several reasons: (1) depression is a chronic, prevalent, and impairing condition in adolescence that is often undetected, and which is more difficult to treat as chronicity increases; (2) there have been no large-scale studies of the prevention of depression in adolescence; and (3) by basing this study in managed care organizations, it will be possible to ascertain the costs and benefits of incorporating this intervention into "best practice" in real world settings. This application is based in Nashville (Judy Garber, PI), and interlocks with applications from Boston (William Beardslee, PI), Pittsburgh (David Brent, PI), and Portland (Greg Clarke, PI). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PREVENTION OF DEPRESSION IN LATINO PARENTS Principal Investigator & Institution: Cardemil, Esteban V.; Psychology; Clark University (Worcester, Ma) 950 Main Street Worcester, MA 01610 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Description (provided by applicant): This application is a request for a Scientist Development Award for New Minority Faculty (K01) that will enable Dr. Cardemil to continue to develop his programmatic line of research in the prevention of depression in Latinos. Depression is among the most prevalent of the major psychiatric disorders in the general population, and emerging evidence suggests that members of low-income racial/ethnic minorities may be particularly at-risk for its development. Research that develops and evaluates programs designed to prevent the development of depression in low-income racial/ethnic minorities may prove especially beneficial. Dr. Cardemil's training goals are to (1) broaden his conceptual knowledge in researching the prevention and treatment of depression, (2) enhance his experience with family- and child assessments and interventions for depression, (4) improve his methodological skills in order to effectively conduct large-scale randomized prevention trials, (5) acquire experience developing and evaluating a therapist-training program, (6) improve his statistical skills in order to more effectively evaluate longitudinal outcome data, and (7) improve his grant- and publication-writing skills. These training goals will be achieved through (1) the resources available at the Brown University Medical School, (2) the high quality of mentorship provided by Dr. Ivan Miller, Dr. Ricardo Mufioz, and Dr. Ronald Seifer, and the expertise of the assembled consultant team, (3) focused coursework and clinical experiences, and (4) the proposed research project. The proposed research project extends the natural progression of Dr. Cardemil's current depression prevention work under the auspices of a NRSA F32 fellowship. The F32 project is a cognitivebehavioral depression prevention program for low-income Latino parents that integrates 6 group-based interventions with 2 family-based interventions: the Family Coping Skills Program (FCSP). The specific research aims of this application are to (1) implement a randomized clinical trial to evaluate the efficacy of the FCSP on Latino parents using both interviewer and self-report measures, (2) in an exploratory fashion, evaluate the effects of the FCSP on the family-level functioning in a subsample of the participants using both interviewer and self-report measures, (3) in an exploratory fashion, evaluate the effects of the FCSP on the children of a subsample of participants using both interviewer and self-report measures, and (4) develop and evaluate a therapist-training program for the efficacious delivery of the FCSP. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PREVENTION OF DEPRESSION IN LOW-INCOME SINGLE MOTHERS Principal Investigator & Institution: Peden, Ann R.; Associate Professor; None; University of Kentucky 109 Kinkead Hall Lexington, KY 40506 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2003 Summary: The ultimate goal of this program of research is to decrease the incidence of clinical depression in high risk individuals through prevention intervention. Lowincome, single mothers are at high risk for depression which may have negative effects on their children. The specific aim of this randomized controlled prevention trial is to test the effects of a cognitive-behavioral intervention designed to reduce negative thoughts, chronic stress, and depressive symptoms and increase self-esteem of low income single mothers experiencing subclinical depressive symptoms. In addition, the

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effects of the intervention on mothers' reports of behavioral problems of their 2- to 6year old children will be tested. While cognitive-behavioral interventions with depressed individuals have been used extensively, the effects of affirmations and thought stopping techniques in reducing the risk of depression have not been tested empirically. A sample of 550 single mothers at least 18 years of age will be recruited for the cross-sectional phase of this study. Inclusion and exclusion criteria are: (1) no prior treatment for psychiatric care; (2) not now or ever on antidepressants; (3) never diagnosed with clinical depression; (4) not suicidal; (5) never married, separated at least 6 months, or divorced; (6) at least one child 2 to 6 years of age living with the mother; (7) no child under the age of 2; (8) not pregnant by self-report; (9) not currently in counseling; (10) at or below 185% of Federal poverty level guidelines by family size. Baseline data on depressive symptoms, negative thoughts, self-esteem, chronic stressors, and mothers' report of child behavior will be collected from all women. Recruitment will continue until 160 women with a Beck Depression Inventory score between 9 and 35 and/or a Center for Epidemiologic Studies--Depression Scale score between 16 and 40 are identified and agree to participate in the clinical trial. As women are recruited for the intervention phase, each will be randomly assigned to the control or experimental condition. The intervention consists of six one-hour per week group sessions that target identification and management of negative thinking as it effects depressive symptoms. Though stopping and the use of affirmations (positive self-talk) are the primary techniques that are taught. Experimental and control subjects will be re-interviewed at one-month, six-months and twelve-month post-intervention to assess their negative thinking, depressive symptoms, self-esteem, and chronic stressors and to obtain reports of their children's behavior. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SUPPLEMENT

PREVENTION

OF

DEPRESSION

WITH

A

WEB-BASED

Principal Investigator & Institution: Seligman, Martin E.; Professor; Psychology; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 22-SEP-2001; Project End 31-AUG-2006 Summary: (provided by investigator): Our aim is to create and validate robust prevention of depression and anxiety among young adults at risk for depression, using a classroom-based cognitive-behavioral intervention in combination with Web-based ancillary material. We propose a targeted intervention with a population of 260 college students - 130 in the intervention group and 130 in a no-intervention control group. At risk is defined as those who score in the worst quartile of depressive symptoms but excluding those with severe depressive symptoms. We will track all participants for three years following the intervention, assessing depressive episodes and symptoms, anxiety episodes and symptoms, physical health, grades, and cognitive mediators. We hypothesize that the intervention group will have fewer episodes of depression and anxiety, fewer symptoms of depression and anxiety, better physical health, and higher grades than the control group. We propose that our replicated classroom-based intervention will, when supplemented by Web-based resources, one-on-one boosters, and ongoing Web-based boosters, produce robust prevention of depression and anxiety, as well as maintain durable cost-effective prevention effects. Our ultimate goal is to provide school settings, such as universities, colleges, and high schools with easily implemented prevention programs against depression and anxiety. If this intervention can prevent depression and anxiety robustly, it is possible that such programs can be widely disseminated, producing nationally measurable mental health benefits.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREVENTION OF POST-STROKE DEPRESSION-TREATMENT STRATEGY Principal Investigator & Institution: Robinson, Robert G.; Professor and Head; Psychiatry; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Previous studies have shown that about 35% of all depression occurring in the 2 years following stroke begin after the acute in-hospital period. We have shown that both acute and delayed onset depression influence cognitive and ADL recovery throughout the 1st year following stroke. A recent treatment study aimed at preventing the development of post-stroke depression found that nortriptyline (NT) and fluoxetine were effective in preventive depression (i.e., 1 of 13 patients given NT and 1 of 13 given fluoxetine became depressed compared with 5 of 15 patients given placebo; p=.03). During the next 6 mos. after treatment, a significantly greater number of active treatment patients developed depression compared with patients given fluoxetine or placebo. This increased rate of depression among the treated patients raises the question of whether a longer period of treatment would continue to prevent depression. Furthermore, a 7-year follow-up of the 37 nondepressed patients who were given fluoxetine, nortriptyline or placebo found that those given antidepressants were more likely to survive than those given placebo (Kaplan Meier Log Rank, x(2)=4.3, df=1, p=0.4)(i.e., 65% treated survived vs 29% of placebo). This grant will examine these questions by treating consenting non-depressed stroke patients who are within the first 3 mos. post-stroke. Patients will be given problemsolving therapy (PST) over 12 mos. or 12 mos. of double blind treatment with NT, citalopram or placebo. Patients who develop depressing meeting criterion for major or minor depression of at least 2 weeks duration will be given all of the tests intended to be given at 12 mos. and then will be terminated so that their depression can be treated. After 1 year of treatment, all patients will be followed without treatment of another 6 mos. We will determine whether psychosocial or pharmacological treatment provides extended protection from depression and thereby enhances post-stroke recovery. We will also determine whether abnormalities in startle response either before or after treatment or atrophy of specific rain regions are correlated with the development of depression. The significance of this study is that it will answer the most important question with remains in the therapeutics of post-stroke depression and that is whether prophylactic antidepressant treatment of this population should be given to all stroke patients because it will enhance their recovery from stroke by decreasing their likelihood of suffering the emotional, physical, cognitive and mortality consequences of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT

PRISM--COMORBIDITY

DIAGNOSIS

FOR

DRUG

ABUSE

Principal Investigator & Institution: Hasin, Deborah S.; Associate Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001; Project Start 15-MAR-1998; Project End 28-FEB-2003 Summary: (Applicant's Abstract): Psychiatric comorbidity, particularly depression, occurs often in substance abusers, and is associated with poor outcome. However, previous diagnostic instruments have been unreliable, controversy has surrounded the concepts of comorbidity diagnosis, and results of treatment studies have been

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inconsistent. In particular, questions persist on whether a treatment-responsive depressive disorder exists in non-abstinent substance abusers. For treatment research to begin to accumulate meaningful results on substance abuse comorbidity, concepts and diagnoses must be clear and reliable. To begin to address this problem, we developed the DSM-111-R Psychiatric Research Interview for Substance and Mental Disorders (PRISM), which showed very good test-retest reliability for primary major depression and other DSM-111-R mental disorders in substance abuse and psychiatric patients. To address the problem of current DSM-IV diagnosis of depression and other disorders in non-abstinent substance abusers, we developed a new version of the PRISM. This version uses phenomenologically-oriented methods for differentiating between primary disorders, substance-induced disorders, and the expected effects of intoxication/withdrawal. These PRISM methods were carefully designed to be consistent with DSM-IV. A reliability and validity test of the new PRISM is needed, with special focus on the differentiation between current primary depression, substanceinduced depression and expected intoxication/withdrawal effects. We propose such a study in 510 methadone maintenance and dual diagnosis psychiatric patients. Interviews will be conducted by clinicians. The sample will allow for separate reliability coefficients for each site. Subjects will be sampled to ensure stable reliability estimates for African-American as well as white patients. The data will also allow tests of the effects of demographic, clinical and process factors on reliability. An initial validity study will also be conducted, focused on the PRISM differentiation between primary major depression, substance-induced major depression, and the expected effects of intoxication/withdrawal. For the validity study, we will use family history and inperson expert psychiatrist evaluation of the need for antidepressant treatment as validators. If the PRISM shows good reliability and validity, it will offer a significant methodological advance for treatment research in substance abusers with psychiatric comorbidity. The study results will provide empirical evidence that is likely to be useful in formulating DSM-V. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

PROBLEM-SOLVING

TREATMENT

FOR

PRIMARY

CARE

Principal Investigator & Institution: Oxman, Thomas E.; Professor; Psychiatry; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, NH 03755 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: Minor depression is one of the most common types of depressive disorders in primary care. It is not clear that antidepressants are indicated for minor depression, and even if they are, a substantial proportion of patients cannot or will not take them. Alternative treatment approaches are indicated. The purpose of this project is to use a four-week watchful waiting period to identify patients with persistent minor depression, potentially most in need of depression specific treatment, and then test the therapeutic effect of Problem- Solving Treatment for Primary Care (PST-PC), a manual driven, six-session, behavioral treatment for depression in primary care. In this project, 300 primary care, minor depression patients will be identified and followed. The relationship of patient predictors to remission will be examined. After four weeks, patients who do not demonstrate symptomatic remission (approximately 50 percent or 150 patients) will be entered into a randomized nine-week clinical trial comparing PSTPC with Usual Care. Subjects will be followed for six months after completing the trial. The primary aim of this project is to test the therapeutic effect of PST-PC versus Usual Care for persistent minor depression in primary care. As a subsidiary aim the project

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will examine the relationship of characteristics of the patient (social support, adverse life events, personality traits, comorbidity) to early remission of minor depression. Patient and therapy characteristics will also be examined as predictors of recovery six months after the trial. The broader, long-term goal of this line of investigation is to disseminate practical, non-pharmacologic mental health treatments for use by non-physician practitioners (e.g. psychologists, nurses, social workers, counselors) who will increasingly be working in primary care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PST DYSFUNCTION

IN

GERIATRIC

DEPRESSION

WITH

EXECUTIVE

Principal Investigator & Institution: Alexopoulos, George S.; Professor and Vice Chair; Psychiatry; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This study proposes to compare the efficacy of Problem Solving Therapy (PST) to that of Supportive Therapy (ST) in non-demented elderly patients with major depression and cognitive impairment. Among them, we will focus on patients with major depression and executive dysfunction because this combination of symptoms (as defined in our preliminary studies) is prevalent, debilitating, and responds poorly to treatment with antidepressant agents. Therefore, we find it compelling to identify an effective treatment for these patients, who would otherwise remain depressed, debilitated, and demoralized during the last years of their lives. We selected PST because it can address depression as well as deficits in problem solving skills that impact on the patients' ability to negotiate their environment and contribute to their depression and disability. Moreover we now have empirical evidence suggesting that PST can reduce depressive symptoms and disability in cognitively unimpaired depressed elderly patients as well as elderly patients with major depression and executive dysfunction. The subjects will be 240 (120 from each Center) elderly (>64 years) patients with non-psychotic, unipolar major depression and executive dysfunction and will be randomly assigned to receive 12 sessions of PST or ST. The study is designed to test the hypotheses that the PST is more effective than ST in reducing depressive symptoms and disability. Furthermore, we hypothesize that these effects are mediated by improvement in generation of alternative solutions, decision making, and solution implementation. While we are aware of the methodological problems and confounds posed by studying a "sick and old population", we bring to this project two groups with complementary expertise in treatment studies and psychotherapy research, and experience in directing multicenter studies. Moreover, the project will be supported by the structures of the Cornell Intervention Research Center (IRC), whose principal objective is to develop treatment interventions targeting specific clinical and biological characteristics of geriatric depression. Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PSYCHIATRIC DISORDERS IN ADULTS WITH DIABETES MELLITUS Principal Investigator & Institution: Lustman, Patrick J.; Professor of Psychiatry; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 01-JUL-1985; Project End 31-MAR-2004

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Summary: Diabetes increases the risks of maternal, fetal, and neonatal complications from pregnancy. Tight glycemic control during pregnancy reduces these risks but is difficult to achieve. Major depression is present in approximately 25 percent of diabetic women and is associated with significant deterioration in glycemic control. There has been no study in diabetic or nondiabetic subjects of depression treatment during pregnancy, and the effects of depression treatment on obstetric outcomes remain unknown. Recently, we showed that cognitive behavior therapy (CBT) was an effective nonpharmacologic treatment for depression in diabetes that produced durable improvements in glycemic control. In this study we plan to treat major depression in pregnant diabetic women with CBT and determine its effects on depression, glycemic control, and maternal and neonatal outcomes. We also plan to assess the relationship of diabetes during pregnancy and postpartum depression to neuropsychological development of the infants. 150 pregnant diabetic women will be recruited for study: 100 with and 50 without major depression. The nondepressed subjects function only as a comparison group in some of the statistical analyses. All subjects will be assessed serially during the 2nd and 3rd trimesters and the 1 year postpartum period while receiving the usual degree of intensive medical care for the diabetic pregnancy. Depressed patients will be assigned randomly to treatment with individual CBT (n =50) or supportive counseling (n =50). The pregnancy care team is informed of the depression status of all subjects and advised to give usual care for depression. The design blinds the pregnancy care team to treatment assignment, controls for nonspecific effects of attention and the influence of enhanced diabetes control on mood, provides a comparison group likely to remain depression free during gestation and the postpartum period, and is sensitive to human subject issues. We hypothesize that CBT will be superior to supportive counseling in terms of improving depression and glycemic control, and that the treatment-related improvements in glycemic control will reduce the adverse effects of diabetes in pregnancy, including c-section, macrosomia, neonatal hypoglycemia, and fetal hyperinsulinemia. We also expect that by improving glycemic control during pregnancy and reducing the risk of postpartum depression CBT will improve neuropsychological development in the offspring. The findings should demonstrate the relevance of depression treatment to maternal and neonatal outcomes of diabetic pregnancies and translate directly to the management of patients living with diabetes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PSYCHOSOCIAL TREATMENT OF DEPRESSION IN DELINQUENTS Principal Investigator & Institution: Rohde, Paul D.; Research Scientist; Oregon Research Institute 1715 Franklin Blvd Eugene, OR 97403 Timing: Fiscal Year 2001; Project Start 15-SEP-1997; Project End 30-APR-2004 Summary: (Adapted from applicant's abstract): Given the high rate of psychiatric comorbidity with depression in adolescents, treatment interventions that have been shown to be effective with "pure" samples of depressed adolescents need to be evaluated with youth who have comorbid conditions. The goal of this proposal is to evaluate the efficacy of a cognitive-behavioral group treatment intervention for adolescents whose depression is comorbid with conduct disorder. Adolescents, ages 1317, who have been charged with at least two criminal violations but are not in juvenile detention in the Lane Country Department of Youth Services (DSY) will be referred to participation in the study. Adolescents meeting initial inclusion criteria will be recruited to participate in a diagnostic interview (K-SADS for DSM-IV) assessing all major psychiatric disorders, including depression (major depression and dysthymia) and

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conduct disorder. Over a four-year period, 200 adolescents with comorbid depression/conduct disorder will be randomly assigned to one of two interventions conditions: (1) the Adolescent Coping With Depression (CWD-A) course, or (2) academic tutoring. Adolescents will be assessed pre- and post-treatment (estimated n=150) and at 6 and 12 months post-treatment (estimated n=120). In addition, academic and criminal arrest records will be monitored for 12 months pre- and post-treatment (a total of 24 months). Analyses will focus on 3 primary issues: (1) Group differences in treatment outcome (depression and conduct disorder). The main hypotheses are that the CWD-A intervention will be superior to academic tutoring in reducing depression and conduct disorder, both of which will be evaluated as numerical and categorical (diagnosis vs. no diagnosis) measures. The intervention is predicted to impact depression more significantly than conduct disorder. (2) Group differences in additional outcome measures (e.g., future suicidal behavior, criminal recidivism, and academic performance). (3) Predictors of participation vs. attrition, improvement vs. nonrecovery, and maintenance of gains vs. relapse. Predictors will include pre-treatment patient variables, in-session variables, and interventionist variables. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PUFA AUGMENTATION IN TREATMENT OF MAJOR DEPRESSION Principal Investigator & Institution: Gertsik, Lev G.; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, CA 90048 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 31-MAR-2005 Summary: (provided by applicant): This is a second revision of an Investigator-Initiated Exploratory/Developmental Research (R21) grant application to the National Center for Complementary and Alternative Medicine to explore the use of polyunsaturated fatty acids (PUFAs) as an augmentation strategy for the treatment of unipolar major depression. Major depression is a common mental disorder, and is associated with serious functional impairment, morbidity and mortality. Moreover, it also produces a significant financial burden on our society. Despite the availability of numerous pharmacologic and psychotherapeutic interventions, the current treatment of depression is not optimal. Even in patients who do respond to treatment, remission is rarely complete. In addition, the onset of action of antidepressants is delayed; the drugs usually must be taken for three weeks or more before improvement is clinically discernible. Accordingly, a number of augmentation strategies to hasten the onset of activity and increase the efficacy of traditional antidepressants have been proposed and tested, but many of these produce significant side-effects, and some patients still do not respond. PUFAs are found in high concentrations in the central nervous system, and they appear to be involved in many aspects of signal transduction. Recently, evidence has surfaced suggesting that the dietary intake of PUFAs might be related to depression, and the administration of PUFAs might reduce depressive symptomatology. In this application, we propose testing the hypothesis that administration of one of the PUFAs, eicosapentanoic acid (EPA), in combination with a selective serotonin reuptake inhibitor (SSRI) antidepressant will improve treatment outcome in unipolar major depression. In addition, we will determine whether the onset of antidepressant activity occurs more rapidly when EPA supplementation is combined with selective serotonin uptake inhibitor. The results of the proposed study might provide a new, economical, safe, and potentially important alternative approach to the treatment of unipolar major depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: QALYS FOR DEPRESSION: WHOSE VALUATIONS TO USE FOR CEA Principal Investigator & Institution: Pyne, Jeffrey M.; Psychiatry and Behavioral Scis; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, AR 72205 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2004 Summary: (provided by applicant): Recent evidence suggests that health status may strongly influence an individual's valuation of depression outcomes. This proposal will explore the health policy implications of obtaining depression outcome valuations for use in cost-effectiveness analyses from persons with varying levels of depression severity and the general public. This proposal is motivated by the concern that cost effectiveness analyses based on outcome valuations from persons without experience with depression may discriminate against treatments for persons with depression. The general public's continued misunderstanding of mental disorders in general and its undervaluation of depression outcomes in particular, could bias cost-effectiveness analyses (CEAs) against depression treatments (e.g. they will appear to be less costeffective) and ultimately result in inequitable healthcare resource allocation decisions. The specific aims are (1) examine differences in incremental depression outcome and prevention valuations across four groups: i) general population, ii) previous history of depression but not currently depressed, iii) less severe current depression, iv) more severe current depression; (2) examine the extent to which specific depression severity characteristics of the respondent (e.g. symptom severity, episode frequency, chronicity, past history of depression treatment, recent changes in depression severity, and health status) are associated with incremental depression outcome and prevention valuations; (3) examine CERs for hypothetical treatment and prevention interventions using depression outcome valuations obtained from the populations defined above and explore the health policy implications. Depression outcome valuations will be collected from 400 subjects: 100 subjects from the general population, 200 primary care patients (100 with a history of depression but not currently depressed, 75 with mild to moderate depression, and 25 with moderately severe to severe depression), and 100 mental health clinic patients (75 with moderately severe to severe depression and 25 with mild to moderate depression). We will examine two common methods for eliciting outcome valuations, rating scale and standard gamble, using an interactive computer-based program. The depression outcome descriptions will be based on the Patient Health Questionnaire (PHQ) nine-item depression module and the Medical Outcomes Study SF-12. We will also explore the equity implications of using depressed patient versus general public depression outcome and prevention valuations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: QUALITY IMPROVEMENT FOR DEPRESSION Principal Investigator & Institution: Ford, Daniel E.; Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 31-MAY-2003 Summary: Policy makers do not know how to alter the structure and process of primary care to provide treatment which will improve and sustain improvement in the functional impairment associated with major depression, the fourth leading cause of disability worldwide. To address this problem, we propose an R-10 to fund Quality Improvement for Depression (QID). The specific aims of QID are: (1) to provide integrated analyses of the long term impact of four distinct but related primary care interventions to improve depression treatment during the acute, continuation, and

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maintenance phase of care; and (2) to estimate the effects of high quality primary care depression treatment on long term disability. In the early stages of QID collaboration, funded investigators of four separately conceived quality improvement interventions planned and implemented a coordinated strategy for recruitment, intervention, and data collection in 108 primary care clinics in network and staff model HMOs, IPAs, PPOs, and mixed model settings. In addition to common baseline organizational and provider data, QID investigators are collecting over 80 common variables from 1,980 patients with major depression at each of three waves across the first year. This application seeks support to conduct effectiveness analyses in the combined database after standardizing patient follow-up during the second year across the four projects. This effort is needed to understand the "big picture" of how four dissemination interventions which are feasible to integrate across a variety of practice settings and populations, impact the quality and outcome of care, with sufficient power to determine whether they improve outcomes over a duration meaningful to policy makers. The analyses will inform policy debates about effective mental health treatment by providing generalizable estimates of the effect of antidepressant medication and psychotherapy on disability over the long term. To address these policy questions through the QID is more efficient than funding another large new project and more scientifically rigorous than drawing conclusions from heterogeneous studies whose differing methodologies complicate meta- analytic methods and conclusions. In addition to serving as a competing continuation for the Depression Guidelines Cooperative Agreement, QID serves as an important model of how mental health effectiveness research can be efficiently conducted by intensive collaboration of independently funded projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF SYNAPTIC AMINO ACID RECEPTORS Principal Investigator & Institution: Trussell, Laurence O.; Professor; Otolaryngology Head & Neck Surgery; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001; Project Start 01-MAY-1991; Project End 30-APR-2004 Summary: The control of the strength of individual synapses is essential to fine- tuning the performance of neural circuits. Synaptic strength may be regulated in the short term by trains of high frequency pre-synaptic action potential which at many synapses leads to short-term synaptic depression. Using the large calyceal synapses of the chick cochlear nucleus (nucleus magnocellularis, or nMAG), we will carry out experiments which are based upon the following hypothesis: We propose that there are multiple forms of short-term depression, each with distinctive properties, and that these become recruited at specific frequencies of neural activity. By the independent regulation of these forms of depression, neurons may produce changes in synaptic strength at specific ranges of frequencies and not at others. This concept, which we term complex depression, would provide a powerful and sophisticated means for control of neural circuits, and will be comprehensively tested in the proposed studies. These will employ patch clamp recordings and the direct measurement of pre- and postsynaptic signals during the course of depression, testing specific hypotheses about the types, origins and function of depression. Specifically, we will first document that there are different components to depression and how each contributes to the control of synaptic strength at specific frequencies of synaptic activity. Then, we will identify the probable cellular mechanisms that underlie different forms of depression. Moreover, we will examine how depression can be regulated by transmitter uptake systems and by patterns of activity. Finally, we will determine the functional consequences of depression when synapses converse onto a single target cell. The results of the analyses will give new

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insight into the factors that determine the optical transmission of signals in the brain, and will contribute to an understanding of sensory or cognitive deficits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RELATIONAL GROUP INTERVENTION FOR POSTPARTUM DEPRESSION Principal Investigator & Institution: Clark, Roseanne; Associate Professor; Psychiatry; University of Wisconsin Madison 750 University Ave Madison, WI 53706 Timing: Fiscal Year 2001; Project Start 18-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): Major and minor depression in the postpartum period occurs in 10-15 percent of all new mothers, representing a significant public health problem. One of the major mechanisms by which PPD may influence infant outcomes is through its impact on the quality of the mother's affective and behavioral interactions during infancy, a critical time when physiological and emotional regulation and the capacity for human attachments are developing. Risk for disturbances in the mother-infant relationship as well as developmental delays and psychopathology in their infants represent significant areas of morbidity associated with postpartum depression and have not been addressed adequately by current intervention approaches. Therefore, the investigation of the efficacy of mother-infant relational treatment approaches for major depression during the postpartum period is warranted. The proposed study, representing a revision of the first R01 application by the principal investigator has four major aims: (1) To compare the efficacy of a manualized, relationally focused group treatment approach (M-ITG) for women with major depression in the postpartum period and their infants with a standard individual treatment (IPT) to ameliorate depressive symptoms and reduce recurrent episodes; (2) To compare the efficacy of M-ITG and IPT in improving the quality of mother-infant interactions; (3) To determine whether improvements in the mother-infant interaction mediate the impact of maternal depression on infant emotional, behavioral, and attention regulation; and (4) To examine the unique effects of depression severity and chronicity, comorbid anxiety and personality pathology on mother-infant interaction quality, and infant outcomes. Two hundred and eight women meeting criteria for major depression will be randomly assigned to one of two treatments for depression (1) MITG for mothers and their infants or (2) IPT. Assessments of mother, infant and motherinfant dyadic functioning, as well as parenting stress and marital conflict will be conducted at pre and post-treatment and at two follow-up points(l2 months posttreatment and when the infant is 24 months of age). Measures include diagnostic interviews, self and other report instruments and observational coding methods. The long-range objectives addressed by this research are to identify an effective intervention for postpartum depression that also reduces recurrences of depressive episodes in mothers, prevents subsequent psychopathology in their young children, and identifies key relational mechanisms that may inform the development of specifically targeted preventive interventions for high-risk dyads. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: REWARD SENSITIVITY IN DEPRESSION: A BIOBEHAVIORAL STUDY Principal Investigator & Institution: Shankman, Stewart A.; Psychology; State University New York Stony Brook Stony Brook, NY 11794 Timing: Fiscal Year 2002; Project Start 12-SEP-2002; Project End 31-AUG-2004

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Summary: (provided by applicant): In recent years, many researchers have been interested in discovering a neuropsychological basis of emotion and emotional disorders. One of the more widely studied of these models has been Davidson's approach-withdrawal model (Davidson, 1998), which posits two separate neural systems of motivation and emotion and hypothesizes that these systems are responsible for individual differences in reactivity to emotional stimuli, or "affective styles." The model also proposes that abnormalities in these systems play an etiological role in emotional disorders: depression is characterized by a deficit in reward seeking behavior (i.e., approach motivation) and anxiety is characterized by a tendency to withdraw from aversive stimuli (i.e., withdrawal motivation). These abnormalities are also hypothesized to be associated with specific asymmetries in frontal activation (depression = decrease in left frontal; anxiety = increase in right frontal). While several researchers have found support for this model, no study has directly tested whether the hypothesized frontal asymmetry reflects this "low approach style" in depression. This project will be able to test this hypothesis by comparing the EEG activation of depressed and non-depressed individuals during tasks that manipulate approach and withdrawal motivation. This study will also be able to explore whether the relationship between motivation and EEG asymmetry is different for individuals with particular clinical characteristics (e.g., a comorbid anxiety disorder, chronic depression). This project will not only be able to address the relationship between motivation and depression but will also further the understanding of the heterogeneity of depression by teasing apart its biological correlates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RISK AND PREDICTORS OF POSTPARTUM DEPRESSION Principal Investigator & Institution: Altshuler, Lori L.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2003; Project Start 11-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): The postpartum period is a time of heightened risk for the emergence of psychiatric illness, particularly in women who already have a history of mood disorder. Given the prevalence of depressive disorders during the childbearing years, it is crucial to identify women who are at highest risk for new onset or recurrence of depression during the postpartum period. Identification of those women at greatest risk for postpartum depression may allow for interventions that would limit maternal morbidity associated with untreated postpartum depression. This proposal outlines a multi-institutional collaborative research project (R01) in response to PA-00-074, in which risk for postpartum depression will be evaluated in women with histories of major depressive disorder. Subjects who have had at least one episode of DSM-IV major depression will be followed prospectively from late pregnancy (32-36 weeks gestation) up to six months after delivery using a series of standardized instruments. The primary aims of this investigation are (1) to identify clinical and psychosocial predictors of postpartum depression and functional impairment and (2) to determine the extent to which treatment (pharmacologic, nonpharmacologic or a combination) proximate to delivery modulates risk for postpartum relapse. How clinical and psychosocial variables including history of postpartum depression, severity of past depression, number of previous episodes, age at illness onset, depression during pregnancy, and social support affect risk for postpartum depression, as well as psychosocial functioning, will be investigated. The current submission is a natural extension of an ongoing academically productive collaboration in which risk for depressive relapse is evaluated in pregnant women with histories of major depression

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who either discontinue or maintain antidepressant treatment. This proposal provides an opportunity to study a rigorously followed population into a period of risk -- the postpartum period -- and to investigate the factors that confer or modulate risk for depression at this time. The three participating sites for this investigation include the Perinatal and Reproductive Psychiatry Clinical Research Program at the Massachusetts General Hospital, Harvard Medical School (Drs. Cohen, Nonacs and Otto), the Women's Life Center and Mood Disorders Research Program at UCLA (Dr. AItshuler, Dr. Hendrick), and the Emory Women's Mental Health Program at Emory University School of Medicine (Dr. Stowe). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RISK AND PREVENTION OF DEPRESSION IN YOUTH Principal Investigator & Institution: Garber, Judy; Professor; Psychology & Human Development; Vanderbilt University 3319 West End Ave. Nashville, TN 372036917 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): This is a request for an NIH Independent Scientist Award (K02) to enhance the Pl's ability to contribute to the understanding of the processes underlying the development of depressive disorders in children and adolescents and to develop and test interventions aimed at preventing depression in youth. The Pl's research program has evolved from studying psychosocial risk factors that predict depression in children and adolescents, to examining the role of these risk factors as mediators of the link between parent and child psychopathology, to testing a prevention program that targets several of the risk factors identified in the earlier studies. This proposal describes three research programs involving five different but related studies. The first program includes two separate longitudinal studies that examine the contribution of varbus psychosocial factors (e.g., family dysfunction, social feedback, stress) to the development of negative cognitions and depressive disorders in children and adolescents. The second program is comprised of two different investigations of whether decreases in parents' depression as a result of treatment (cognitive-behavioral and/or pharmacotherapy) are associated with changes in their children's psychopathology and functioning, and whether these changes are mediated by improvements in parent-child relationships, negative cognitions, and/or decreases in stressful life events. The last project uses knowledge about risk factors learned from the first two research programs to test a cognitive-behavioral intervention for preventing depression in adolescents at risk for mood disorders due to their having a parent in treatment for depression, and themselves having either a past depressive ecandidatesode or current subsyndromal depressive symptoms. The goal of the career development plan is to expand the candidate's skills in two areas: quantitative methods and prevention science. Because most of the candidate's research is longitudinal, learning state-of-the-art statistical methods (e.g. latent growth curve, linear and nonlinear mixed effects models, survival analysis, structural equations modeling) will broaden the kinds of research questions that can be addressed with both existing and new data. In addition, she will update and expand her knowledge of preventive interventions, particularly cognitive-behavioral approaches, with the aim of further developing and testing the efficacy of programs for preventing depression in high-risk adolescents. This K award will allow the candidate to bridge emcandidaterical research with practice by using basic knowledge about etiology to address the practical problem of preventing the onset and recurrence of the serious public health condition of depression, particularly among those at greatest risk for the disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ROLE OF NUCLEUS ACCUMBENS CREB IN DEPRESSION Principal Investigator & Institution: Carlezon, William A.; Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: From applicant's abstract): The proposed studies are designed to examine if the transcription factor CREB (cAMP response element binding protein) in the nucleus accumbens shell (NASh) plays a role in depression. Although the NASh is involved in the hedonic (pleasurable) effects of food, sex, and addictive drugs, little is known about its involvement in mood disorders. We found previously that blockade of CREB function in the NASh increases cocaine reward in rats, whereas elevated CREB function in this region eliminates cocaine reward. Because anhedonia (a diminished ability to experience pleasure) is a hallmark symptom of depression, these data suggest that CREB (and genes regulated by CREB) in the NASh may be involved in depressive syndromes. To address this question, we have examined relationships between CREB function in the NASh and behavior in the Porsolt forced swim test (FST), a model of depression. In preliminary studies, we find that exposure to the FST causes immediate increases in phospho-CREB (P-CREB, an activated form of CREB) in the NASh. To examine the significance of this effect, we elevated CREB expression in the NASh by viral-mediated gene transfer. This treatment increases immobility in the FST (suggesting increased depression), whereas blockade of CREB function in the NASh (by overexpression of a dominant negative CREB) decreases immobility (suggesting an antidepressant effect). Together, our work suggests that CREB in the NASh is a molecular regulator of at least some symptoms of depression (anhedonia, despair). We propose to further examine the interaction of CREB (and CREB-regulated genes) in the NASh with two antidepressants (desipramine, fluoxetine) in the FST. First, we will determine if antidepressants block CREB-induced increases in immobility. Second, we will examine the time course of FST-induced P-CREB elevations in the NASh, and determine if they are blocked by antidepressants. Third, we will determine if the FST increases expression of dynorphin, a target gene of CREB. Fourth, we will determine if blockade of the brain receptors for dynorphin (k opioid receptors) has antidepressant actions. Finally, we will use intracranial self-stimulation (ICSS) to examine if elevated CREB expression in the NASh produces symptoms of depression in a second behavioral assay. These studies may establish that elevated CREB expression in the NASh is a "molecular trigger" for depression, and identify novel targets for pharmacotherapies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SERTRALINE FOR ALCOHOL DEPENDENCE AND DEPRESSION Principal Investigator & Institution: Pettinati, Helen M.; Director; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 31-MAR-2004 Summary: This is a competing continuation proposal to extend results from a 5- year NIAAA-funded project on sertraline for depressed alcoholics. Comorbidity in substance abusers traditionally has been associated with a more severe clinical picture and a poorer prognosis for drinking outcome, compared to cases of uncomplicated alcoholism. In clinical populations, one-third to one-half of patients seeking alcohol treatment have a lifetime major depressive disorder. Persistent depression in abstinent alcoholics is both disabling and a risk factor for relapse to drinking, and further clinical deterioration that may result in suicide. Because we have effective, FDA-approved pharmacotherapy for alleviating depressive symptoms, it is important that we are fully informed about the

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advantages (or disadvantages) of treating primary or secondary depression in alcoholics with antidepressant medications. Results from our initial, project suggested that comorbidly depressed alcoholics appeared to have reduced antidepressant effects from sertraline and sertraline did not reduce their drinking (more than placebo). To address these results, we propose a study that will examine if we can achieve a more optimal outcome in comorbidly depressed alcoholics by directly treating the alcoholism with naltrexone, and combining this pharmacotherapy with the use of sertraline for treating depression. Thus, the primary aim of this proposal is to examine in depressed alcoholic outpatients whether combining naltrexone (an FDA-approved pharmacological intervention to reduce drinking) with sertraline (an FDA-approved pharmacological intervention to treat depression) will result in greater reductions in both drinking and depression over either medication alone or placebo. A secondary aim is to examine whether certain patient features, e.g., extent of pre-treatment drinking or severity of depression, will predict response to sertraline, naltrexone, or the combination. Patients who present to the University of Pennsylvania Treatment Research Center will be recruited for participation in this study over a 5-year period. There will be 160 males and females with a current DSM-IV diagnosis of alcohol dependence and also of major depression (via PRISM) who will be randomized to one of four treatment groups (40 per group): 1) the combination of 100mg/day naltrexone and 200mg/day sertraline, 2) 100mg/day naltrexone, 3) 200mg/day sertraline, or 4) placebo. Subjects will also receive once- weekly sessions of Cognitive Behavioral Therapy that has been adapted to include a medication compliance enhancement component. The treatment phase will last 16 weeks (includes a week of baseline, and a week of single-blind, placebo lead-in, and 14 weeks of double-blind pharmacotherapy). The follow-up phase includes two visits at 6 and 9 months post-treatment entry. Overall, this project will determine if combining pharmacotherapies results in a better response in comorbidly depressed alcoholics than either medication alone or placebo. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEVERE DEPRESSION IN WOMEN AFTER CARDIAC SURGERY Principal Investigator & Institution: Doering, Lynn V.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2003 Summary: Women account for 27% of the estimated 573,000 coronary artery bypass (CABG) graft surgeries performed annually and suffer greater perioperative mortality and post-operative morbidity, including depression, than men. Depression is a predictor of both mortality and morbidity in other cardiac patients. It has been associated with decreased cell-mediated immunity. While depression after CABG is common, little is known about its severity or its association with post-operative outcomes, such as immune function, infectious complications, functional status, psychosocial adjustment, and quality of life. A structured cognitive behavioral intervention designed specifically to relieve depression has not been tested during early postoperative recovery of CABG patients, even though it is the therapy of choice for mild to moderate depression. The proposed research plan has two overall objectives. The first objective is to obtain evidence regarding the risk of postoperative complications associated with compromised immune function in depressed women compared to non-depressed women undergoing CABG. The second objective is to describe the application of cognitive behavioral therapy in depressed women early after CABG. The overall objective of the proposed award is to increase the applicant's knowledge in immunology and in the delivery of cognitive behavioral therapy, so that

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she is better equipped to pursue a research career in biobehavioral science. A 3-year training plan is proposed. The plan incorporates formal classes in immunology and cognitive behavioral therapy with laboratory training, under the direction of scientists and clinical experts, in each field. The research proposed as part of the award is designed to completed the applicant's formal and laboratory training. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEXUAL ABUSE, SUBSTANCE ABUSE AND DEPRESSION Principal Investigator & Institution: Lewis-Jack, Ometha; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2005 Summary: Clinicians that treat female substance abusers consistently report having to treat other pathologies besides substance abuse. It is typical for a female substance abuser to enter treatment because of drug use, yet, during the process of achieving abstinence, other issues such as depression and sexual abuse emerge and become major treatment concerns. Both depression and sexual abuse seem to be more inherent among the female substance abusing population than the male substance abusing population. Also, males tend to use alcohol for social reasons whereas women report using alcohol to escape from distress rather than for social reasons. Thus, women may tend to use alcohol and drugs more often to mediate distressful feelings. If this is the case, issues that are related to depression, such as sexual abuse, and the depression itself must be identified and then addressed therapeutically to maximize recovery. Additionally, substance-abusing women who have experienced childhood abuse may have children who will also encounter childhood abuse. Sedlak and Broadhurst cited reports from the National Clearinghouse on Child Abuse and Neglect indicating that illicit drug abuse probably contributed significantly to increased rates of suspected child maltreatment and documented injuries. Thus, needs of the mothers and children for which they are responsible. Subsequently, treatment should result in family preservation and prevention of further childhood abuse. The present study has two specific aims (1) to examine the relationship between childhood sexual abuse, depression, and substance abuse among women, and (2) to examine the relationship between substance abusing women who have experienced childhood abuse and the incidence of abuse among their children. The goal of the study is to gain a better understanding of substance abusing women's issues and their impact on recovery and family preservation. The present study also has two long-term objectives (1) to advanced a more comprehensive model of recovery that addresses the specific needs of African American women who have experienced childhood sexual and/or physical abuse and (2) to reduce the incidence of subsequent substance abuse and other mental illness resulting from childhood abuse by developing a more comprehensive model of treatment designed to detect, prevention, and treat abuse among children of substance abusing women. Utilizing factorial ANOVA's, MANOVA's, Pearson Correlation's and Multiple Regressions, the current research intends to examine the relationship childhood sexual abuse, depression, substance abuse and the incidence of sexual abuse among children of substance abusers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SLEEP IMAGING STUDIES IN DEPRESSION Principal Investigator & Institution: Nofzinger, Eric A.; Associate Professor of Psychiatry; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260

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Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Reliable changes in EEG sleep characterize depression although the neurobiology of these changes remain unknown. Preliminary findings from our lab suggest that depressed patients suffer from two related behavioral state changes: deficits in the generation and maintenance of slow wave sleep, and increases in measures related to behavioral arousal including sleep continuity and REM sleep disturbances. We propose that these changes are related to functional alterations in two related brain systems: 1) an anterior paralimbic and prefrontal cortex system (anterior cingulate, basal forebrain, hypothalamus and prefrontal cortex); and 2) a generalized arousal system (pontine reticular formation, thalamus and amygdala). Career development activities to further this line of investigation focus on three areas: 1) the application o neurobiological studies to longitudinal clinical trials; 2) the cognitive neuroscience of limbic/prefrontal cortex interactions and their applications to the functional neuroanatomy of sleep in depression; and 3) the pharmacologic modulation of limbic/prefrontal cortex interactions across behavioral states in depression. The research plan of the K24 award will test a functional neuroanatomic model of behavioral state (sleep/wake) changes in depression that are proposed to be central to the pathophysiology of depression. We will recruit 27 depressed outpatients and 27 healthy controls into a five-day sleep brain imaging study. Measures of behavioral state include EEG sleep and regional quantitative EEG. Measures of brain function include -FDG PET relative regional glucose metabolism during waking, NREM and REM sleep. Repeated measures multivariate analyses of covariance and multivariate multiple regressions will test the above hypotheses. This plan has previously been funded as the R01 "Sleepguided PET studies in depression" (EA Nofzinger, P1, MH61 566). Findings from this study are expected to significantly advance our understanding of the pathophysiology of depression. The goals of mentoring activities are to recruit and mentor at least one new trainee per year from the ranks of medical students, residents, or post-doctoral fellows. Success in mentoring will be measured by trainee's productivity in peerreviewed publications, presentations of research at scientific meetings, and pursuit of independent career development awards and funding proposals. The principal investigator will mentor trainees in conducting patient* oriented research, including the development of IRB approved protocols, implementing a research plan, and interpreting and presenting data. Content areas for mentoring young investigators include functional neuroimaging methods for use during sleep, the neuroscience of behavioral state regulation, and in the ethical conduct of research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SMOKING AND METABOLIC COMPLICATIONS IN ADOLESCENT GIRLS Principal Investigator & Institution: Dorn, Lorah D.; Associate Professor of Nursing & Psychia; Health Promotion & Development; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2003; Project Start 15-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): Adolescence is a time of vulnerability for youth where depression rates increase, particularly in girls, and smoking behaviors are also initiated. Increased morbidity and mortality in women who are smokers has been highlighted by recent statistics showing that women now have an increased rate of smoking over the last several decades. Morbidity and mortality is usually defined by cardiovascular and respiratory disorders. Less attention has been paid to the effect of smoking on aspects of health such as the relationship between smoking and depression

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and anxiety, and in turn, their combined effects on reproductive and bone health. No studies have examined such issues in puberty. The aims of this study are to examine: (1) baseline relationships between puberty, smoking status, depression anxiety, reproductive and bone health, (2) causal direction between smoking status and depression and anxiety across 3 years, (3) characteristics of individual differences in developmental trajectories of: (a) reproductive and (b) bone health (accrual of bone mineral content; BMC) across a 3 year period, (4) the systematic effects of timing of puberty, smoking status and depression and anxiety on individual differences in developmental trajectories of reproductive and bone health (accrual of BMC) across a 3 year period, (5) the relationship of individual differences in developmental trajectories of adolescent reproductive health with individual differences in developmental trajectories of bone health across a 3 year period, and (6) whether baseline levels of smoking status, depression, and pubertal timing predict the simultaneous developmental trajectories of reproductive and bone health. The study will include 252 girls, ages 11-17 years enrolled in a cross-sequential design for three annual visits. Measures include smoking status, depression and anxiety, pubertal timing, gonadal and adrenal hormones, menstrual cycle information, and accrual of BMC. Examining the combined impact of smoking, depression and anxiety, on timing of puberty has import for future intervention and prevention strategies. Any negative influence during this critical period, such as smoking or depression, may have significant long-term consequences for bone (i.e. increased risk of osteoporotic fracture) or reproductive health (i.e. menstrual irregularity & endocrine disruption, infertility, dysmenorrhea). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SOCIAL CHANGE, HEART DISEASE, AND DEPRESSION Principal Investigator & Institution: Fechner, Mary J.; Anthropology; University of Oregon Eugene, OR 97403 Timing: Fiscal Year 2001; Project Start 01-SEP-2001 Summary: INVESTIGATOR'S The research is part of a larger goal to understand the role of culture on the experience of heart disease, depression, and their co-morbidity. The research begins with a cultural investigation of post-socialism in eastern Germany, but will culminate in an understanding of illness as a meaningful experience in a context of rapid social change. Research suggests that heart disease (and heart disease co-morbid with depression) is sensitive to biologic and psychosocial variables, but few studies have investigated the role of culture in heart disease, or its co-morbid state. This work builds on research into culture and hypertension, and culture and depression, to fill a gap in our understanding of the cultural processes at work in the expression of heart disease, but adds a new dimension by exploring co-morbidity. The research will take place in eastern Germany, where individuals are at increased risk to both conditions since 1989. Research aims include: 1) a community-based cultural study of the political-economic transition; 2) a community-based cultural study of cardiac and mental health; and 3) a clinic- or hospital based appraisal of cultural factors among patients expressing: a) heart disease; or, b) co-morbid heart disease and depression. Data sources will include: ethnographic interviews of post-socialism; idioms of distress, explanatory models, illness narratives, and semantic illness networks for heart disease and depression; a cultural consonance measure; measures for depression; demographics; and, local health statistics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: LIFECOURSE

SOCIAL

INEQUALITIES

IN

DEPRESSION

ACROSS

THE

Principal Investigator & Institution: Buka, Stephen L.; Associate Professor; Maternal and Child Health; Harvard University (Sch of Public Hlth) Public Health Campus Boston, MA 02460 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2003 Summary: This application addresses two major current themes in the epidemiology and prevention of adult mental disorders: a) social and economic disparities in health status: and b) early origins of adult health status. Where most of the current work in these areas has focused on physical health conditions (e.g., cardiovascular illness. diabetes) there is mounting evidence of the relevance of these lines of inquiry to psychiatric disorders. Furthermore, while socioeconomic disparities in depression in adulthood have been documented consistently, the mechanisms generating these disparities have yet to be fully elucidated. Accordingly, we seek to conduct new data analyses examining socioeconomic disparities in major depressive disorder in relation to adult and childhood socioeconomic status, and to examine the role of other childhood environmental factors in the development of depression. These investigations will be based on the Providence follow-up National Collaborative Perinatal Project, a thirtyyear, longitudinal study of 1,263 individuals who were enrolled at birth and systematically followed for an average of 27.8 years. Comprehensive prospective assessment of childhood environmental conditions have been obtained at multiple points in time and adult psychiatric diagnoses obtained using structured diagnostic interviews. We will employ a range of analytic strategies including discrete-time survival analyses. The specific aims of this study are to examine the effects of childhood socioeconomic status on the occurrence and severity of major depressive disorder in adulthood. Furthermore, we will assess the direct role of childhood environmental factors in the occurrence of depression as well as their potential to mediate the association between early-life socioeconomic conditions and subsequent depression. Finally, we will study the risk that substance abuse disorders pose on the incidence of depression and examine whether this risk is modified by childhood conditions. The prospective nature of this study, the comprehensive assessment of parental and childhood variables, and the rigorous measurement of psychiatric disorders in adulthood make this sample uniquely suited to addressing these aims. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SOCIAL SUPPORT AND DEPRESSION AMONG DIALYSIS PATIENTS Principal Investigator & Institution: Brown, Stephanie L.; Survey Research Center; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): The proposed three-year research and training plan is designed to foster the academic development of the candidate in preparation for her career as a translation research scientist. Specifically, the plan is intended to (a) foster the candidate's transition from conducting experimental research on interpersonal relationships to conducting pre-intervention research on depression in chronically ill populations and (b) enable the candidate to design an intervention for depression that is informed by her program of research. The research plan is described below. The purpose of the proposed research project is to identify malleable factors that influence

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depression among patients undergoing dialysis therapy for renal failure. We direct special focus on the exchange of emotional and practical support between dialysis patients and their caregivers in order to isolate the unique effects of giving and receiving. We intend to examine whether giving has beneficial effects for the giver, and whether receiving has adverse effects for recipients who feel like a burden. These possibilities have typically been overlooked. Instead, investigations have focused on the benefits of receiving support from relationship partners (House, Landis, & Umberson, 1988). A longitudinal study consisting of two waves of data collection--baseline and an eight-month follow-up-is proposed to examine the unique effects of giving and receiving social support, feeling like a burden, and a number of other personality and relationship measures on depression, health, and well-being. 160 dialysis patients within the University of Michigan Health Care System will be invited to participate in two 1-hour interviews over the course of eight months. Participants will be asked to respond to questions about their current mental health status (e.g., depression, anxiety), and about their relationship to a caregiver (e.g., social bonds, the exchange of social support). In addition, caregiver reports and medical records indicating patient health and compliance will be correlated with interpersonal relationship measures. The results of this project will be used to develop and test a mental health intervention for dialysis patients that takes into consideration the potential risks and benefits of social support. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SPIRAL OF DEPRESSION AND DISABILITY IN LATE LIFE Principal Investigator & Institution: Bruce, Martha L.; Professor; Psychiatry; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001; Project Start 05-AUG-1998; Project End 31-JUL-2003 Summary: (Adapted from applicant's abstract): This application for a NIMH Independent Scientist Award(K02) requests support for the candidate's career goal of identifying strategies which can effectively intervene on the potential spiral of depression and functional disability in older adults. The K02 career development aims are: a) to foster collaborative study of these issues with an interdisciplinary set of scientists with clinical, biological, and psychosocial orientations, and b) to develop personal expertise in: i) theory and assessment of functional disability, and ii) methodology for assessing the feasibility and effectiveness of intervention strategies for reducing the causal effects of disability and depression on each other. The specific K02 research aims are to further the understanding of the relationship between depression and functional disability in elderly adults by testing hypotheses in data from both naturalistically treated and controlled treatment samples of elderly adults about: a) specific attributes of depression and disability that contribute to the risk of each condition over time, and b) the effect of systematic treatment interventions for depression on changes in functional disability in relationship to changes in depressive status. Depression and disability are both highly prevalent in advanced age and both associated with immense personal suffering, burden on family and expensive health care. Longitudinal population-based and clinical-based studies demonstrate that depression and disability affect each other's onset and course. The K02 award offers an opportunity to introduce the concept of heterogeneity to this research, both in terms of the severity and other clinical features of depression but also in terms of the assessment of functional disability. Disaggregating these phenomena and specifying attributes of depression and disability associated with the downward course of both promises two sets of scientific contributions. First, this research will identify specific mechanisms relating depression to functional disability in older adults. Second, it will identify

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potential avenues for effective intervention into these relationships in high risk populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STRESS RESILIENCE IN AN ANIMAL MODEL OF DEPRESSION Principal Investigator & Institution: Kohen, Ruth; Psychiatry and Behavioral Scis; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): Major depression is the most common psychiatric disorder, affecting over 17% of individuals over the course of their lifetime. Genetic and environmental factors working in concert determine an individual's vulnerability to depression by affecting the use of genetic information in the brain. This use of genetic information can be measured as the amount of messenger RNA (mRNA) that is produced from a single gene, a process described as 'gene expression analysis'. In the proposed study we will use an animal model of depression, the forced swim test, to investigate the influence of environmental stress and chronic antidepressant treatment on gene expression in rat hippocampus. We hypothesize that resilience to depression occurs as a result of adaptive changes in the brain. We will observe these adaptive changes by large-scale gene expression analysis, using oligonucleotide microarrays and quantitative reverse transcription polymerase chain reaction (RT-PCR). We further hypothesize that animals show behavioral depression if and when these adaptive changes in gene expression fail to occur. We will also test the hypothesis that chronic treatment with antidepressant drugs works by facilitating this adaptive pattern of gene expression changes. This is a departure from the traditional way of thinking about depressive illness. The traditional view suggests that depressive illness occurs as a result of a change of metabolism or neuronal circuitry in the brain of affected subjects. We propose just the opposite: that stress resilience is accompanied by an adaptive change in brain neurochemistry that is missing in depressed individuals. Hence, depressed subjects resemble controls that have not been challenged with environmental stress. Our approach is novel because it focuses on investigating factors that protect the individual from depression, rather than on changes that occur as a result of the disease. If our hypothesis is true, it would mean a paradigm shift in our understanding of affective illness that could alter the focus of treatment from the current management of symptoms to their prevention Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: STRESS RESPONSE DIFFERENCES IN FEMALES: ESTRADIOL'S ROLE Principal Investigator & Institution: Faraday, Martha M.; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, MD 20852 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): In response to stress, pre-menopausal women are more likely to become depressed than are men, suggesting that being female and exposure to cycling female sex hormones may constitute part of depression vulnerability. Only some women develop depressive illness, however, indicating that women differ in stress sensitivity and depression vulnerability. Rodent models of depression that examine responses of stress-vulnerable vs. stress-resistant females would be valuable to understand the biologic basis of differential stress and depression vulnerability in women but models of depression generally have used male rats as

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subjects. Preliminary data indicate that Sprague-Dawley female rats are markedly more sensitive to stress than are Long-Evans female rats across several behaviors and biologic indices, including a behavioral model of depression and hypothalamo-pituitaryadrenocortical (HPA) axis responses. These differences in response to stress could be the result of many factors, including actions of estradiol on brains that are different and line differences in how stress affects estradiol levels or estrus cycling. Estradiol is the major sex hormone with behavioral and biologic actions in females. Estradiol interacts with stress-sensitive brain systems (i.e., serotonergic, dopaminergic) that control the behaviors under study. Estradiol also interacts with the HPA axis. Therefore, examining estradiol's role in stress responding of stress-sensitive female rats (Sprague-Dawley) and stress-resistant female rats (Long-Evans) is a critical step toward understanding why some females are more vulnerable to stress and depression than others. Behavioral and corticosterone responses of Sprague-Dawley and Long-Evans females that are intact, ovariectomized, or ovariectomized with estradiol replacement will be evaluated in response to daily restraint stress. Responses also will be compared with intact male rats. To determine whether female line differences in response to stress are the result of changes in estrus cycling or line differences in estradiol levels, estrus cycle and estradiol levels of intact females also will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STRUCTURE AND ASSESSMENT OF SYMPTOMS OF DEPRESSION Principal Investigator & Institution: Watson, David B.; Professor; Psychology; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-APR-2008 Summary: (provided by applicant): Many of the most frequently used depression instruments were created more than 40 years ago, without the benefit of rigorous psychometric development and testing. Most of these measures were designed to provide only a single overall index of depression, so that they do not yield reliable and valid subscales assessing specific types of depressive symptoms. Furthermore, progress in this area is hampered by our limited understanding of the internal structure of depressive symptoms. The proposed work will result in a multi-dimensional measure of depression that will include a wide range of depression symptoms, as well as symptoms of related anxiety disorders such as generalized anxiety disorder, social phobia, and panic disorder. The scales comprising the final measure will be suitable for use in clinical outcome research as well as other studies of the etiology and consequences of depression. The process will begin with the creation of a comprehensive item pool; our review of the literature indicates that this pool should multiple groups of items assessing prominent symptoms of depression, another group of items measuring positive emotionality, and several clusters of anxiety-related items. These items will undergo extensive testing with diverse samples of both clinical and non-clinical adult populations. The goal of the initial phases of the proposed research is to determine the factor structure of depression and related symptoms so that appropriate subscales are modeled in the final measure. Further studies will assess the construct validity of the resulting factor-based measures through analyses of their (a) sensitivity to change and (b) convergence with other self-report and clinician-rated measures of depression and anxiety. The next group of proposed studies will use advanced psychometric methods (including confirmatory factor analysis and item response theory) to assess the suitability of the measure--at both the subscale and item level--in different populations (e.g., adolescents, pregnant and postpartum women, and older adults) and to modify the instrument as necessary for use with these populations.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SUBCORTICAL MICROVASCULAR DISEASE IN DEPRESSION Principal Investigator & Institution: Salloway, Stephen P.; Associate Professor; Rhode Island Hospital (Providence, Ri) Providence, RI 02903 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: The objective of this five year Mentored Clinical Scientist Development Award is to become an independent investigator in the pathogenesis, prevention, and treatment of subcortical microvascular disease in geriatric depression. The award will help the nominee develop skills in the following areas: clinical research methodology and statistics, quantitative magnetic resonance imaging (MRI) analysis, pathogenesis of cerebral small artery disease, and assessment of cognitive function and clinical manifestations of geriatric depression. These skills will be utilized to conduct a pilot study of the role of subcortical microvascular disease in geriatric depression. The study will use a case control design to compare two groups of geriatric depressed inpatients with and without high levels of subcortical microvascular disease. The specific aim is to look for differences in hypertensive burden, cognitive function, phenomenology of depression, and rate of decline in cognition and activities of daily living (ADLs). Subsidiary analyses will correlate the regional distribution of MRI hyperintensities with the pattern of cognitive dysfunction, and will evaluate the presence of apolipoprotein E4 alleles as a marker for the development of microvascular disease. The findings from this study should have important implications for prevention, prognosis, and treatment of geriatric depression associated with microvascular disease. The nominee plans to submit an RO1 level grant on subcortical microvascular disease in geriatric depression based on results obtained in the pilot study prior to the completion of the award. The nominee plans to develop a high quality morphometric imaging laboratory which will be used as a resource for a number of clinical studies in the departments of psychiatry and clinical neurosciences at Brown. The nominee further plans on assuming a leadership role in developing a post-doctoral clinical research training program in geriatric neuropsychiatry at Brown University. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SUBMISSIVE BEHAVIOR AS A MODEL OF DEPRESSION Principal Investigator & Institution: Tunnicliff, Godfrey; Pharmacology and Toxicology; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, IN 462025167 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2003 Summary: (provided by applicant): Depression is one of the most prevalent mental disorders in the United States and is associated with high levels of morbidity and mortality. It is estimated that costs associated with depression (from absenteeism, lost productivity, lost earnings, treatment and rehabilitation) exceed $40 billion in the United States alone. Our work is focused on the investigation of the mechanism of depression and antidepressant drug action. We developed a new animal model of depression, reduction of submissive behavior (RSBM) that differs from existing behavioral tests by not subjecting animals to pain or artificially stressful conditions. Instead, pairs of rats compete during a daily 5-minute trial period for a limited amount of food. Half of the rats tested under this condition develop a dominant/submissive relationship that is a characteristic feature of normal animal social behavior. The submissive behavior observed can be objectively measured as the amount of time spent on the feeder relative

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to that by the paired dominant animal. We have shown that this submissive behavior has qualities of human depression and can be greatly reduced or eliminated by treatment with a wide variety of antidepressant drugs. We want to adopt the RSBM to mice for testing mouse mutants for candidate gene related to depression. The extension of the dominance-submissive model to mice is of particular importance because of the development of many genetically distinct mouse strains and the availability of mice with specific genetic modifications (i.e. knockout strains). The studies in this proposal are designed to test the hypothesis that mice, like rats, will form dominant-submissive behavior and to demonstrate the activity of antidepressant drugs in mice using the model as described above. We will also determine whether selected mouse strains are more prone to submissiveness than others. Furthermore we will study whether specific knockout mice showing depressive-like behaviors in other models of depression will be submissive as compared with the wild type animals. Human depression shows an inheritance pattern consistent with a genetic component. The identification of genetic elements in mice associated with depression-like behavior can be tested for homology in human patients that could ultimately lead to an understanding of genetic defects underlying depression in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SUBSTANCE DEPENDENT TEENS--IMPACT OF TREATING DEPRESSION Principal Investigator & Institution: Riggs, Paula D.; Associate Professor of Psychiatry; Psychiatry; University of Colorado Hlth Sciences Ctr Uchsc at Fitzsimons Aurora, CO 800450508 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-JUL-2005 Summary: (Applicant's Abstract) Adolescents with substance use disorders (SUD) and conduct disorder (CD) have high rates of comorbid depression. Despite the high prevalence of depression in such youth, little is known about effective treatment of such depressions. Moreover, the effects of treating depression on substance use and other problem behaviors in such youth are not known. Only serotonergic agents, fluoxetine (FLX) and paroxetine, with most support for FLX, have empirical support in the treatment of depression in adolescents without serious comorbidity. It is not known whether FLX (or paroxetine) are effective in treating the depressions of adolescents with SUD and CD. The proposed study is a randomized, placebo-controlled trial comparing placebo to fluoxetine for major depressive disorder (MDD) in 120 adolescents with SUD and CD. Adolescents with DSM-1V SUD, CD, and MDD assessed both clinically and with structured assessment instruments, will be randomized to one of these two treatment cells for 16 weeks. All subjects will also receive standardized, manual-driven cognitive behavior treatment for adolescent SUD for the duration of the trial as the background "treatment as usual" Medication compliance will be electronically monitored. Adverse side effects will be monitored weekly. The specific aims of this study are to test the following hypotheses: 1. Fidoxeline + CBT will be more effective in treating unipolar depression in adolescents with SUD and CD than placebo + CBT. 2. The treatment of depression with RX + CBT, in depressed adolescents with SUD and CD will be more effective than placebo + CBT in reducing substance use and improving conduct symptoms. 3. The treatment of depression with RX will result in greater retention in, and compliance with substance treatment (CBT) and reduction in both substance use and conduct problems than treatment with placebo. This research will contribute important knowledge regarding effective treatment of depression in

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conduct-disordered adolescents with SUD and provide information about the effects of treating depression on substance and other behavioral outcomes as well. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TELECOM ANTIDEPRESSANTS

SYSTEM

TO

IMPROVE

ADHERENCE

TO

Principal Investigator & Institution: Friedman, Robert H.; Director, Ambulatory Medicine; Boston Medical Center Gambro Bldg, 2Nd Fl, 660 Harrison Ave, Ste a Boston, MA 02118 Timing: Fiscal Year 2001; Project Start 21-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): The purpose of this pilot study is the development and preliminary evaluation of an automated telecommunications system to help adult patients with unipolar depression improve adherence to their antidepressant medication regimens and scheduled office visits with their mental health care providers. Based on Social Cognitive Theory (SCT), particularly its self-efficacy construct, the Telephone-Linked Care for Adherence to Treatment Regimen in Depression (TLCDepression) will automatically monitor adherence to treatment regimens as well as disease symptoms and functional status of patients and will give information, advice and counseling to patients to reinforce adherence. TLC-Depression will also generate reports from the information obtained from the patients and will communicate it to their mental health caregivers in order to assist the responsible physician in better monitoring of the patients medication-taking behavior, their depression symptoms and their functioning. The study will entail 2 components: 1) A qualitative evaluation of TLCDepression that will be carried out with a maximum of 20 patients with the purpose of modification and refinement of the system. These patients will be screened for a period of 1 month to determine eligibility (medication adherence as measured by MEMS track caps less than 80 percent, and pill count audit). In-Depth interviews will be conducted twice a month with eligible subjects who will use TLC-Depression for 2 months. The results of the interviews will be utilized to improve and refine the intervention. 2) A quantitative pilot study to test TLC-Depression in order to utilize the system in a future randomized clinical trial with sufficient power to evaluate its efficacy. Sixty eligible patients will be randomized to the intervention (TLC) and usual care (UC) groups for a period of 4 months. All patients will be screened for a 1-month period to determine adherence eligibility (medication adherence as measured by MEMS track caps less than 80 percent, and pill count audit). Patients will call TLC-Depression and will converse with the system through the touch-tone keypad on their telephones. Patients will call TLC-Depression once a week at a scheduled time. The analysis will compare TLC and UC patients between baseline and follow-up 4 months later. Patients' self-efficacy, psychological and physical health status will be measured at baseline and at the end of the study. We hypothesize that TLC Depression will improve adherence, self-efficacy and psychological and physical health status among patients in the intervention group over a 4-month period in comparison with those in the control group. And that TLCDepression will be acceptable and usable by the patients Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TELEPHONE PSYCHOTHERAPY--TREATMENT OF DEPRESSION IN MS Principal Investigator & Institution: Mohr, David C.; Northern California Institute Res & Educ San Francisco, CA 941211545

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Timing: Fiscal Year 2001; Project Start 08-SEP-2000; Project End 31-JUL-2005 Summary: (Adapted from the Applicant's Abstract): Rates of depression in multiple sclerosis (MS) have been estimated at between 14% and 54%, and have been shown to be higher than rates in the general population or in other chronic illnesses. While untreated depression in MS is likely to worsen over time, it has been shown to respond well to treatment with cognitive behavioral therapy (CBT). Nevertheless, many patients with MS remain untreated. This may be due in part to common symptoms of MS, which can interfere with regular office visits. We are proposing to test a model of CBT, administered over the telephone, designed to treat depression in MS. While the use of telephone counseling and support services is increasing, empirical evidence on the efficacy of such services for the treatment of depression is scant at best. A patient workbook and therapist CBT treatment manual were developed by the PI and tested in an uncontrolled pilot study. In the 8-week pilot, 32 MS patients were randomly assigned to either telephone CBT or standard care (SC) in an HMO. Patients receiving telephone CBT showed improvement, as compared to patients receiving SC as measured by the Profile of Mood States Depression-Dejection scale (p=.01). This study proposed to enroll 128 patients in a randomized treatment study. Patients will be selected from the diverse population of patients in the Northern California Kaiser Permanente Medical Care Group (KPMC). Patients who meet inclusion criteria, including definite MS, activity limitation (disability) criteria, and DSM-IV diagnosis of Major Depressive Disorder (MDD), will be randomized into one of two treatment groups: 1) Coping with MS (CMS) telephone psychotherapy, which is a 16 week, 18 session, manualized form of telephone CBT that focuses on depression and adjustment to illness; or 2) a non-directive (ND) therapy contrast condition that controls for the nonspecific effects of psychotherapy. Outcomes include dichotomous and continuous measures of MDD, Quality of Life, and activity limitations. Patients will be followed for one year after the end of treatment. If the treatment proves efficacious, it will result in a validated form of telephone CBT for the treatment of depression that can be provided to MS patients independent of their mobility status or geographic location. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TESTING CAREGIVERS

THE

DIATHESIS

STRESS

MODEL

WITH

LAY

Principal Investigator & Institution: Clark, Michele C.; None; University of Texas Medical Br Galveston 301 University Blvd Galveston, TX 77555 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2004 Summary: (Provided by the Applicant) Caregivers providing direct and indirect care often experience depression, which impairs their health and compromises their ability to provide care. Using the Diathesis-Stress Model developed from cognitive theory (Beck, 1983; Clark & Beck, 1999), this study will evaluate whether researchers and clinicians can differentiate between lay caregivers susceptible to clinical depression and those who are not. The Diathesis-Stress Model examines sociotropy, autonomy, and negative assumptions. Sociotropy is defined as the beliefs and attitudes that lead an individual to depend on others for personal satisfaction. Sociotropic individuals tend to place high value on approval, intimacy, affection, guidance, and help. Autonomy represents self-evaluation about one's abilities in mastery, control, and achievement. Negative assumptions are the rules individuals develop to support beliefs about their own characteristics of sociotropy and autonomy. Specifically, this study aims to (1) evaluate the influence of caregiver burden on depression; (2) explore the influence of caregiver burden on caregiver's individual levels of sociotropy, autonomy, and negative

160 Depression

assumptions; (3) measure the influence of sociotropy, autonomy, and negative assumptions on depression; and (4) compare the magnitude of the direct influence of caregiver burden on depression with three indirect influences of sociotropy, autonomy, and negative assumptions. A causal model will be tested to achieve the study aims. Participants will consist of 109 caregivers providing a minimum of 10 hours per week of instrumental or personal care to a community dwelling elderly (60 +) family member. To test the overall Diathesis-Stress Model for Caregivers, a structural model will be constructed. Caregiver burden is hypothesized to have a direct influence on depression. Additionally, caregiver burden is also expected to influence depression through the mediating variables of sociotropy, autonomy, and negative assumptions. Differentiating between lay caregivers susceptible to clinical depression and those who are not is important. Identifying depression-prone caregivers can accelerate researchers' abilities to design programs that prevent or reduce depression among individuals and communities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE BEHAVIORAL TREATMENT OF DEPRESSED CANCER PATIENTS Principal Investigator & Institution: Hopko, Derek R.; Psychology; University of Tennessee Knoxville Knoxville, TN 37996 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2003 Summary: (provided by applicant): Among cancer patients, major depression is the most common psychiatric disorder, with as many as 50-85% of patients considered clinically depressed, the majority of which present to a primary care environment for treatment (ct. Stevens, et al., 1995). Among primary care patients with depression, treatment satisfaction is moderate to low and response rates are lower than those anticipated based on the Agency for Health Care Policy and Research Guidelines (Wells et al., 1999). Accordingly, the need to focus on quality improvement has been highlighted (Coyne, 2000). The primary objective of the study is to explore the effectiveness and feasibility of a brief behavioral activation treatment for depression (BA TD; Lejuez, Hopko, & Hopko, 2001) for clinically depressed cancer patients within primary care. The BATD protocol may be a viable means to improve quality of care and quality of life for cancer patients in that the treatment addresses primary symptoms often associated with cancer and depression and may reduce practical problems associated with mainstream psychosocial treatments for depression in primary care (Coyne, 2000). This research is important considering the paucity of psychosocial treatment outcome work focused on depressed cancer patients, methodological limitations of studies, lack of effectiveness research in "real-world" (primary care) settings where most patients present with depressive symptoms, and limitations of existing psychosocial treatments in this context. The design involves the collection of pilot data within a small open trial (N = 12). Using a heterogenous sample, the effects of BATD at post-treatment will be evaluated using clinical, functional, satisfaction, and service utilization outcome measures. Clinical outcomes include measurement of target symptoms (depression) and potentially coexistent clinical conditions (i.e., anxiety, substance use). Functional outcomes will assess functional status and quality of life. Satisfaction outcome will assess patient satisfaction with BATD. Longer-term effects of BATD will be assessed on these variables at 3-month follow- up. The project is an important first step toward developing a large-scale, multi-site, randomized hybrid efficacy-effectiveness study that will assess the clinical utility of BA TD in treating depressed cancer patients within primary care, and the efficacy of this treatment

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compared with alternative (psychosocial and pharmacological) interventions for depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

THE

ECONOMIC

VALUE

OF

NEW

TREATMENTS

FOR

Principal Investigator & Institution: Conti, Rena M.; Health Care Policy; Harvard University (Medical School) Medical School Campus Boston, MA 02115 Timing: Fiscal Year 2003; Project Start 15-JUN-2004 Summary: (provided by applicant): Depression is a prevalent chronic condition nationally and is associated with high levels of impairment. Extraordinary advances have been achieved in the last two decades in the pharmacological treatment of depression. The introduction of these agents has altered the way in which depression is treated in the US and may have a large impact on individuals and their well being. New treatments are also more expensive than older medications and are associated with remarkable increases in spending. The principal goal of this research is to develop practical, aggregate measures of the economic values of new methods for treating depression. I propose to measure the economic welfare generated by innovation in depression treatment by estimating a demand system that explicitly accounts for some unique features of the delivery of mental health care. From the demand estimates, several types of commonly used measures of welfare gain for the treatment of depression will be constructed. There are several competing approaches to measuring welfare change from innovation, of which the demand side approach is one. Welfare gains using the demand side approach will be compared to alternative measures. The specific aims of the research application are: 1. To review the literature on the nature of clinical decision making for depression treatment. To perform a careful review of the economics and health policy literature regarding demand estimation and consumer price index (CPI) construction. Discussions with established researchers and practitioners in the field will also be pursued; 2. To perform a series of descriptive analyses regarding the composition of depression treatment, illness characteristics, patient demographics and institutional determinants of treatment over time; 3. To estimate a model of economic welfare based on the demand for depression treatment before and after new treatment introduction. From the demand estimates, several types of welfare measures will be constructed; 4. To compare demand side estimates of welfare gain from innovation to other measures reported in the literature. Alternative measures will also be constructed and compared. The proposed research would be the first attempt to develop a comprehensive measure of the value of depression treatment innovation using the demand approach. It will also be among the first projects to extend and compare alternative empirical methodologies for valuing consumer welfare in the mental health context. The derivation of accurate measures of economic welfare from treatment innovation has important policy implications. Specifically, the results of this research may be useful to policy makers who must interpret and make judgments about the benefits associated with mental health spending. Progress on this issue will also be useful for government agencies charged with constructing accurate measures of medical sector productivity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TRANSITION TO ADULTHOOD IN YOUTH AT RISK FOR DEPRESSION Principal Investigator & Institution: Brennan, Patricia A.; Psychology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 30-SEP-1995; Project End 31-AUG-2005 Summary: (adapted from the investigator's abstract): The proposed study examines the effect of maternal depression on young adult outcomes in a unique community sample of Australian youth who have previously been studied by the investigators at age 15. The youth and their families are a high-risk sample from a birth cohort study in Queensland, Australia. The original birth cohort study by Australian investigators included interviews of mothers at pregnancy, birth, and six-months post-partum, with evaluations at children's ages 5 and 14 to assess socio-demographic predictors of health and child development. The 15-year-old follow-up by the present investigators focused intensively on maternal depression and child mental health and adjustment. The present proposal is for a follow-up at age 20 with these youth, their peers, and their mothers in order to address a number of gaps in the field concerning the transition to adulthood for high-risk youth. The proposed follow-up period marks the challenging developmental transition, and it is expected that during this period the youth in the sample will encounter significant stress, and will be particularly susceptible to depressive outcomes. The two primary aims of the study are (1) to examine the diagnostic outcomes, as well as functional impairments in high-risk youth from the ages of 15 to 20 years as well as the role of paternal psychopathology, co-morbidity, protective factors and gender in this process; and (2) to examine interpersonal models of intergenerational transmission of depression, and models of the stress-depression relationship as relevant to the period of early adulthood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TRANSLATING DEPRESSION GUIDELINES IN SUBSTANCE ABUSE TX Principal Investigator & Institution: Curran, Geoffrey M.; Psychiatry and Behavioral Scis; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, AR 72205 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): The applicant is requesting five years of funding though the Mentored Career Development Award (K01) program to enhance his knowledge base and methodological skills for diffusion of renovation research-specifically, to translate evidence-based care for depression into community substance use treatment settings. The applicant's strong background in medical sociology, the developmental course of substance use disorders, and health services/outcomes research is an ideal foundation for developing expertise in technology transfer in these settings. The proposed career development plan supports this goal by providing specific training in five areas: 1) organizational change theory and methods; 2) clinical provision of care for substance abuse and depression 3) the current organizational/policy structure of substance abuse and mental healthcare services, focusing on continuity of care within and across systems; 4) quantitative and qualitative methods pertinent to the proposed research plan; and 5) the ethical conduct of research. The research plan seeks to develop, implement, and test an organizational intervention in community substance abuse treatment settings to establish guideline-concordant treatment of comorbid depression. The intervention will assist programs in their own implementation of a

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guidelines-based treatment algorithm to improve the recognition of depression and initiation of pharmacotherapy. The algorithm will involve two assessment-to-treatment steps-- 1) early post-detoxification assessment of depressive symptoms plus a patient history of depression, with initiation of pharmacotherapy if the patient reports both current symptoms and a history of major depression during periods of sobriety; 2) assessment of depression symptoms at least 4 weeks post-detoxification, with initiation of pharmacotherapy if an independent diagnosis of depression is indicated. We know from previous guideline implementation research that the simple dissemination of guidelines does little to influence provider/system behavior. Rather, a multi-component diffusion of innovation intervention is necessary to maximize the adoption of guideline concordant behavior. Study 1 analyzes the barriers and facilitators to technology transfer of depression management in participating facilities. These data will inform the development of the technology transfer intervention, its implementation tools, and the depression algorithm. Study 2 implements and tests the intervention. The evaluation will examine program- and provider-level outcomes. Program level outcomes will include feasibility, extent of adoption of the algorithm, and provider/organizational attitudes and beliefs about the intervention's design and effectiveness. Patient-level outcomes will include depressive symptoms, substance use outcomes, medication adherence quality of life, and services use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TRANSLATIONAL STUDIES OF DEPRESSION, PLATELETS, & CAD Principal Investigator & Institution: Badimon, Juan Jose.; Professor of Medicine; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2002; Project Start 10-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Depressive symptoms significantly increase the risk of acute coronary syndromes recurrence (ACS). Platelet-thrombus formation over a disrupted atherosclerotic plaque is fundamental for ACS recurrence.Serotonin (5-HT) is an important stimulant of platelet reactivity. Increased 5-HT-mediated platelet reactivity due to upregulation of the platelet 5-HT2A receptor, increases thrombosis formation and has been postulated to a major mechanism linking depression to ACS recurrence. It is not known at this time if depression interventions reverse the increased risk of ACS events in depressed patients. The selective serotonin reuptake inhibitors (SSRIs) and the 5-HT2A receptor antidepressants improve depressive symptoms at equal rates. Both types of antidepressants may attenuate platelet reactivity by improving depressive symptoms (CNS mediated indirect effects). However, the SSRIs and the 5-HT2A receptor antagonists may have additional but divergent pharmacologic effects on platelet reactivity (direct platelet effects). Given the relationship between depression, platelet-thrombus formation, and the ACS, those antidepressants capable not only of improving depression symptoms but also of inhibiting platelet reactivity directly, may have the greatest net (direct + indirect) impact in inhibiting platelet-thrombus formation and preventing ACS events. A cross-sectional, case-control study will be conducted to compare 5-NT-mediated platelet reactivity and thrombosis between depressed and nondepressed patients with coronary artery disease (CAD) history. The direct in vitro effects of the SSRIs and 5-HT2A receptor antagonists will also be assessed. A randomized, 3 active arm, 1 control arm, depression intervention trial will be conducted to compare the in vivo net effects of pharmacologic (the SSRIs and 5-HT2A receptor antagonists) treatment and the indirect effects of a non-pharmacologic (cognitive behavioral therapy) treatment on platelet reactivity and thrombosis in depressed CAD

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patients. By defining differences in direct-platelet, CNS-mediated indirect, and net effects on platelet reactivity and thrombus formation, depression interventions that are best at inhibiting platelet reactivity and thrombogenicity can then be tested for reducing cardiovascular morbidity and mortality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATING DEPRESSED MOTHERS IN A COMMUNITY CLINIC Principal Investigator & Institution: Swartz, Holly A.; Assistant Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): When mothers suffer from depression, the effects of their illness are borne not only by mothers but also by their dependent offspring. The converse may also be true: that is, effective treatments for mothers with depression may also improve outcomes for their children. The purpose of this proposed Mentored Patient-Oriented Research Career Development (K23) Award is to promote the Candidate's long-term goal of conducting clinical trials of psychosocial interventions for mothers with depression in community settings and to study the impact of these treatments on mothers and their dependent children. The activities described in this application will enable the Candidate to assess the reciprocal relationship between maternal depression and child illness, successfully engage and retain mothers in multisession psychosocial treatments, and collaborate with health services researchers in order to enhance the public health value of the intervention. Interpersonal psychotherapy (IPT), an efficacious treatment for depression, addresses both depressive symptoms and problematic interpersonal relationships. For mothers whose struggles caring for ill children contribute to her psychiatric illness, IPT provides the opportunity to resolve both the depression itself and depression-engendering conflicts with a child or partner. The first phase of the research plan consists of modifying an 8-session form of IPT (IPT-B) for depressed mothers with ill children by incorporating an engagement strategy and minimizing practical barriers to care. The second phase of the research plan consists of a small, preliminary, randomized trial comparing enhanced IPT-B to a referral for usual care in a sample of depressed mothers who bring their school-age children for treatment in a community mental health clinic. Mothers and children will be assessed at baseline, post-treatment, and 6-month follow-up. The skills, training, and pilot data obtained from this award will subsequently support the Candidate's development of an R01 application in Years 03-05 of the award period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATING FAMILY CAREGIVERS TO LATE-LIFE DEPRSSION PTS Principal Investigator & Institution: Martire, Lynn M.; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2003; Project Start 18-DEC-2002; Project End 30-NOV-2007 Summary: (provided by candidate): This is a revised application for a Mentored Research Scientist Development Award (K01). The candidate is a social psychologist who proposes to acquire the knowledge and skills to design and implement psychosocial interventions for family caregivers to clinically-depressed older adults. Depression in late life is associated with increased health care utilization, amplification of physical disability, cognitive impairment, and increased risk for suicide. Although remission of late-life depression can be achieved with pharmacotherapy and psychotherapy, the long-term prognosis for patients is mixed. Family members who

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provide support and physical assistance to depressed older patients are at high risk for psychiatric and physical morbidity of their own, and may play a critical role in patient treatment adherence and response. The candidate's proposed career development activities focus on acquiring knowledge of the pharmacologic and psychotherapeutic treatment of late-life depression, as a platform for additional training and research activities focused on the assessment and psychosocial treatment of family caregivers to late-life depression patients. In addition, the candidate aims to master advanced statistical techniques for analyzing treatment outcomes for older depressed patients and their family caregivers. The Research Plan of this application includes a study that will examine the prospective relationships between caregiver factors (knowledge, attitudes, burden, and psychiatric symptomatology) and patient treatment adherence and response. A second study will evaluate a pilot psychosocial treatment for adult children of older adults receiving psychiatric treatment for major depression that is designed to provide these caregivers with information and support. Treatment benefits experienced by caregivers may extend to older patients by increasing the likelihood that they will recover from depression and stay well. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATMENT OF DEPRESSION AFTER CORONARY BYPASS SURGERY Principal Investigator & Institution: Freedland, Kenneth E.; Professor of Medical Psychology; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 29-JUN-2001; Project End 31-MAY-2005 Summary: (Adapted from investigator's abstract): Depression is a common and persistent problem after coronary artery bypass graft (CABG) surgery that complicates recovery, increases the risk of cardiac events, and may exacerbate the neurocognitive deficits that are often observed in post-CABG patients. Although CABG is one of the most frequently performed operations in the United States, there have not been any randomized, controlled trials of treatments for depression in this population. The aims of this study are (1) to compare the efficacy of cognitive behavior therapy (CBT), stress management (SM), and usual care (UC) for major depression following CABG surgery; (2) to determine the effects of CBT on neurocognitive performance, psychosocial adjustment, functional status, employment status, and health-related quality of life; and (3) to collect pilot data on the relationship between the treatment of depression and the 12-month incidence of cardiac and cerebrovascular events following CABG. Consenting patients will be screened for depression 4 to 6 weeks after surgery. Those who screen positive will return for a psycho-diagnostic evaluation and additional testing approximately 1 week later. A sample of 165 patients with major depression who meet all other eligibility criteria will be randomized to 12 weeks of CBT, SM, or UC with no restriction on non-study antidepressants. Participants in all 3 arms will be monitored for worsening depression and will be referred for additional care if needed. Depression outcomes will be assessed 12 weeks post-randomization and 6 months after surgery (2 months after termination of CBT or SM.) The primary hypothesis is that the posttreatment severity of depression is lower in patients treated with CBT than with SM or UC, with baseline depression severity and non-study treatment as planned covariates. Secondary analyses will test the effects of treatment on remission, neurocognitive and functional recovery, quality of life, and examine the relationships between treatment process and outcome variables. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT OF DEPRESSION FOLLOWING BYPASS SURGERY Principal Investigator & Institution: Rollman, Bruce L.; Associate Professor of Medicine; Medicine; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2003; Project Start 24-AUG-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Depression is highly prevalent among patients following coronary artery bypass graft (CABG) surgery and is associated with reduced health-related quality of life (HRQoL) and increased cardiovascular morbidity and mortality. Since depression is a treatable determinant of HRQoL, evidence-based treatment for post-CABG depression provided in a primary care setting and using proven effective dissemination methods is a novel approach to improve outcomes and potentially reduce health care costs. We will recruit 300 patients who endorse elevated levels of depressive symptoms at both 3-5 days following CABG surgery and when reassessed 2-weeks after hospital discharge. We will randomize these patients to receive either: (1) their physicians' "usual care" for depression; or (2) a stepped collaborative care program involving a telephone based nurse care manager who will contact patients at regular intervals to assess treatment preferences for depression (counseling, selfmanagement workbook, pharmacotherapy, or specialty referral); promote adherence with care; and monitor the therapeutic response in concert with patients' POPs and under the supervision of a study clinician. We will also randomly select 150 nondepressed post-CABG patients to serve as a control cohort to facilitate comparisons with our depressed patients on various baseline and follow-up measures, and to better understand the benefits derived from depression treatment (total N=450). We will conduct blinded telephone assessments at 2-, 4-, 8-, and 12-months post-CABG and then every six months until the Last study patient completes his/her 8-month assessment (range: 8-44 months follow-up). We will use intent-to-treat analyses to test our primary hypothesis that our intervention will produce at least a clinically meaningful 0.5 effect size improvement in HRQoL at 8-months post-CABG, as measured by the SF-36 Mental Component Summary score, compared to patients who receive their POPs' "usual care" for depression. Our secondary hypotheses are that compared to "usual care" patients, intervention patients will: (1) experience higher levels of functional status, and lower levels of depressive symptoms, risk for future cardiovascular events, and health services costs; and (2) report similar levels of HRQoL as non-depressed post-CABG patients. Providing evidence-based stepped collaborative care treatment for post-CABG depression may be an ideal method for organized health care delivery systems to improve outcomes. Our focus on HRQoL and on health services costs will facilitate comparisons of the benefits derived from our intervention to that of other established treatments of cardiovascular risk factors and care for other chronic conditions. This study will enhance our understanding of the impact and course of post-CABG depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT OF DEPRESSION IN ALZHEIMERS DISEASE Principal Investigator & Institution: Lyketsos, Constantine G.; Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 20-JUL-1997; Project End 30-JUN-2003 Summary: Major depression afflicts approximately 25% of patients with Alzheimer's disease (AD). In addition to mental suffering, it is associated with a series of "non-mood" consequences: behavioral disturbance (such as aggression), poor cognition, poor self

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care, caregiver depression, caregiver burden, and early entry into the nursing home. Since major depression is treatable, the excess disability it brings to the Alzheimer patient is potentially avoidable. The use of antidepressants to treat major depression in Alzheimer's is supported by two placebo controlled trials, although a third trial does not show a benefit for antidepressants over plaebo. No published study has assessed whether antidepressant treatment reduces the non- mood consequences of depression. An improvement of the latter would imply a reversal of the accelerated nursing home entry of depressed AD patients. Finally, the safety of antidepressant treatment in depressed AD patients is poorly studied. A conclusive demonstration that depression reduction in AD can be accomplished safely with antidepressant medications, and that depression reduction is associated with improvements in activities of daily living, nonmood behavioral disturbances, caregiver burden, and caregiver depression would have major clinical and cost implications for the care of the Alzheimer patient. This grant request proposes a 12- week, double blind, flexible dose, placebo controlled trial of sertraline in the treatment of outpatients with AD and co-morbid major depression. The hypothesis is that antidepressant treatment is superior to placebo in improving mood, in improving cognition, in reducing physical dependency, in reducing caregiver depression, and in reducing caregiver burden. It is also hypothesized that the degree of depression reductio is correlated with these improvements. It is further hypothesized that the 12 week safety profile of sertraline when compared to placebo is acceptable, especially with regard to risk of falls, sleep disturbance and delirium. One hundred community residing outpatients with probable Alzheimer's disease who also meet DSMIV criteria for major depressive episode will be recruited into the study. They will be randomized to sertraline or placebo and followed through weekly telephone contact by an experienced clinical trials team. Outcomes will be assessed every three weeks, for a total of four follow-up data points. Scales assessing the following domains will be used: depression, cognition, behavioral disturbance, physical dependency, delirium, falls, sleep, other side-effects, caregiver depression, caregiver burden, caregiver functioning, and caregiver health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATMENT OF DEPRESSION IN HOMECARE PATIENTS Principal Investigator & Institution: Brown, Ellen L.; Psychiatry; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2001 Summary: This proposed study of A Physician's Decision: Treatment of Depression Homecare Patients requests 1 year of funding to conduct a pilot investigation into the primary care physicians' perspectives on anti- depressant treatment for t6heir older patient receiving homecare nursing for medical or surgical problems. Depression is highly prevalent in home care patients but usually unrecognized and rarely treated. This pilot will augment the Cornell-Visiting Nurse Services of New York (VNSNY) Depression Treatment Study of the effectiveness of nurse initiated and managed antidepressant treatment for geriatric depression. The primary aims of this study are to (1) describe the knowledge and attitudes of physicians toward antidepressant treatment for older homecare patients, (2) identify both physician-specific and patient-specific factors associated with the physician's willingness to initiate antidepressant treatment in the older depressed home health patient, and (3) describe the interaction between the Advanced Practice Psychiatric Nurse and the treating physician in initiating and managing depression in older adults. The proposed study will contact and attempt to interview the 80 primary care physicians whose patients were enrolled in the Cornell-

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VNSNY Depression Treatment Study. These data as well as information collected by the study's Advanced Practice Psychiatric Nurse about her interaction with each primary care physician, the patient medical record and the patient interview will be used to address the study aims. Funds are being requested to collect additional data to build on and extend ongoing research with the overall goal of improving recognition and treatment of late-life depression in older health care patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATMENT OF DEPRESSION IN PARKINSON'S DISEASE Principal Investigator & Institution: Menza, Matthew A.; Psychiatry; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, NJ 08854 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2006 Summary: (provided by the applicant): Depression is the most common neuropsychiatric disorder found in patients with Parkinson's Disease (PD). It causes immense personal suffering, and is associated with increased disability and caregiver burden. Despite the adverse consequences of depression in patients with PD, there are virtually no empirical data to guide clinical treatment. In the absence of data, the SSRIs are apparently used as the first-line treatment, despite concerns about efficacy, safety, and tolerability in this population. This proposal is for a pilot study to establish the feasibility of, and generate sufficient data to plan, a larger clinical trial that will be able to inform clinical treatment of these patients. This pilot trial will (AIM 1) examine the feasibility of a larger trial, and establish (AIM 2) the effect size for short-term efficacy of anti-depressants, compared to placebo, in this population. It will also (AIM 3) evaluate the effect of long-term depression treatment on quality-of-life. This will be done in the context of a placebo-controlled, double-blind, parallel group, flexible dose trial of an SSRI (Paroxetine), a tri-cyclic (Nortriptyline) and placebo in acute (8 weeks) and longterm treatment (6 months). A total of 75 patients with PD (without significant motor fluctuations or Dementia) and depression (major depression or Dysthymia) will be randomized to each of the three arms in a balanced design. The feasibility issues that will be explored include recruitment, retention, drug tolerability, and the ability to maintain the blind. The outcomes that will be explored for the acute phase include changes in the Hamilton Depression Rating Scale (HAM-D) score, and the percent of patients who are responders (>50% improvement in the HAM-D, or < 10 on the HAMD). The outcome variables explored for the long-term phase include the Parkinson's Disease Questionnaire and the Medical Outcome Study Short Form. Secondary analyses will involve the exploration of anxiety, motor disability, sleep, cognition, and individual or clusters of symptoms that are responsive to treatment in order to facilitate planning a subsequent, full-scale clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT OF DEPRESSION WITH MASSAGE IN END OF LIFE AIDS Principal Investigator & Institution: Poland, Russell E.; Professor and Director of Research; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, CA 90048 Timing: Fiscal Year 2001; Project Start 27-SEP-2001; Project End 31-AUG-2003 Summary: (provided by applicant): This is an Exploratory/Developmental Research (R21) grant application to the National Center for Complementary and Alternative Medicine in response to RFA AT-O1-002 to assess the usefulness of massage therapy for

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treatment of depression and improvement in the quality of life in patients with end of life AIDS. This study will define the clinical and biologic response to massage therapy in patients with AIDS and depression who are clinically stable and on a fixed medical regimen. Depression is a co-morbid condition in individuals with advanced HIV disease and has a negative impact on quality of life. Depression in HIV-infected patients also has been associated with a decrease in adherence to medications and progression of clinical disease. While pharmacologic therapy for depression have resulted in variable success in managing this problem, it is associated with an increase in the number of medications that these patients are required to take, potential for additional drug-drug interactions, and many adverse events. In patients with advanced stage HIV disease, palliative care is often a priority and identifying new treatment modalities that do not require additional medications while improve clinical symptoms and overall quality of life is of the utmost importance. Pilot studies with massage therapy have been performed in HIV-infected and uninfected individuals. These studies have shown a reduction in depression scores in HIV-uninfected subjects. In HIV-infected patients, massage therapy has been shown to improve quality of life measures and decrease plasma cortisol levels. The specific aims of this proposal are 1) to determine the effect of massage therapy on depression in subjects with advanced HIV disease, 2) to investigate the effect of massage therapy on quality of life in subjects with advanced HIV disease, and 3) to investigate the effect of massage therapy on plasma cortisol levels in subjects with advanced HIV disease. This study will randomize advanced stage HIV-infected subjects with depression in a 1:1:1 manner to massage therapy, "sham massage" or no physical intervention. The massage and "sham massage" groups will be treated for one hour, twice per week, for 8 weeks. All enrolled subjects will have depression measured (Hamilton Depression Scale) at baseline, weeks 1, 2, 4, 6 and 8, and quality of life (SF36), and pain assessments (Gracely Pain Scale) at baseline, weeks 4 and 8. In addition, 24-hour urine free cortisol, lymphocyte subsets and HIV RNA measurements will be assessed at baseline and weeks 4 and 8. This will be a rigorously controlled clinical trial using validated measures to assess the clinical (depression and quality of life), and biologic (cortisol levels) effect of massage therapy on subjects with advanced stage HIV disease and clinical depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATMENT OF LATE LIFE DEPRESSION COMPLICATED BY ALCOHOL Principal Investigator & Institution: Oslin, David W.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: The focus of this Mentored Clinical Scientist Development Award (MCSDA) is to enable David Oslin, MD to acquire academic and research expertise for the treatment of late life mental disorders including major depression and comorbid alcoholism. Dr. Oslin is currently an Assistant Professor of Psychiatry at the University of Pennsylvania with appointments in the Section of Geriatric Psychiatry and the Center for Studies on Addiction. His career goals include: 1) gaining expertise in study design and methodology for intervention research, 2) establishing independent research projects on the treatment of comorbid mental health disorders, 3) enhancing his clinical expertise in the prevention, recognition and treatment of late life mental illness, and 4) being a resource for the university community on the research and clinical care of older adults, especially those with comorbid mental health problems. The proposal for this application includes both formal and informal instruction in research design and

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methodology as well as an intervention development project that will have both educational and scientific significance. The research plan for this award includes an intervention development study for older adults with primary major depression complicated by alcohol dependence. The aim of the project is to evaluate the tolerability and efficacy of naltrexone compared to placebo as a treatment for alcoholism in combination with sertraline as a treatment for primary major depression. Focusing on older adults enhances the goal of examining primary depression and comorbid alcoholism as the literature suggests that alcoholism is more often secondary to major depression in older adults compared to younger adults. This research plan is seen as a step toward the design of future studies of comorbidity in late life major depression. A growing awareness of a strong association between depression and alcohol abuse/dependence, the need for safe and effective treatments for comorbidity, and everpresent problem of gaining patient compliance with treatment regimens all appear to be fertile ground for study in an older population. The MCSDA would provide an important vehicle via course work and mentoring to enable Dr. Oslin to advance his knowledge and experience in these areas, which in turn, may advance the field of psychiatry's understanding of these complex issues. Dr. Oslin's training in geriatric psychiatry and addictions also makes him a good candidate to conduct the proposed intervention study. Finally, proposed plans for this MCSDA are well coordinated with the research activities of the Section of Geriatric Psychiatry and the Center for Studies on Addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPRESSION

TREATMENT

WITH

EXERCISE

AUGMENTATION

FOR

Principal Investigator & Institution: Trivedi, Madhukar H.; Associate Professor; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): This study proposes to examine the efficacy of a public health dose (PHD) of exercise as an augmentation strategy in the treatment of Major Depressive Disorder (MDD). We will assess patients on SSRI treatment who still have significant residual symptoms of depression, defined by a Hamilton Rating Scale for Depression (17-item; HRSD17) score >14. Incomplete response with significant residual symptoms is common in MDD and is associated with an increased likelihood of relapse and poorer quality of life and function. Augmentation strategies are often implemented to alleviate residual symptoms. However, limitations of pharmacological augmentation, such as lack of overwhelming evidence for efficacy for most agents and increased risks of adverse side effects, often render this strategy undesirable. Exercise may be a viable augmenting strategy for the treatment of residual symptoms of depression since it is associated with a reduced risk of side effects, as well as many associated benefits, including increased longevity and reduced risks of many common medical conditions. Our recently completed randomized controlled trial, DOSE (Depression Outcomes Study of Exercise), revealed that a public health dose of exercise significantly reduced symptoms of depression, measured by the HRSD17, compared to a low dose of exercise or flexibility exercise control group. A logical next step in our investigation of the use of exercise in the treatment of depression is to assess its viability as an augmenting strategy in persons who responded to SSRI therapy, but still endorse significant residual depressive symptoms. The goal of our exercise intervention will be remission, defined as an HRSD17 score of 7 or less. Patients meeting DSM-IV criteria for Major Depressive Disorder, who have been taking an SSRI at an adequate dose for 8-12

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weeks, will be randomized to a PHD or low dose of exercise for 12 weeks. The HRSD17 will serve as the primary outcome measure. In addition, the 30-item versions of the Inventory for Depressive Symptomatology, Clinician-Rated (IDS-C30) and Self-Report (IDS-SR30) will be assessed. Quality of life and satisfaction will also be evaluated. The primary aims of the study are to: 1) compare the effectiveness of PHD exercise augmentation to low dose augmentation in eliciting remission in responders to SSRI treatment who have significant residual symptoms of depression; 2) to compare functioning and quality of life between treatment groups; 3) to examine the extent to which symptom reduction mediates improvement in social function; and 4) to explore the pattern of symptom reduction that occurs over the course of exercise augmentation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: USING BEHAVIORAL SCIENCE TO EXPLAIN PCP DEPRESSION CARE Principal Investigator & Institution: Meredith, Lisa S.; Staff Scientist; Rand Corporation 1700 Main St Santa Monica, CA 90401 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2003 Summary: (provided by applicant): Improving care for depression is a fundamental goal of mental health services research. The need to improve care within primary care is particularly relevant because most patients receive care solely within that setting. Primary care provider (PCP) behavior is a key vehicle for achieving improvement. This application (responding to PAR99-073) aims to enhance the understanding of underlying relationships among provider attitudes, intentions, and PCP treatment behavior to improve care for depression. The multidisciplinary research team will examine and compare selected theories from the social and behavioral sciences to gain new insights into PCP depression treatment behavior. This work will ask old questions about improving mental health care in new ways by applying and integrating models traditionally used to study personal health behavior to study PCP depression treatment behavior. Lessons from application of these frameworks could inform future interventions for changing provider behavior to improve depression care. These objectives will be addressed through secondary analyses of data from a sample of 414 PCPs and 2,030 patients (5-15 per provider) with major depression participating in the four Quality Improvement for Depression consortium studies. These PCPs are from 80 different clinics in 11 different managed care organizations across the U.S. Few databases contain the breadth of constructs necessary for broad theoretical testing with a relatively large sample of providers. Regression and structural equation analyses will elucidate the degree to which the selected expectancy-value frameworks from social and health psychology, and agency theory from behavioral economics explain provider depression treatment behavior. The relative efficacy of these adapted theories will be compared (using indicators of variance explained and relative goodness of fit) to identify the most useful combination of PCP attitudes, behavioral intentions, and treatment choices in modeling PCP depression treatment behavior. We will also outline the strengths and weaknesses of the models from the different disciplines. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: VALIDATION OF PRESCHOOL DEPRESSIVE SYNDROME Principal Investigator & Institution: Luby, Joan L.; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2003; Project Start 01-DEC-2002; Project End 30-NOV-2007

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Summary: (provided by applicant): Numerous developmental studies have detected very early behavioral and biological changes in infants and toddlers at high-risk for depression. Despite these highly suggestive findings, prior to the investigator's preliminary study, there was insufficient data to address the question of whether children younger than six could manifest clinically significant depression. The need to identify depression at the earliest developmental point is underscored by the known chronic and relapsing course, and relative treatment resistance of the disorder when identified after six years of age. The investigator and colleagues are completing a federally funded study of the nosology of preschool depression. Findings from this study are the first to demonstrate that a valid depressive syndrome can be identified in preschool children using DSM-IV MDD criteria when the assessment is modified for age adjusted symptom manifestations. Preliminary validation of this syndrome has been established based on the association with numerous markers including a specific and stable symptom constellation, increased family history of related disorders, significant depression severity compared to controls and social impairment. Study findings raised questions about the duration of an episode of clinical depression and the criteria that distinguish syndromal from sub-syndromal states. This application proposes to utilize the sensitive and specific criteria derived from this study to ascertain a community based sample of depressed preschoolers (and appropriate controls) for a field trial and longitudinal follow-up. To address questions raised by the preliminary study, this investigation proposes to define the clinical characteristics of preschool depression using a new comprehensive and age appropriate diagnostic measure, in addition to assessing impairment in multiple domains. The need to validate diagnostic criteria for preschool depression is heightened by the alarming national increase in the off-label prescription of antidepressants to these young children, representing a serious public health crisis. While treatment unsupported by data is an obvious danger, the potential for earlier intervention in depression is a compelling possibility that must be aggressively explored. Valid diagnostic criteria are necessary for these future treatment studies and to facilitate investigations of the developmental neurobiology of this disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VULNERABILITY TO DEPRESSION--GENETIC EPIDEMIOLOGY Principal Investigator & Institution: Rende, Richard; Miriam Hospital Providence, RI 02906 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: This application is a request for a Mentored Research Scientist Developmental Award to develop necessary skills to conduct genetic epidemiological studies of depression in childhood and adolescence. Although recent advances in genetic research hold promise for the identification of genetic markers of potential relevance to the effective disorders, the successful application of such techniques will depend on clear and valid definitions of the phenotype which reflects genetic vulnerability. This proposal is designed to provide the applicant with necessary skills to conduct informative genetic epidemiological studies of depression geared toward the identification of homogeneous subtypes. The guiding hypothesis is that a critical indicator of a potentially homogeneous subtype is depression with an initial onset prior to adulthood, as suggested by recent family-genetic studies. This hypothesis will be tested through a refinement of the family study/high risk design by focusing on siblings of depressed youth as an informative family member matched for age and cohort. Within this framework, a pilot study has been designed to address two aims: (1) to

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determine the feasibility of longitudinal high-risk sibling studies; and (2) to sharpen diagnostic boundaries of phenotypic indicators of familial vulnerability for depression. In conjunction with the research goals, two primary training goals will be pursued: (1) training in the evaluation of depression, and related psychopathology, in children and adolescents; (2) training in the application of novel biostatistical techniques used to help sharpen diagnostic boundaries for genetic studies. The overall purpose of research and training is to acquire requisite skills to examine transactions between genetic and environmental risk factors specific to depression, and their interplay during sensitive developmental periods, as such a focus may eventually carry implications for future preventative efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “depression” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for depression in the PubMed Central database: •

[gamma]-Aminobutyric acid type A receptors modulate cAMP-mediated long-term potentiation and long-term depression at monosynaptic CA3 --CA1 synapses. by Yu TP, McKinney S, Lester HA, Davidson N. 2001 Apr 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33198

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A cross-sectional study of early identification of postpartum depression: Implications for primary care providers from The Ontario Mother & Infant Survey. by Watt S, Sword W, Krueger P, Sheehan D. 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=107838

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Accuracy of a single question in screening for depression in a cohort of patients after stroke: comparative study. by Watkins C, Daniels L, Jack C, Dickinson H, van den Broek M. 2001 Nov 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=59850

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Admission for depression among men in Scotland, 1980-95: retrospective study. by Shajahan PM, Cavanagh JT. 1998 May 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28549

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Age-Specific Inbreeding Depression and Components of Genetic Variance in Relation to the Evolution of Senescence. by Charlesworth B, Hughes KA. 1996 Jun 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=39203

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms. by Chilvers C, Dewey M, Fielding K, Gretton V, Miller P, Palmer B, Weller D, Churchill R, Williams I, Bedi N, Duggan C, Lee A, Harrison G. 2001 Mar 31; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30555

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Antidepressants in bipolar depression: when less is more. by Ruzickova M, Alda M. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161665

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Asynchronous Pre- and Postsynaptic Activity Induces Associative Long-Term Depression in Area CA1 of the Rat Hippocampus in vitro. by Debanne D, Gahwiler BH, Thompson SM. 1994 Feb 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=43111

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Brief Dendritic Calcium Signals Initiate Long-Lasting Synaptic Depression in Cerebellar Purkinje Cells. by Konnerth A, Dreessen J, Augustine GJ. 1992 Aug 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=49643

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Bullying in schools: self reported anxiety, depression, and self esteem in secondary school children. by Salmon G, James A, Smith DM. 1998 Oct 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28678

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Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. by Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantanen P. 1999 Aug 7; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28187

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Calcium is an Intracellular Mediator of the Climbing Fiber in Induction of Cerebellar Long-Term Depression. by Sakurai M. 1990 May 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=53904

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Capture of a protein synthesis-dependent component of long-term depression. by Kauderer BS, Kandel ER. 2000 Nov 21; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27226

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Comparison of St John's wort and imipramine for treating depression: randomised controlled trial. by Woelk H. 2000 Sep 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27467

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Cooperative Interactions Among Afferents Govern the Induction of Homosynaptic Long-Term Depression in the Hippocampus. by Kerr DS, Abraham WC. 1995 Dec 5; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=40457

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Cooperative Interactions in the Induction of Long-Term Potentiation and Depression of Synaptic Excitation between Hippocampal CA3-CA1 Cell Pairs in vitro. by Debanne D, Gahwiler BH, Thompson SM. 1996 Oct 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=38312

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Coordinate Depression of Bradykinin Receptor Recycling and MicrotubuleDependent Transport by Taxol. by Hamm-Alvarez SF, Alayof BE, Himmel HM, Kim PY, Crews AL, Strauss HC, Sheetz MP. 1994 Aug 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=44492

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Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. by Kessler D, Lloyd K, Lewis G, Gray DP. 1999 Feb 13; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27737

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Decreased probability of neurotransmitter release underlies striatal long-term depression and postnatal development of corticostriatal synapses. by Choi S, Lovinger DM. 1997 Mar 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=20146

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Dependence of Long-Term Depression on Postsynaptic Metabotropic Glutamate Receptors in Visual Cortex. by Kato N. 1993 Apr 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=46359

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Depression and coronary artery disease: time to move from observation to trials. by Lesperance F, Frasure-Smith N. 2003 Mar 4; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=149252

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Depression and prognosis following hospital admission because of acute myocardial infarction. by Lauzon C, Beck CA, Huynh T, Dion D, Racine N, Carignan S, Diodati JG, Charbonneau F, Dupuis R, Pilote L. 2003 Mar 4; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149246

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Depression and unintended pregnancy in the National Longitudinal Survey of Youth: a cohort study. by Reardon DC, Cougle JR. 2002 Jan 19; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64517

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Depression as a risk factor for ischaemic heart disease in men: population based casecontrol study. by Hippisley-Cox J, Fielding K, Pringle M. 1998 Jun 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28573

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Depression, antidepressants, and the shrinking hippocampus. by Sapolsky RM. 2001 Oct 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=60045

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Detection of depression and anxiety in primary care: follow up study. by Kessler D, Bennewith O, Lewis G, Sharp D. 2002 Nov 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=131021

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Diagnosis and management of depression in primary care: a clinical update and review. by Remick RA. 2002 Nov 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=134138

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Effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy to treat patients with depression: randomised controlled trial. by King M, Davidson O, Taylor F, Haines A, Sharp D, Turner R. 2002 Apr 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=102328

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Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and

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meta-analysis. by MacGillivray S, Arroll B, Hatcher S, Ogston S, Reid I, Sullivan F, Williams B, Crombie I. 2003 May 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=154760 •

Efficacy of combined, sequentialand crossover psychotherapy and pharmacotherapy in improving outcomes in depression. by Segal Z, Vincent P, Levitt A. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161662

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Endogenous cannabinoids mediate long-term synaptic depression in the nucleus accumbens. by Robbe D, Kopf M, Remaury A, Bockaert J, Manzoni OJ. 2002 Jun 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=123076

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Evidence of a role for cyclic ADP-ribose in long-term synaptic depression in hippocampus. by Reyes-Harde M, Empson R, Potter BV, Galione A, Stanton PK. 1999 Mar 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=22420

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Experience-dependent plasticity without long-term depression by type 2 metabotropic glutamate receptors in developing visual cortex. by Renger JJ, Hartman KN, Tsuchimoto Y, Yokoi M, Nakanishi S, Hensch TK. 2002 Jan 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117426

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Factors Associated with Depression of Photosynthetic Quantum Efficiency in Maize at Low Growth Temperature.. by Fryer MJ, Oxborough K, Martin B, Ort DR, Baker NR. 1995 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=157398

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Follow up study of longstanding depression as predictor of mortality in elderly people living in the community. by Pulska T, Pahkala K, Laippala P, Kivela SL. 1999 Feb 13; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27733

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Glutamate and [gamma]-aminobutyric acid mediate a heterosynaptic depression at mossy fiber synapses in the hippocampus. by Vogt KE, Nicoll RA. 1999 Feb 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=15360

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Growth Depression in Mycorrhizal Citrus at High-Phosphorus Supply (Analysis of Carbon Costs).. by Peng S, Eissenstat DM, Graham JH, Williams K, Hodge NC. 1993 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=158726

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Hippocampal Atrophy in Recurrent Major Depression. by Sheline YI, Wang PW, Gado MH, Csernansky JG, Vannier MW. 1996 Apr 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=39458

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Hippocampal Long-Term Depression and Depotentiation are Defective in Mice Carrying a Targeted Disruption of the Gene Encoding the RI[beta] Subunit of cAMPDependent Protein Kinase. by Brandon EP, Zhuo M, Huang Y, Qi M, Gerhold KA, Burton KA, Kandel ER, McKnight GS, Idzerda RL. 1995 Sep 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=41065

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Homosynaptic Long-Term Depression in Area CA1 of Hippocampus and Effects of NMethyl-D-Aspartate Receptor Blockade. by Dudek SM, Bear MF. 1992 May 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=49082

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Homosynaptic long-term depression: A mechanism for memory? by Bear MF. 1999 Aug 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33710

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Hypericum extract versus imipramine or placebo in patients with moderate depression: randomised multicentre study of treatment for eight weeks. by Philipp M, Kohnen R, Hiller KO. 1999 Dec 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28296

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Hypothalamic-pituitary-thyroid system activity during lithium augmentation therapy in patients with unipolar major depression. by Bschor T, Baethge C, Adli M, Lewitzka U, Eichmann U, Bauer M. 2003 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161745

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Identifying depression in primary care: a comparison of different methods in a prospective cohort study. by Henkel V, Mergl R, Kohnen R, Maier W, Moller HJ, Hegerl U. 2003 Jan 25; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=140277

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Immediate Early Gene Expression Associated with the Persistence of Heterosynaptic Long-Term Depression in the Hippocampus. by Abraham WC, Christie BR, Logan B, Lawlor P, Dragunow M. 1994 Oct 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=44955

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Incidence of major depression in Canada. by Patten SB. 2000 Sep 19; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80167

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Increase in the cerebrospinal fluid content of neurosteroids in patients with unipolar major depression who are receiving fluoxetine or fluvoxamine. by Uzunova V, Sheline Y, Davis JM, Rasmusson A, Uzunov DP, Costa E, Guidotti A. 1998 Mar 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=19726

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Induction of long-term depression and rebound potentiation by inositol trisphosphate in cerebellar Purkinje neurons. by Khodakhah K, Armstrong CM. 1997 Dec 9; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28423

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Influence of symptoms of anxiety on treatment of depression in later life in primary care: questionnaire survey. by Kirby M, Denihan A, Bruce I, Radic A, Coakley D, Lawlor BA. 1999 Feb 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27763

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Interaction of the AMPA receptor subunit GluR2 /3 with PDZ domains regulates hippocampal long-term depression. by Kim CH, Chung HJ, Lee HK, Huganir RL. 2001 Sep 25; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=58797

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Intracellular Injection of Ca2+ Chelators Blocks Induction of Long- Term Depression in Rat Visual Cortex. by Brocher S, Artola A, Singer W. 1992 Jan 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=48188

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Late-onset minor and major depression: early evidence for common neuroanatomical substrates detected by using MRI. by Kumar A, Jin Z, Bilker W, Udupa J, Gottlieb G. 1998 Jun 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=22713

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Longitudinal comparison of depression, coping, and turnover among NHS and private sector staff caring for people with dementia. by Margallo-Lana M, Reichelt K, Hayes P, Lee L, Fossey J, O'Brien J, Ballard C. 2001 Mar 31; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30553

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Long-Term Depression of Glutamate-Induced [gamma]-Aminobutyric Acid Release in Cerebellum by Insulin-Like Growth Factor I. by Castro-Alamancos MA, TorresAleman I. 1993 Aug 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=47142

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Long-Term Depression: Not So Depressing After All. by Malenka RC. 1993 Apr 15; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=file&artid=46250&blobname=[PNASPDFPath]/1993/90-08/pdf/pq003121.pdf

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Low-dose dexamethasone challenge in women with atypical major depression: pilot study. by Levitan RD, Vaccarino FJ, Brown GM, Kennedy SH. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=149795

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Male --male competition magnifies inbreeding depression in wild house mice. by Meagher S, Penn DJ, Potts WK. 2000 Mar 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=16238

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Managing depression as a chronic disease: a randomised trial of ongoing treatment in primary care. by Rost K, Nutting P, Smith JL, Elliott CE, Dickinson M. 2002 Oct 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=130058

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Meta-analysis of effects and side effects of low dosage tricyclic antidepressants in depression: systematic review. by Furukawa TA, McGuire H, Barbui C. 2002 Nov 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=131022

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Mirtazapine for treatment-resistant depression: a preliminary report. by Wan DD, Kundhur D, Solomons K, Yatham LN, Lam RW. 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161726

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Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial. by Llewellyn-Jones RH, Baikie KA, Smithers H, Cohen J, Snowdon J, Tennant CC. 1999 Sep 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28220

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Muscarinic and [beta]-Adrenergic Depression of the Slow Ca2+- Activated Potassium Conductance in Hippocampal CA3 Pyramidal Cells is not Mediated by a Reduction of Depolarization-Induced Cytosolic Ca2+ Transients. by Knopfel T, Vranesic I, Gahwiler BH, Brown DA. 1990 Jun 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=54051

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Novelty acquisition is associated with induction of hippocampal long-term depression. by Manahan-Vaughan D, Braunewell KH. 1999 Jul 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=17586

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Patients' perceptions of entitlement to time in general practice consultations for depression: qualitative study. by Pollock K, Grime J. 2002 Sep 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=126657

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Phagocytosis and killing of Staphylococcus aureus: effects of stress and depression in children.. by Bartlett JA, Demetrikopoulos MK, Schleifer SJ, Keller SE. 1997 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=170533

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Phantom pain, anxiety, depression, and their relation in consecutive patients with amputated limbs: case reports. by Fisher K, Hanspal RS. 1998 Mar 21; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28494

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Prevalence and outcome of partial remissionin depression. by Tranter R, O'Donovan C, Chandarana P, Kennedy S. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161658

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Problem solving treatment and group psychoeducation for depression: multicentre randomised controlled trial. by Dowrick C, Dunn G, Ayuso-Mateos JL, Dalgard OS, Page H, Lehtinen V, Casey P, Wilkinson C, Vazquez-Barquero JL, Wilkinson G. 2000 Dec 9; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27549

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Pronounced and sustained central hypernoradrenergic function in major depression with melancholic features: Relation to hypercortisolism and corticotropin-releasing hormone. by Wong ML, Kling MA, Munson PJ, Listwak S, Licinio J, Prolo P, Karp B, McCutcheon IE, Geracioti TD Jr, DeBellis MD, Rice KC, Goldstein DS, Veldhuis JD, Chrousos GP, Oldfield EH, McCann SM, Gold PW. 2000 Jan 4; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26662

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Psychosocial and clinical predictorsof response to pharmacotherapy for depression. by Bagby RM, Ryder AG, Cristi C. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161659

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Quality of web based information on treatment of depression: cross sectional survey. by Griffiths KM, Christensen H. 2000 Dec 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27555

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Quantification of spread of cerebellar long-term depression with chemical twophoton uncaging of glutamate. by Wang SS, Khiroug L, Augustine GJ. 2000 Jul 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27000

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Quantitative EEG amplitude across REM sleep periods in depression: preliminary report. by Liscombe MP, Hoffmann RF, Trivedi MH, Parker MK, Rush AJ, Armitage R. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149794

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Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth. by Small R, Lumley J, Donohue L, Potter A, Waldenstrom U. 2000 Oct 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27510

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Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness. by Ward E, King M, Lloyd M, Bower P, Sibbald B, Farrelly S, Gabbay M, Tarrier N, Addington-Hall J. 2000 Dec 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27542

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Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. II: Cost effectiveness. by Bower P, Byford S, Sibbald B, Ward E, King M, Lloyd M, Gabbay M. 2000 Dec 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27543

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Randomised controlled trial of problem solving treatment, antidepressant medication, and combined treatment for major depression in primary care. by Mynors-Wallis LM, Gath DH, Day A, Baker F. 2000 Jan 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27250

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Randomised trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care. by Simon GE, VonKorff M, Rutter C, Wagner E. 2000 Feb 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27299

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Readily releasable pool size changes associated with long term depression. by Goda Y, Stevens CF. 1998 Feb 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=18746

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Regional Cerebral Glucose Metabolism in Late-Life Depression and Alzheimer Disease: A Preliminary Positron Emission Tomography Study. by Kumar A, Newberg A, Alavi A, Berlin J, Smith R, Reivich M. 1993 Aug 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=47067

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Reliability, Validity and Psychometric Properties of the Greek Translation of the Center for Epidemiological Studies-Depression (CES-D) Scale. by Fountoulakis K, Iacovides A, Kleanthous S, Samolis S, Kaprinis SG, Sitzoglou K, Kaprinis GS, Bech P. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34551

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Reliability, validity and psychometric properties of the Greek translation of the Major Depression Inventory. by Fountoulakis KN, Iacovides A, Kleanthous S, Samolis S, Gougoulias K, Tsiptsios I, Kaprinis GS, Bech P. 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149454

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Reliability, validity and psychometric properties of the Greek translation of the zung depression rating scale. by Fountoulakis KN, lacovides A, Samolis S, Kleanthous S, Kaprinis SG, Kaprinis GS, Bech P. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64635

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Reversal of Synaptic Depression by Serotonin at Aplysia Sensory Neuron Synapses Involves Activation of Adenylyl Cyclase. by Goldsmith BA, Abrams TW. 1991 Oct 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=52643

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Routinely administered questionnaires for depression and anxiety: systematic review. by Gilbody SM, House AO, Sheldon TA. 2001 Feb 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26571

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Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study. by O'Brien J, Ames D, Chiu E, Schweitzer I, Desmond P, Tress B. 1998 Oct 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28682

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Should thyroid replacement therapy be considered for patients with treatmentrefractory depression? by Joffe RT. 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=149799

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Spreading depression and focal brain ischemia induce cyclooxygenase-2 in cortical neurons through N-methyl-d-aspartic acid-receptors and phospholipase A2. by Miettinen S, Fusco FR, Yrjanheikki J, Keinanen R, Hirvonen T, Roivainen R, Narhi M, Hokfelt T, Koistinaho J. 1997 Jun 10; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=21079

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Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: cohort study. by Hughes PM, Turton P, Evans CD. 1999 Jun 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=31099

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Synaptic depression creates a switch that controls the frequency of an oscillatory circuit. by Nadim F, Manor Y, Kopell N, Marder E. 1999 Jul 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=22213

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Synaptic Inhibition Regulates Associative Interactions Between Afferents During the Induction of Long-Term Potentiation and Depression. by Tomasulo RA, Ramirez JJ, Steward O. 1993 Dec 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=48027

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Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. by Harrington R, Whittaker J, Shoebridge P, Campbell F. 1998 May 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28555

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The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. by Lawlor DA, Hopker SW. 2001 Mar 31; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30551

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The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. by Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161819

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The Hospital Anxiety And Depression Scale. by Snaith RP. 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=183845

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The influence of age on the female/male ratio of treated incidence rates in depression. by Gutierrez-Lobos K, Scherer M, Anderer P, Katschnig H. 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=65549

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The Norwegian naturalistic treatment study of depression in general practice (NORDEP) ---I: randomised double blind study. by Malt UF, Robak OH, Madsbu HP, Bakke O, Loeb M. 1999 May 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34546

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The Use of Spreading Depression Waves for Acute and Long-Term Monitoring of the Penumbra Zone of Focal Ischemic Damage in Rats. by Koroleva VI, Bures J. 1996 Apr 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=39677

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Transient Protein Kinase C Activation Primes Long-Term Depression and Suppresses Long-Term Potentiation of Synaptic Transmission in Hippocampus. by Stanton PK. 1995 Feb 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=42592

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Treatment for chronic depression: cognitive behavioral analysis system of psychotherapy (CBASP). by Bland RC. 2001 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=167192

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Treatment Plans and Interventions for Depression and Anxiety Disorders. by Antony MM. 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=167202

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Two distinct forms of long-term depression coexist at the mossy fiber-CA3 synapse in the hippocampus during development. by Domenici MR, Berretta N, Cherubini E. 1998 Jul 7; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=20972

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Why treat depression differently from other medical problems? by Blier P. 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161655

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with depression, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “depression” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for depression (hyperlinks lead to article summaries):

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A Clinical Practice Guideline approach to treating depression in long-term care. Author(s): Kaldyand J, Tarnove L. Source: Journal of the American Medical Directors Association. 2003 March-April; 4(2 Suppl): S60-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807572&dopt=Abstract

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A comparative study into the one year cumulative incidence of depression after stroke and myocardial infarction. Author(s): Aben I, Verhey F, Strik J, Lousberg R, Lodder J, Honig A. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 May; 74(5): 581-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700297&dopt=Abstract

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A computer algorithm for calculating the adequacy of antidepressant treatment in unipolar and bipolar depression. Author(s): Oquendo MA, Baca-Garcia E, Kartachov A, Khait V, Campbell CE, Richards M, Sackeim HA, Prudic J, Mann JJ. Source: The Journal of Clinical Psychiatry. 2003 July; 64(7): 825-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12934985&dopt=Abstract

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A confirmatory study on the mechanisms behind reduced P300 waves in depression. Author(s): Roschke J, Wagner P. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 July; 28 Suppl 1: S9-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827138&dopt=Abstract

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A double-blind, placebo-controlled study of sertraline in the prevention of depression in stroke patients. Author(s): Rasmussen A, Lunde M, Poulsen DL, Sorensen K, Qvitzau S, Bech P. Source: Psychosomatics. 2003 May-June; 44(3): 216-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724503&dopt=Abstract

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A hidden problem: identifying depression in older people. Author(s): Hope K. Source: British Journal of Community Nursing. 2003 July; 8(7): 314-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920466&dopt=Abstract

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A history of depression and smoking cessation outcomes among women concerned about post-cessation weight gain. Author(s): Levine MD, Marcus MD, Perkins KA. Source: Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco. 2003 February; 5(1): 69-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745508&dopt=Abstract

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A longitudinal evaluation of adolescent depression and adult obesity. Author(s): Richardson LP, Davis R, Poulton R, McCauley E, Moffitt TE, Caspi A, Connell F. Source: Archives of Pediatrics & Adolescent Medicine. 2003 August; 157(8): 739-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12912778&dopt=Abstract

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A pilot study of a parent-education group for families affected by depression. Author(s): Sanford M, Byrne C, Williams S, Atley S, Miller J, Allin H. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 March; 48(2): 78-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655904&dopt=Abstract

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A prospectively studied clinicopathological case of 'vascular depression'. Author(s): O'Brien JT, Thomas A, English P, Perry R, Jaros E. Source: International Journal of Geriatric Psychiatry. 2003 July; 18(7): 656-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833311&dopt=Abstract

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A psychopathological study into the relationship between attention deficit hyperactivity disorder in adult patients and recurrent brief depression. Author(s): Hesslinger B, Tebartz van Elst L, Mochan F, Ebert D. Source: Acta Psychiatrica Scandinavica. 2003 May; 107(5): 385-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752035&dopt=Abstract

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A qualitative study of clinical nurse specialists' views on depression in palliative care patients. Author(s): Lloyd Williams M, Payne S. Source: Palliative Medicine. 2003 June; 17(4): 334-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12822850&dopt=Abstract

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A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease. Author(s): de Godoy DV, de Godoy RF. Source: Archives of Physical Medicine and Rehabilitation. 2003 August; 84(8): 1154-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917854&dopt=Abstract

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A screening program for depression. Author(s): American College of Occupational and Environmental Medicine. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2003 April; 45(4): 346-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708137&dopt=Abstract

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A sib-pair study of the Temperament and Character Inventory scales in major depression. Author(s): Farmer A, Mahmood A, Redman K, Harris T, Sadler S, McGuffin P. Source: Archives of General Psychiatry. 2003 May; 60(5): 490-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742870&dopt=Abstract

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A simplified predictive index for the detection of women at risk for postnatal depression. Author(s): Webster J, Pritchard MA, Creedy D, East C. Source: Birth (Berkeley, Calif.). 2003 June; 30(2): 101-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752167&dopt=Abstract

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A study comparing patients with amyotrophic lateral sclerosis and their caregivers on measures of quality of life, depression, and their attitudes toward treatment options. Author(s): Trail M, Nelson ND, Van JN, Appel SH, Lai EC. Source: Journal of the Neurological Sciences. 2003 May 15; 209(1-2): 79-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686407&dopt=Abstract

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A survey of prescribing preferences in the treatment of refractory depression: recent trends. Author(s): Kornbluh R, Papakostas GI, Petersen T, Neault NB, Nierenberg AA, Rosenbaum JF, Fava M. Source: Psychopharmacology Bulletin. 2001 Summer; 35(3): 150-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397884&dopt=Abstract

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A tripartite of HIV-risk for African American women: the intersection of drug use, violence, and depression. Author(s): Johnson SD, Cunningham-Williams RM, Cottler LB. Source: Drug and Alcohol Dependence. 2003 May 21; 70(2): 169-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732410&dopt=Abstract

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Abnormal nocturnal blood pressure fall in senile-onset depression with subcortical silent cerebral infarction. Author(s): Hamada T, Murata T, Omori M, Takahashi T, Kosaka H, Wada Y, Yoshida H. Source: Neuropsychobiology. 2003; 47(4): 187-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824741&dopt=Abstract

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Acceleration and augmentation strategies for treating bipolar depression. Author(s): Altshuler LL, Frye MA, Gitlin MJ. Source: Biological Psychiatry. 2003 April 15; 53(8): 691-700. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706955&dopt=Abstract

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ADA: isolated bouts of depression do not qualify as a disability. Author(s): Prieto-Gonzalez M. Source: The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics. 2003 Spring; 31(1): 165-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762116&dopt=Abstract

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Addressing depression in obstetrics/gynecology practice. Author(s): Scholle SH, Haskett RF, Hanusa BH, Pincus HA, Kupfer DJ. Source: General Hospital Psychiatry. 2003 March-April; 25(2): 83-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676420&dopt=Abstract

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Adolescent depression, cortisol and DHEA. Author(s): Angold A. Source: Psychological Medicine. 2003 May; 33(4): 573-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785459&dopt=Abstract

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Adult brain neurogenesis and depression. Author(s): Jacobs BL. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 602-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401475&dopt=Abstract

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Adult oncology and chronically ill patients: comparison of depression, anxiety and caregivers' quality of life. Author(s): Sherif T, Jehani T, Saadani M, Andejani AW. Source: East Mediterr Health J. 2001 May; 7(3): 502-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690772&dopt=Abstract

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Advances in the pharmacologic treatment of bipolar depression. Author(s): Keck PE Jr, Nelson EB, McElroy SL. Source: Biological Psychiatry. 2003 April 15; 53(8): 671-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706953&dopt=Abstract

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Age and major depression after mild traumatic brain injury. Author(s): Rapoport MJ, McCullagh S, Streiner D, Feinstein A. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2003 May-June; 11(3): 365-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724117&dopt=Abstract

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Age differences in symptoms of depression and anxiety: examining behavioral medicine outpatients. Author(s): Goldberg JH, Breckenridge JN, Sheikh JI. Source: Journal of Behavioral Medicine. 2003 April; 26(2): 119-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12776382&dopt=Abstract

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Age-specific norms and determinants of anxiety and depression in 731 women with breast cancer recruited through a population-based cancer registry. Author(s): Osborne RH, Elsworth GR, Hopper JL. Source: European Journal of Cancer (Oxford, England : 1990). 2003 April; 39(6): 755-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651200&dopt=Abstract

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Alterations in pattern of rapid eye movement activity during REM sleep in depression. Author(s): Wichniak A, Antczak J, Wierzbicka A, Jernajczyk W. Source: Acta Neurobiol Exp (Wars). 2002; 62(4): 243-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12659290&dopt=Abstract

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Amitriptyline versus other types of pharmacotherapy for depression. Author(s): Guaiana G, Barbui C, Hotopf M. Source: Cochrane Database Syst Rev. 2003; (2): Cd004186. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804503&dopt=Abstract

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An 8-week multicenter, parallel-group, double-blind, placebo-controlled study of sertraline in elderly outpatients with major depression. Author(s): Schneider LS, Nelson JC, Clary CM, Newhouse P, Krishnan KR, Shiovitz T, Weihs K; Sertraline Elderly Depression Study Group. Source: The American Journal of Psychiatry. 2003 July; 160(7): 1277-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832242&dopt=Abstract

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An examination of the response styles theory of depression in third- and seventhgrade children: a short-term longitudinal study. Author(s): Abela JR, Brozina K, Haigh EP. Source: Journal of Abnormal Child Psychology. 2002 October; 30(5): 515-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12403154&dopt=Abstract

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Analyses of nursing home residents with multiple sclerosis and depression using the Minimum Data Set. Author(s): Buchanan RJ, Wang S, Tai-Seale M, Ju H. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 March; 9(2): 171-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708813&dopt=Abstract

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Analysis of structural polymorphisms and C-1018G promoter variant of the 5-HT(1A) receptor gene as putative risk factors in major depression. Author(s): Arias B, Arranz MJ, Gasto C, Catalan R, Pintor L, Gutierrez B, Kerwin RW, Fananas L. Source: Molecular Psychiatry. 2002; 7(9): 930-2. Erratum In: Mol Psychiatry. 2003 February; 8(2): 246. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399944&dopt=Abstract

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Analysis of the concept of aloneness. As applied to older women being treated for depression. Author(s): Pierce LL, Wilkinson LK, Anderson J. Source: Journal of Gerontological Nursing. 2003 July; 29(7): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874936&dopt=Abstract

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Anger in bipolar depression. Author(s): Benazzi F. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 480-1; Author Reply 481. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716253&dopt=Abstract

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Antidepressants for the treatment of depression in people with schizophrenia: a systematic review. Author(s): Whitehead C, Moss S, Cardno A, Lewis G. Source: Psychological Medicine. 2003 May; 33(4): 589-99. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785461&dopt=Abstract

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Antihistamines and potentiation of opioid induced sedation and respiratory depression. Author(s): Anwari JS, Iqbal S. Source: Anaesthesia. 2003 May; 58(5): 494-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694022&dopt=Abstract

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Antisaccade performance of 1,273 men: effects of schizotypy, anxiety, and depression. Author(s): Smyrnis N, Evdokimidis I, Stefanis NC, Avramopoulos D, Constantinidis TS, Stavropoulos A, Stefanis CN. Source: Journal of Abnormal Psychology. 2003 August; 112(3): 403-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943019&dopt=Abstract

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Anxiety and depression are related to autonomic nervous system function in women with irritable bowel syndrome. Author(s): Jarrett ME, Burr RL, Cain KC, Hertig V, Weisman P, Heitkemper MM. Source: Digestive Diseases and Sciences. 2003 February; 48(2): 386-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643620&dopt=Abstract

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Anxiety and depression influence the relation between disability status and quality of life in multiple sclerosis. Author(s): Janssens AC, van Doorn PA, de Boer JB, Kalkers NF, van der Meche FG, Passchier J, Hintzen RQ. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 August; 9(4): 397403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926846&dopt=Abstract

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Anxiety, depression and anger suppression in infertile couples: a controlled study. Author(s): Fassino S, Piero A, Boggio S, Piccioni V, Garzaro L. Source: Human Reproduction (Oxford, England). 2002 November; 17(11): 2986-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407062&dopt=Abstract

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Anxiety, depression and informed consent in patients referred to a radiotherapy department. Author(s): Cazzaniga LF, Maroni D, Bianchi E, Bossi A, Cagna E, Cosentino D, Palmieri L, Scandolaro L, Valli MC. Source: Tumori. 2003 March-April; 89(2): 176-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841667&dopt=Abstract

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Apathy and cognitive performance in older adults with depression. Author(s): Feil D, Razani J, Boone K, Lesser I. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 479-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789667&dopt=Abstract

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Apolipoprotein E genotype and major depression in a community of older adults. The Cache County Study. Author(s): Steffens DC, Norton MC, Hart AD, Skoog I, Corcoran C, Breitner JC; Cache County Study Group. Source: Psychological Medicine. 2003 April; 33(3): 541-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701674&dopt=Abstract

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Applicability of the Spanish Translation of the Zung Self-Rating Depression Scale in a general Puerto Rican population. Author(s): Martinez KG, Guiot HM, Casas-Dolz I, Gonzalez-Tejera G, Colon de Marti LN. Source: P R Health Sci J. 2003 June; 22(2): 179-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866143&dopt=Abstract

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Aspects of quality of life in persons with pre-lingual deafness using sign language: subjective wellbeing, ill-health symptoms, depression and insomnia. Author(s): Werngren-Elgstrom M, Dehlin O, Iwarsson S. Source: Archives of Gerontology and Geriatrics. 2003 July-August; 37(1): 13-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849069&dopt=Abstract

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Assessing risk for major depression on patients selected for percutaneous transluminal coronary angioplasty: is it a worthwhile venture? Author(s): Burton HJ, Kline SA, Cooper BS, Rabinowitz A, Dodek A. Source: General Hospital Psychiatry. 2003 May-June; 25(3): 200-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748033&dopt=Abstract

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Assessment and prevalence of depression in women 45-55 years of age visiting gynecological clinics in Poland: screening for depression among midlife gynecologic patients. Author(s): Wojnar M, Drod W, Araszkiewicz A, Szymanski W, Nawacka-Pawlaczyk D, Urbanski R, Hegedus AM. Source: Archives of Women's Mental Health. 2003 August; 6(3): 193-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920617&dopt=Abstract

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Association analysis for neuronal nitric oxide synthase gene polymorphism with major depression and fluoxetine response. Author(s): Yu YW, Chen TJ, Wang YC, Liou YJ, Hong CJ, Tsai SJ. Source: Neuropsychobiology. 2003; 47(3): 137-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759556&dopt=Abstract

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Association between dorsolateral prefrontal N-acetyl aspartate and depression in chronic back pain: an in vivo proton magnetic resonance spectroscopy study. Author(s): Grachev ID, Ramachandran TS, Thomas PS, Szeverenyi NM, Fredrickson BE. Source: Journal of Neural Transmission (Vienna, Austria : 1996). 2003 March; 110(3): 287312. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658377&dopt=Abstract

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Association between visual impairment and depression in the elderly. Author(s): Tsai SY, Cheng CY, Hsu WM, Su TP, Liu JH, Chou P. Source: J Formos Med Assoc. 2003 February; 102(2): 86-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709736&dopt=Abstract

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Association of depression and rheumatoid arthritis. Author(s): Dickens C, Jackson J, Tomenson B, Hay E, Creed F. Source: Psychosomatics. 2003 May-June; 44(3): 209-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724502&dopt=Abstract

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Association of depression with agitation in elderly nursing home residents. Author(s): Heeren O, Borin L, Raskin A, Gruber-Baldini AL, Menon AS, Kaup B, Loreck D, Ruskin PE, Zimmerman S, Magaziner J. Source: Journal of Geriatric Psychiatry and Neurology. 2003 March; 16(1): 4-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641365&dopt=Abstract

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Association of exaggerated HPA axis response to the initial injection of interferonalpha with development of depression during interferon-alpha therapy. Author(s): Capuron L, Raison CL, Musselman DL, Lawson DH, Nemeroff CB, Miller AH. Source: The American Journal of Psychiatry. 2003 July; 160(7): 1342-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832253&dopt=Abstract

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Association of exercise-induced, silent ST-segment depression with the risk of stroke and cardiovascular diseases in men. Author(s): Kurl S, Laukkanen JA, Tuomainen TP, Rauramaa R, Lakka TA, Salonen R, Eranen J, Sivenius J, Salonen JT. Source: Stroke; a Journal of Cerebral Circulation. 2003 July; 34(7): 1760-5. Epub 2003 June 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829872&dopt=Abstract

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Association of life events and psychosocial factors with early but not late onset depression in the elderly: implications for possible differences in aetiology. Author(s): Grace J, O'Brien JT. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 473-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789666&dopt=Abstract

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Associations between ST depression, four year mortality, and in-hospital revascularisation in unselected patients with non-ST elevation acute coronary syndromes. Author(s): Hyde TA, French JK, Wong CK, Edwards C, Whitlock RM, White HD. Source: Heart (British Cardiac Society). 2003 May; 89(5): 490-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695448&dopt=Abstract

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Associations of blood glucose control with self-efficacy and rated anxiety/depression in type II diabetes mellitus patients. Author(s): Ikeda K, Aoki H, Saito K, Muramatsu Y, Suzuki T. Source: Psychological Reports. 2003 April; 92(2): 540-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785638&dopt=Abstract

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Asthma symptoms associated with depression and lower quality of life: a population survey. Author(s): Goldney RD, Ruffin R, Fisher LJ, Wilson DH. Source: The Medical Journal of Australia. 2003 May 5; 178(9): 437-41. Erratum In: Med J Aust. 2003 July 7; 179(1): 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12720509&dopt=Abstract

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Attachment and dysthymia: the contributions of preoccupied attachment and agency of self to depression in women. Author(s): West M, George C. Source: Attachment & Human Development. 2002 December; 4(3): 278-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12537847&dopt=Abstract

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Attentional and executive dysfunctions in schizophrenia and depression: evidence from dichotic listening performance. Author(s): Hugdahl K, Rund BR, Lund A, Asbjornsen A, Egeland J, Landro NI, Roness A, Stordal KI, Sundet K. Source: Biological Psychiatry. 2003 April 1; 53(7): 609-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679239&dopt=Abstract

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Attitudes accentuate attributes in social judgment: the combined effects of substance use, depression, and technical incompetence on judgments of professional impairment. Author(s): Beckstead JW. Source: The Journal of Social Psychology. 2003 April; 143(2): 185-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12735517&dopt=Abstract

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Avoiding drug-induced switching in patients with bipolar depression. Author(s): Henry C, Demotes-Mainard J. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2003; 26(5): 337-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650634&dopt=Abstract

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Awareness about depression: important for all physicians. Author(s): Glass RM. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3169-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813124&dopt=Abstract

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Background and rationale for the sequenced treatment alternatives to relieve depression (STAR*D) study. Author(s): Fava M, Rush AJ, Trivedi MH, Nierenberg AA, Thase ME, Sackeim HA, Quitkin FM, Wisniewski S, Lavori PW, Rosenbaum JF, Kupfer DJ. Source: The Psychiatric Clinics of North America. 2003 June; 26(2): 457-94, X. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778843&dopt=Abstract

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Back-neck pain and symptoms of anxiety and depression: a population-based twin study. Author(s): Reichborn-Kjennerud T, Stoltenberg C, Tambs K, Roysamb E, Kringlen E, Torgersen S, Harris JR. Source: Psychological Medicine. 2002 August; 32(6): 1009-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214782&dopt=Abstract

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Barriers to postpartum depression prevention and treatment: a policy analysis. Author(s): Sobey WS. Source: Journal of Midwifery & Women's Health. 2002 September-October; 47(5): 331-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361344&dopt=Abstract

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Baseline prolactin and L-tryptophan availability predict response to antidepressant treatment in major depression. Author(s): Porter RJ, Mulder RT, Joyce PR. Source: Psychopharmacology. 2003 January; 165(3): 216-21. Epub 2002 November 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439628&dopt=Abstract

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Beck Depression Inventory-II items associated with self-reported symptoms of ADHD in adult psychiatric outpatients. Author(s): Steer RA, Ranieri WF, Kumar G, Beck AT. Source: Journal of Personality Assessment. 2003 February; 80(1): 58-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584068&dopt=Abstract

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Behavioral activation and inhibition systems and the severity and course of depression. Author(s): Kasch KL, Rottenberg J, Arnow BA, Gotlib IH. Source: Journal of Abnormal Psychology. 2002 November; 111(4): 589-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428772&dopt=Abstract

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Behavioural inhibition and symptoms of anxiety and depression: is there a specific relationship with social phobia? Author(s): Neal JA, Edelmann RJ, Glachan M. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2002 November; 41(Pt 4): 361-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437791&dopt=Abstract

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Beliefs about alcohol among UK Jews and Protestants: do they fit the alcoholdepression hypothesis? Author(s): Loewenthal KM, MacLeod AK, Cook S, Lee M, Goldblatt V. Source: Social Psychiatry and Psychiatric Epidemiology. 2003 March; 38(3): 122-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616309&dopt=Abstract

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Benefits and risks to mother and infant of drug treatment for postnatal depression. Author(s): Misri S, Kostaras X. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2002; 25(13): 903-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381212&dopt=Abstract

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Beta-blocker therapy and depression. Author(s): Messerli FH, Grossman E. Source: Jama : the Journal of the American Medical Association. 2002 October 16; 288(15): 1845-6; Author Reply 1846. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377075&dopt=Abstract

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Beta-blocker therapy and depression. Author(s): Terao T. Source: Jama : the Journal of the American Medical Association. 2002 October 16; 288(15): 1845; Author Reply 1846. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377074&dopt=Abstract

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Bibliotherapy as an adjunct to psychotherapy for depression in older adults. Author(s): Floyd M. Source: Journal of Clinical Psychology. 2003 February; 59(2): 187-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12552627&dopt=Abstract

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Biological markers of atypical depression. Author(s): Posternak MA. Source: Harvard Review of Psychiatry. 2003 January-February; 11(1): 1-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866736&dopt=Abstract

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Biological mechanisms in the relationship between depression and heart disease. Author(s): Grippo AJ, Johnson AK. Source: Neuroscience and Biobehavioral Reviews. 2002 December; 26(8): 941-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667498&dopt=Abstract

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Biological risk factors for late life depression. Author(s): Tiemeier H. Source: European Journal of Epidemiology. 2003; 18(8): 745-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12974548&dopt=Abstract

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Bipolar depression and melancholia. Comments on Parker et al. 'The nature of bipolar depression: implications for the definition of melancholia'. J. Affect. Disord. 59 (2000) 217-224. Author(s): Benazzi F. Source: Journal of Affective Disorders. 2002 November; 72(2): 201-2; Author Reply 203-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12200211&dopt=Abstract

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Bipolar depression: criteria for treatment selection, definition of refractoriness, and treatment options. Author(s): Yatham LN, Calabrese JR, Kusumakar V. Source: Bipolar Disorders. 2003 April; 5(2): 85-97. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680897&dopt=Abstract

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Bipolar depression: management options. Author(s): Malhi GS, Mitchell PB, Salim S. Source: Cns Drugs. 2003; 17(1): 9-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467490&dopt=Abstract

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Bipolar depression: relationship between episode length and antidepressant treatment. Author(s): Frankle WG, Perlis RH, Deckersbach T, Grandin LD, Gray SM, Sachs GS, Nierenberg AA. Source: Psychological Medicine. 2002 November; 32(8): 1417-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455940&dopt=Abstract

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Blunted prolactin response to fentanyl in depression. Normalizing effect of partial sleep deprivation. Author(s): Frecska E, Perenyi A, Arato M. Source: Psychiatry Research. 2003 May 30; 118(2): 155-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798980&dopt=Abstract

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Borderline personality disorder in major depression: symptomatology, temperament, character, differential drug response, and 6-month outcome. Author(s): Joyce PR, Mulder RT, Luty SE, McKenzie JM, Sullivan PF, Cloninger RC. Source: Comprehensive Psychiatry. 2003 January-February; 44(1): 35-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12524634&dopt=Abstract

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Boundary maintenance as a barrier to mental health help-seeking for depression among the Old Order Amish. Author(s): Reiling DM. Source: The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association. 2002 Summer; 18(3): 42836. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186317&dopt=Abstract

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Breaking the myths: new treatment approaches for chronic depression. Author(s): Michalak EE, Lam RW. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 September; 47(7): 635-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355675&dopt=Abstract

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Bringing depression out of the shadows. Author(s): Linnell AL. Source: Nursing. 2003 June; 33(6): 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799579&dopt=Abstract

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Burden of illness and suicide in elderly people. Physical disease and depression are prevalent in elderly Finnish suicide victims. Author(s): Timonen M, Viilo K, Vaisanen E, Rasanen P, Hakko H, Sarkioja T. Source: Bmj (Clinical Research Ed.). 2002 August 24; 325(7361): 441. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12193366&dopt=Abstract

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By the way doctor. Last fall, my mother went into a deep depression. The same thing happened about five years ago, but she took an antidepressant for a few weeks and it went away. This time she's been depressed for nearly a year. No medication has helped. Now her doctors want her to try electroshock therapy, but that scares her--and me. Author(s): Lee TH. Source: Harvard Health Letter / from Harvard Medical School. 2002 August; 27(10): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217840&dopt=Abstract

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Can long-term treatment with antidepressant drugs worsen the course of depression? Author(s): Fava GA. Source: The Journal of Clinical Psychiatry. 2003 February; 64(2): 123-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633120&dopt=Abstract

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Can only reversed vegetative symptoms define atypical depression? Author(s): Benazzi F. Source: European Archives of Psychiatry and Clinical Neuroscience. 2002 December; 252(6): 288-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563537&dopt=Abstract

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Can routine information improve case finding of depression among 65 to 74 year olds in primary care? Author(s): Freudenstein U, Arthur A, Matthews R, Jagger C. Source: Family Practice. 2002 October; 19(5): 520-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356706&dopt=Abstract

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Can we prevent postnatal depression? A randomized controlled trial to assess the effect of continuity of midwifery care on rates of postnatal depression in high-risk women. Author(s): Marks MN, Siddle K, Warwick C. Source: J Matern Fetal Neonatal Med. 2003 February;13(2):119-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12735413&dopt=Abstract

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Cancer pain and depression: management of the dual-diagnosed patient. Author(s): Valentine AD. Source: Current Pain and Headache Reports. 2003 August; 7(4): 262-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828875&dopt=Abstract

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Case histories for understanding depression in primary care. Author(s): Baron DA. Source: J Am Osteopath Assoc. 2003 August; 103(8 Suppl 4): S16-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956253&dopt=Abstract

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Catecholamine and HPA axis dysfunction in depression: relationship with suicidal behavior. Author(s): Pitchot W, Reggers J, Pinto E, Hansenne M, Ansseau M. Source: Neuropsychobiology. 2003; 47(3): 152-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759559&dopt=Abstract

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Cathartic effect of suicide attempts not limited to depression: a short-term prospective study after deliberate self-poisoning. Author(s): Sarfati Y, Bouchaud B, Hardy-Bayle MC. Source: Crisis. 2003; 24(2): 73-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880225&dopt=Abstract

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Cervical vagus nerve stimulation for treatment-resistant depression. Author(s): Carpenter LL, Friehs GM, Price LH. Source: Neurosurg Clin N Am. 2003 April; 14(2): 275-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856494&dopt=Abstract

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Challenges in the treatment of depression with psychotic features. Author(s): Rothschild AJ. Source: Biological Psychiatry. 2003 April 15; 53(8): 680-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706954&dopt=Abstract

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Child and adolescent depression: short-term treatment effectiveness and long-term opportunities. Author(s): Ryan ND. Source: Int J Methods Psychiatr Res. 2003; 12(1): 44-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830309&dopt=Abstract

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Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: issues of co-morbidity and specificity. Author(s): Levitan RD, Rector NA, Sheldon T, Goering P. Source: Depression and Anxiety. 2003; 17(1): 34-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577276&dopt=Abstract

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Childhood depression: Be on the alert. Author(s): Nelms BC. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 2003 July-August; 17(4): 161-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847424&dopt=Abstract

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Childhood parental separation experiences and depressive symptomatology in acute major depression. Author(s): Takeuchi H, Hiroe T, Kanai T, Morinobu S, Kitamura T, Takahashi K, Furukawa TA. Source: Psychiatry and Clinical Neurosciences. 2003 April; 57(2): 215-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667169&dopt=Abstract

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Childhood trauma and depression. Author(s): Levitan RD, Parikh SV. Source: The American Journal of Psychiatry. 2003 June; 160(6): 1188; Author Reply 11889. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777288&dopt=Abstract

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Chronic complex depression. Author(s): Staller JA. Source: Psychiatric Services (Washington, D.C.). 2003 June; 54(6): 771. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12773588&dopt=Abstract

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Chronic depression and comorbid personality disorders: response to sertraline versus imipramine. Author(s): Russell JM, Kornstein SG, Shea MT, McCullough JP, Harrison WM, Hirschfeld RM, Keller MB. Source: The Journal of Clinical Psychiatry. 2003 May; 64(5): 554-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755659&dopt=Abstract

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Citalopram in children and adolescents with depression or anxiety. Author(s): Baumgartner JL, Emslie GJ, Crismon ML. Source: The Annals of Pharmacotherapy. 2002 November; 36(11): 1692-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12398561&dopt=Abstract

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Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Author(s): Katon WJ. Source: Biological Psychiatry. 2003 August 1; 54(3): 216-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893098&dopt=Abstract

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Clinical and neurobiological effects of tianeptine and paroxetine in major depression. Author(s): Nickel T, Sonntag A, Schill J, Zobel AW, Ackl N, Brunnauer A, Murck H, Ising M, Yassouridis A, Steiger A, Zihl J, Holsboer F. Source: Journal of Clinical Psychopharmacology. 2003 April; 23(2): 155-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640217&dopt=Abstract

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Clinical and personality correlates of a new measure of depression: a general practice study. Author(s): Parker G, Hilton T, Hadzi-Pavlovic D, Irvine P. Source: The Australian and New Zealand Journal of Psychiatry. 2003 February; 37(1): 104-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534665&dopt=Abstract

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Clinical and phenomenological comparisons of delusional and non-delusional major depression in the Chinese elderly. Author(s): Lee TW, Tsai SJ, Yang CH, Hwang JP. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 486-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789668&dopt=Abstract

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Clinical differences between bipolar II depression and unipolar major depressive disorder: lack of an effect of age. Author(s): Benazzi F. Source: Journal of Affective Disorders. 2003 July; 75(2): 191-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798259&dopt=Abstract

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Clinical outcome after trimipramine in patients with delusional depression - a pilot study. Author(s): Frieboes RM, Sonntag A, Yassouridis A, Eap CB, Baumann P, Steiger A. Source: Pharmacopsychiatry. 2003 January; 36(1): 12-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649769&dopt=Abstract

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Clinical practice guidelines for depression in young people. Author(s): Jureidini JN, Tonkin AL. Source: The Medical Journal of Australia. 2003 March 17; 178(6): 300; Author Reply 3002. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633493&dopt=Abstract

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Clinical trial of interactive and videotaped educational interventions reduce infection, reactive depression, and rehospitalizations for sepsis in patients on home parenteral nutrition. Author(s): Smith CE, Curtas S, Kleinbeck SV, Werkowitch M, Mosier M, Seidner DL, Steiger E. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2003 March-April; 27(2): 13745. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12665170&dopt=Abstract

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Clinical utility of ST-segment depression in lead AVR in acute myocardial infarction. Author(s): Senaratne MP, Weerasinghe C, Smith G, Mooney D. Source: Journal of Electrocardiology. 2003 January; 36(1): 11-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607191&dopt=Abstract

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Clonazepam in the long-term treatment of patients with unipolar depression, bipolar and schizoaffective disorder. Author(s): Winkler D, Willeit M, Wolf R, Stamenkovic M, Tauscher J, Pjrek E, Konstantinidis A, Schindler S, Barnas C, Kasper S. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 2003 March; 13(2): 129-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650958&dopt=Abstract

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Cognitive and somatic symptoms of depression are associated with medical comorbidity in patients after acute myocardial infarction. Author(s): Watkins LL, Schneiderman N, Blumenthal JA, Sheps DS, Catellier D, Taylor CB, Freedland KE; ENRICHD Investigators. Source: American Heart Journal. 2003 July; 146(1): 48-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851607&dopt=Abstract

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Cognitive aspects of chronic depression. Author(s): Riso LP, du Toit PL, Blandino JA, Penna S, Dacey S, Duin JS, Pacoe EM, Grant MM, Ulmer CS. Source: Journal of Abnormal Psychology. 2003 February; 112(1): 72-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653415&dopt=Abstract

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Cognitive behavior therapy for depression? Choose horses for courses. Author(s): Parker G, Roy K, Eyers K. Source: The American Journal of Psychiatry. 2003 May; 160(5): 825-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727682&dopt=Abstract

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Cognitive behavioural therapy skills training for adolescent depression. Author(s): Rowe L, Tonge B. Source: Aust Fam Physician. 2003 May; 32(5): 364-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12772372&dopt=Abstract

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Cognitive functions and depression as predictors of poor outcome 15 months after stroke. Author(s): Pohjasvaara T, Vataja R, Leppavuori A, Kaste M, Erkinjuntti T. Source: Cerebrovascular Diseases (Basel, Switzerland). 2002; 14(3-4): 228-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12403956&dopt=Abstract

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Cognitive predictors of symptom return following depression treatment. Author(s): Beevers CG, Keitner GI, Ryan CE, Miller IW. Source: Journal of Abnormal Psychology. 2003 August; 112(3): 488-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943027&dopt=Abstract

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Cognitive, interpersonal, and behavioral predictors of patients' and spouses' depression. Author(s): Teichman Y, Bar-El Z, Shor H, Elizur A. Source: Journal of Affective Disorders. 2003 May; 74(3): 247-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738043&dopt=Abstract

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Comorbid personality disorder predicts suicide after major depression: a 10-year follow-up. Author(s): Hansen PE, Wang AG, Stage KB, Kragh-Sorensen P; Danish University Antidepressant Group. Source: Acta Psychiatrica Scandinavica. 2003 June; 107(6): 436-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752020&dopt=Abstract

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Comorbidity and depression treatment. Author(s): Krishnan KR. Source: Biological Psychiatry. 2003 April 15; 53(8): 701-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706956&dopt=Abstract

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Comorbidity of depression with other medical diseases in the elderly. Author(s): Krishnan KR, Delong M, Kraemer H, Carney R, Spiegel D, Gordon C, McDonald W, Dew M, Alexopoulos G, Buckwalter K, Cohen PD, Evans D, Kaufmann PG, Olin J, Otey E, Wainscott C. Source: Biological Psychiatry. 2002 September 15; 52(6): 559-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361669&dopt=Abstract

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Comorbidity of late life depression: an opportunity for research on mechanisms and treatment. Author(s): Alexopoulos GS, Buckwalter K, Olin J, Martinez R, Wainscott C, Krishnan KR. Source: Biological Psychiatry. 2002 September 15; 52(6): 543-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361668&dopt=Abstract

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Co-morbidity of migraine and major depression in the Turkish population. Author(s): Kececi H, Dener S, Analan E. Source: Cephalalgia : an International Journal of Headache. 2003 May; 23(4): 271-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716344&dopt=Abstract

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Comparative study of anxiety, depression, somatization, functional disability, and illness attribution in adolescents with chronic fatigue or migraine. Author(s): Smith MS, Martin-Herz SP, Womack WM, Marsigan JL. Source: Pediatrics. 2003 April; 111(4 Pt 1): E376-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671155&dopt=Abstract

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Comparing anxiety disorders and anxiety-related traits in bipolar disorder and unipolar depression. Author(s): Simon NM, Smoller JW, Fava M, Sachs G, Racette SR, Perlis R, Sonawalla S, Rosenbaum JF. Source: Journal of Psychiatric Research. 2003 May-June; 37(3): 187-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650739&dopt=Abstract

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Comparing depression treatments. Author(s): Rifkin A. Source: The American Journal of Psychiatry. 2003 June; 160(6): 1186-7; Author Reply 1187. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777284&dopt=Abstract

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Comparing the effectiveness of process-experiential with cognitive-behavioral psychotherapy in the treatment of depression. Author(s): Watson JC, Gordon LB, Stermac L, Kalogerakos F, Steckley P. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 773-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924682&dopt=Abstract

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Comparing various short-form Geriatric Depression Scales leads to the GDS-5/15. Author(s): Weeks SK, McGann PE, Michaels TK, Penninx BW. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2003; 35(2): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854293&dopt=Abstract

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Comparison of immunological and endocrinological markers associated with major depression. Author(s): Jozuka H, Jozuka E, Takeuchi S, Nishikaze O. Source: J Int Med Res. 2003 January-February; 31(1): 36-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635532&dopt=Abstract

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Complications associated with surveying medical student depression: the importance of anonymity. Author(s): Levine RE, Breitkopf CR, Sierles FS, Camp G. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Spring; 27(1): 12-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824115&dopt=Abstract

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Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Author(s): Proudfoot J, Goldberg D, Mann A, Everitt B, Marks I, Gray JA. Source: Psychological Medicine. 2003 February; 33(2): 217-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622301&dopt=Abstract

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Confronting depression and suicide in physicians: a consensus statement. Author(s): Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H, Laszlo J, Litts DA, Mann J, Mansky PA, Michels R, Miles SH, Proujansky R, Reynolds CF 3rd, Silverman MM. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3161-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813122&dopt=Abstract

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Consequences and correlates of adolescent depression. Author(s): Glied S, Pine DS. Source: Archives of Pediatrics & Adolescent Medicine. 2002 October; 156(10): 1009-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361447&dopt=Abstract

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Considerations in the management of the patient with comorbid depression and anxiety. Author(s): Sekula LK, DeSantis J, Gianetti V. Source: Journal of the American Academy of Nurse Practitioners. 2003 January; 15(1): 23-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12613410&dopt=Abstract

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Construct validity of the 15-item geriatric depression scale in older medical inpatients. Author(s): Incalzi RA, Cesari M, Pedone C, Carbonin PU. Source: Journal of Geriatric Psychiatry and Neurology. 2003 March; 16(1): 23-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641369&dopt=Abstract

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Contingency-competence-control-related beliefs and symptoms of anxiety and depression in a young adolescent sample. Author(s): Muris P, Schouten E, Meesters C, Gijsbers H. Source: Child Psychiatry and Human Development. 2003 Summer; 33(4): 325-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12723904&dopt=Abstract

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Controlled trial of the short- and long-term effect of psychological treatment of postpartum depression. I. Impact on maternal mood. Author(s): Cooper PJ, Murray L, Wilson A, Romaniuk H. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 May; 182: 412-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724244&dopt=Abstract

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Controlled trial of the short- and long-term effect of psychological treatment of postpartum depression: 2. Impact on the mother-child relationship and child outcome. Author(s): Murray L, Cooper PJ, Wilson A, Romaniuk H. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 May; 182: 420-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724245&dopt=Abstract

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Conventional antipsychotic prescription in unipolar depression, I: an audit and recommendations for practice. Author(s): Wheeler Vega JA, Mortimer AM, Tyson PJ. Source: The Journal of Clinical Psychiatry. 2003 May; 64(5): 568-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755661&dopt=Abstract

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Conventional antipsychotic prescription in unipolar depression, II: withdrawing conventional antipsychotics in unipolar, nonpsychotic patients. Author(s): Mortimer AM, Martin M, Wheeler Vega JA, Tyson PJ. Source: The Journal of Clinical Psychiatry. 2003 June; 64(6): 668-72; Quiz 738-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823081&dopt=Abstract

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Convergent and divergent effects of odors and emotions in depression. Author(s): Pause BM, Raack N, Sojka B, Goder R, Aldenhoff JB, Ferstl R. Source: Psychophysiology. 2003 March; 40(2): 209-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12820862&dopt=Abstract

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Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. Author(s): Kennedy P, Duff J, Evans M, Beedie A. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2003 March; 42(Pt 1): 41-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12675978&dopt=Abstract

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Coping strategies and its effects on depression among caregivers of impaired elders in Japan. Author(s): Abe K, Kashiwagi T, Tsuneto S. Source: Aging & Mental Health. 2003 May; 7(3): 207-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775402&dopt=Abstract

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Coping strategies, illness perception, anxiety and depression of patients with idiopathic constipation: a population-based study. Author(s): Cheng C, Chan AO, Hui WM, Lam SK. Source: Alimentary Pharmacology & Therapeutics. 2003 August 1; 18(3): 319-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12895216&dopt=Abstract

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Coping with postnatal depression: a personal perspective. Author(s): Bishop LM. Source: The Medical Journal of Australia. 2002 October 7; 177 Suppl: S106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358567&dopt=Abstract

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Correlation between cortisol level and serotonin uptake in patients with chronic stress and depression. Author(s): Tafet GE, Idoyaga-Vargas VP, Abulafia DP, Calandria JM, Roffman SS, Chiovetta A, Shinitzky M. Source: Cognitive, Affective & Behavioral Neuroscience. 2001 December; 1(4): 388-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467090&dopt=Abstract

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Corticotropin-releasing hormone modulators and depression. Author(s): Holsboer F. Source: Curr Opin Investig Drugs. 2003 January; 4(1): 46-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625028&dopt=Abstract

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Cost of lost productive work time among US workers with depression. Author(s): Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein D. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3135-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813119&dopt=Abstract

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Counseling versus antidepressant therapy for the treatment of mild to moderate depression in primary care: economic analysis. Author(s): Miller P, Chilvers C, Dewey M, Fielding K, Gretton V, Palmer B, Weller D, Churchill R, Williams I, Bedi N, Duggan C, Lee A, Harrison G. Source: International Journal of Technology Assessment in Health Care. 2003 Winter; 19(1): 80-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701941&dopt=Abstract

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Cross-cultural aspects of depression in general practice. Author(s): Ellis CG. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2003 May; 93(5): 342-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830594&dopt=Abstract

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Cytokines and depression: an update. Author(s): Dantzer R, Wollman EE, Yirmiya R. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 501-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401463&dopt=Abstract

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Cytokines and depression: the need for a new paradigm. Author(s): Capuron L, Dantzer R. Source: Brain, Behavior, and Immunity. 2003 February; 17 Suppl 1: S119-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12615197&dopt=Abstract

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Decreasing pain and depression in a health promotion program for people with rheumatoid arthritis. Author(s): Oh H, Seo W. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2003; 35(2): 127-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854292&dopt=Abstract

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Defeat depression. Author(s): Sharma S, Sharma V. Source: The Nursing Journal of India. 2002 December; 93(12): 274-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718117&dopt=Abstract

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Delirium, depression often overlooked. Author(s): Naylor M. Source: The American Journal of Nursing. 2003 May; 103(5): 116. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762330&dopt=Abstract

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Depression and antisocial personality disorder: two contrasting disorders of 5HT function. Author(s): Deakin JF. Source: Journal of Neural Transmission. Supplementum. 2003; (64): 79-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830930&dopt=Abstract

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Depression and anxiety in chronic hepatitis B: effect of hepatitis B virus infection on psychological state in childhood. Author(s): Arslan N, Buyukgebiz B, Ozturk Y, Akay AP. Source: Turk J Pediatr. 2003 January-March; 45(1): 26-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718367&dopt=Abstract

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Depression and assisted suicide in the terminally ill. Author(s): Angelo EJ. Source: Natl Cathol Bioeth Q. 2001 Autumn; 1(3): 307-12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866518&dopt=Abstract

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Depression and Bipolar Support Alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. Author(s): Charney DS, Reynolds CF 3rd, Lewis L, Lebowitz BD, Sunderland T, Alexopoulos GS, Blazer DG, Katz IR, Meyers BS, Arean PA, Borson S, Brown C, Bruce ML, Callahan CM, Charlson ME, Conwell Y, Cuthbert BN, Devanand DP, Gibson MJ, Gottlieb GL, Krishnan KR, Laden SK, Lyketsos CG, Mulsant BH, Niederehe G, Olin JT, Oslin DW, Pearson J, Persky T, Pollock BG, Raetzman S, Reynolds M, Salzman C, Schulz R, Schwenk TL, Scolnick E, Unutzer J, Weissman MM, Young RC; Depression and Bipolar Support Alliance. Source: Archives of General Psychiatry. 2003 July; 60(7): 664-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860770&dopt=Abstract

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Depression and cancer: mechanisms and disease progression. Author(s): Spiegel D, Giese-Davis J. Source: Biological Psychiatry. 2003 August 1; 54(3): 269-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893103&dopt=Abstract

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Depression and cardiovascular disease: mechanisms of interaction. Author(s): Joynt KE, Whellan DJ, O'Connor CM. Source: Biological Psychiatry. 2003 August 1; 54(3): 248-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893101&dopt=Abstract

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Depression and cognitive impairment in disability-free early multiple sclerosis. Author(s): Haase CG, Tinnefeld M, Lienemann M, Ganz RE, Faustmann PM. Source: Behavioural Neurology. 2003; 14(1-2): 39-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719637&dopt=Abstract

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Depression and comorbid medical illness: the National Institute of Mental Health perspective. Author(s): Stover E, Fenton W, Rosenfeld A, Insel TR. Source: Biological Psychiatry. 2003 August 1; 54(3): 184-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893092&dopt=Abstract

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Depression and congestive heart failure. Author(s): Guck TP, Elsasser GN, Kavan MG, Barone EJ. Source: Congestive Heart Failure (Greenwich, Conn.). 2003 May-June; 9(3): 163-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826775&dopt=Abstract

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Depression and increased myocardial ischemic activity in patients with ischemic heart disease. Author(s): Jiang W, Babyak MA, Rozanski A, Sherwood A, O'Connor CM, Waugh RA, Coleman RE, Hanson MW, Morris JJ, Blumenthal JA. Source: American Heart Journal. 2003 July; 146(1): 55-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851608&dopt=Abstract

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Depression and neurocognitive functioning in mild traumatic brain injury patients referred for assessment. Author(s): Ruttan LA, Heinrichs RW. Source: J Clin Exp Neuropsychol. 2003 May; 25(3): 407-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12916653&dopt=Abstract

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Depression and obesity. Author(s): Stunkard AJ, Faith MS, Allison KC. Source: Biological Psychiatry. 2003 August 1; 54(3): 330-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893108&dopt=Abstract

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Depression and other psychological risks following myocardial infarction. Author(s): Frasure-Smith N, Lesperance F. Source: Archives of General Psychiatry. 2003 June; 60(6): 627-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796226&dopt=Abstract

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Depression and satisfaction with health coverage and medical care in the 1998 NRC Healthcare Market Guide survey. Author(s): Haviland MG, Pincus HA, Morales LS. Source: Administration and Policy in Mental Health. 2003 July; 30(6): 511-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13677457&dopt=Abstract

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Depression and suicidal behavior in adolescent inpatients with obsessive compulsive disorder. Author(s): Apter A, Horesh N, Gothelf D, Zalsman G, Erlich Z, Soreni N, Weizman A. Source: Journal of Affective Disorders. 2003 July; 75(2): 181-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798258&dopt=Abstract

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Depression and suicidal behavior: the real estate analogy. Author(s): Goldney RD. Source: Crisis. 2003; 24(2): 87-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880228&dopt=Abstract

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Depression and tinnitus. Author(s): Dobie RA. Source: Otolaryngologic Clinics of North America. 2003 April; 36(2): 383-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856305&dopt=Abstract

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Depression and trail making test scores in a sample of cocaine abusers. Author(s): Horton AM Jr, Roberts C. Source: The International Journal of Neuroscience. 2003 April; 113(4): 595-604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856485&dopt=Abstract

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Depression as a risk factor for Alzheimer disease: the MIRAGE Study. Author(s): Green RC, Cupples LA, Kurz A, Auerbach S, Go R, Sadovnick D, Duara R, Kukull WA, Chui H, Edeki T, Griffith PA, Friedland RP, Bachman D, Farrer L. Source: Archives of Neurology. 2003 May; 60(5): 753-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756140&dopt=Abstract

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Depression as a risk factor for mortality after coronary artery bypass surgery. Author(s): Blumenthal JA, Lett HS, Babyak MA, White W, Smith PK, Mark DB, Jones R, Mathew JP, Newman MF; NORG Investigators. Source: Lancet. 2003 August 23; 362(9384): 604-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12944059&dopt=Abstract

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Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Author(s): Cougle JR, Reardon DC, Coleman PK. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2003 April; 9(4): Cr105-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709667&dopt=Abstract

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Depression care attitudes and practices of newer obstetrician-gynecologists: a national survey. Author(s): Dietrich AJ, Williams JW Jr, Ciotti MC, Schulkin J, Stotland N, Rost K, Baram D, Cornell J. Source: American Journal of Obstetrics and Gynecology. 2003 July; 189(1): 267-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12861173&dopt=Abstract

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Depression during early recovery from heart surgery among early middle-age, midlife, and elderly women. Author(s): Plach SK, Napholz L, Kelber ST. Source: Health Care for Women International. 2003 April; 24(4): 327-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746004&dopt=Abstract

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Depression in adolescents with diabetes. Author(s): Kanner S, Hamrin V, Grey M. Source: Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc. 2003 January-March; 16(1): 15-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790304&dopt=Abstract

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Depression in Alzheimer's disease: heterogeneity and related issues. Author(s): Lee HB, Lyketsos CG. Source: Biological Psychiatry. 2003 August 1; 54(3): 353-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893110&dopt=Abstract

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Depression in cardiovascular disease: can the risk be reduced? Author(s): Kaufmann PG. Source: Biological Psychiatry. 2003 August 1; 54(3): 187-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893093&dopt=Abstract

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Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Author(s): Kanner AM. Source: Biological Psychiatry. 2003 August 1; 54(3): 388-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893113&dopt=Abstract

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Depression in inpatients: bipolar vs unipolar. Author(s): Dorz S, Borgherini G, Conforti D, Scarso C, Magni G. Source: Psychological Reports. 2003 June; 92(3 Pt 1): 1031-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841481&dopt=Abstract

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Depression in medical ill: improving the care. Author(s): Wahid ZU. Source: Journal of the National Medical Association. 2003 April; 95(4): A17-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749612&dopt=Abstract

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Depression in mothers of children presenting for emergency and primary care: impact on mothers' perceptions of caring for their children. Author(s): Grupp-Phelan J, Whitaker RC, Naish AB. Source: Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association. 2003 May-June; 3(3): 142-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708891&dopt=Abstract

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Depression in patients with advanced cancer. Author(s): Bowers L, Boyle DA. Source: Clinical Journal of Oncology Nursing. 2003 May-June; 7(3): 281-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12793334&dopt=Abstract

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Depression in premenopausal women: gonadal hormones and serotonergic system assessed by D-fenfluramine challenge test. Author(s): Rajewska J, Rybakowski JK. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2003 June; 27(4): 705-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787860&dopt=Abstract

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Depression in sickle cell disease. Author(s): Hasan SP, Hashmi S, Alhassen M, Lawson W, Castro O. Source: Journal of the National Medical Association. 2003 July; 95(7): 533-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12911250&dopt=Abstract

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Depression in the elderly: the RN can make a difference. Author(s): Hicks J. Source: Okla Nurse. 2003 June-August; 48(2): 23. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856453&dopt=Abstract

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Depression in women with polycystic ovary syndrome: clinical and biochemical correlates. Author(s): Rasgon NL, Rao RC, Hwang S, Altshuler LL, Elman S, Zuckerbrow-Miller J, Korenman SG. Source: Journal of Affective Disorders. 2003 May; 74(3): 299-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738050&dopt=Abstract

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Depression influences the EDI scores in anorexia nervosa patients. Author(s): Bizeul C, Brun JM, Rigaud D. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2003 May; 18(3): 119-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763297&dopt=Abstract

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Depression of activity in the corticospinal pathway during human motor behavior after strong voluntary contractions. Author(s): Petersen NT, Taylor JL, Butler JE, Gandevia SC. Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 2003 September 3; 23(22): 7974-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12954858&dopt=Abstract

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Depression screening attitudes and practices among obstetrician-gynecologists. Author(s): LaRocco-Cockburn A, Melville J, Bell M, Katon W. Source: Obstetrics and Gynecology. 2003 May; 101(5 Pt 1): 892-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738146&dopt=Abstract

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Depression screening. Author(s): Kessler R. Source: The Journal of Family Practice. 2003 June; 52(6): 466; Author Reply 467. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12836648&dopt=Abstract

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Depression status, medical comorbidity and resource costs. Evidence from an international study of major depression in primary care (LIDO). Author(s): Chisholm D, Diehr P, Knapp M, Patrick D, Treglia M, Simon G; LIDO Group. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 August; 183: 121-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893665&dopt=Abstract

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Depression with atypical features in the National Comorbidity Survey: classification, description, and consequences. Author(s): Matza LS, Revicki DA, Davidson JR, Stewart JW. Source: Archives of General Psychiatry. 2003 August; 60(8): 817-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12912765&dopt=Abstract

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Depression with late onset is associated with right frontal lobe atrophy. Author(s): Almeida OP, Burton EJ, Ferrier N, McKeith IG, O'Brien JT. Source: Psychological Medicine. 2003 May; 33(4): 675-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785469&dopt=Abstract

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Depression with physical symptoms: treating to remission. Author(s): Fava M. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 7: 24-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755649&dopt=Abstract

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Depression, anxiety, and associated health status in low-income Chinese patients. Author(s): Lubetkin EI, Jia H, Gold MR. Source: American Journal of Preventive Medicine. 2003 May; 24(4): 354-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12726874&dopt=Abstract

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Depression, anxiety, and relevant cognitions in persons with mental retardation. Author(s): Glenn E, Bihm EM, Lammers WJ. Source: Journal of Autism and Developmental Disorders. 2003 February; 33(1): 69-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708581&dopt=Abstract

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Depression, fatigue, and health-related quality of life among people with advanced multiple sclerosis: results from an exploratory telerehabilitation study. Author(s): Egner A, Phillips VL, Vora R, Wiggers E. Source: Neurorehabilitation. 2003; 18(2): 125-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867675&dopt=Abstract

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Depression, homicide and diminished responsibility: new Scottish directions. Author(s): Collins P, White T. Source: Med Sci Law. 2003 July; 43(3): 195-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12899423&dopt=Abstract

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Depression, mortality, and medical morbidity in patients with coronary heart disease. Author(s): Carney RM, Freedland KE. Source: Biological Psychiatry. 2003 August 1; 54(3): 241-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893100&dopt=Abstract

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Depression. Coping with a spouse's death. Author(s): Schneider J. Source: U.S. News & World Report. 2003 June 2; 134(19): 58,60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800332&dopt=Abstract

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Depression. Interview by Helen Crane. Author(s): Crane H. Source: Bmj (Clinical Research Ed.). 2003 June 14; 326(7402): 1324. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12805179&dopt=Abstract

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Depression: emerging research and treatment approaches. 16-17 January 2003, Paris, France. Author(s): Moret C. Source: Idrugs. 2003 March; 6(3): 183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12838974&dopt=Abstract

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Depression--a cardiac risk factor in search of a treatment. Author(s): Frasure-Smith N, Lesperance F. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3171-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813125&dopt=Abstract

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Depression-free days as a summary measure of the temporal pattern of response and remission in the treatment of major depression: a comparison of venlafaxine, selective serotonin reuptake inhibitors, and placebo. Author(s): Mallick R, Chen J, Entsuah AR, Schatzberg AF. Source: The Journal of Clinical Psychiatry. 2003 March; 64(3): 321-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716275&dopt=Abstract

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Depression-like changes of the sleep-EEG during high dose corticosteroid treatment in patients with multiple sclerosis. Author(s): Antonijevic IA, Steiger A. Source: Psychoneuroendocrinology. 2003 August; 28(6): 780-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812864&dopt=Abstract

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Dexamethasone suppression test findings in subjects with personality disorders: associations with posttraumatic stress disorder and major depression. Author(s): Grossman R, Yehuda R, New A, Schmeidler J, Silverman J, Mitropoulou V, Sta Maria N, Golier J, Siever L. Source: The American Journal of Psychiatry. 2003 July; 160(7): 1291-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832244&dopt=Abstract

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Differences in anger expression between individuals with and without headache after controlling for depression and anxiety. Author(s): Nicholson RA, Gramling SE, Ong JC, Buenevar L. Source: Headache. 2003 June; 43(6): 651-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12786926&dopt=Abstract

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Different long-term course between chest pain and exercise-induced ST depression in syndrome X. Author(s): Shintani S, Nishiyama Y, Yamamoto K, Koga Y. Source: Japanese Heart Journal. 2003 July; 44(4): 471-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12906029&dopt=Abstract

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Differential sensitivity to induction of spreading depression by partial disinhibition in chronically epileptic human and rat as compared to native rat neocortical tissue. Author(s): Kohling R, Koch UR, Hagemann G, Redecker C, Straub H, Speckmann EJ. Source: Brain Research. 2003 June 13; 975(1-2): 129-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763600&dopt=Abstract

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Differentiate depression from dementia. Author(s): Maynard CK. Source: The Nurse Practitioner. 2003 March; 28(3): 18-9, 23-7; Quiz 27-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800692&dopt=Abstract

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Differentiating anxiety and depression in older adults with generalized anxiety disorder. Author(s): Beck JG, Novy DM, Diefenbach GJ, Stanley MA, Averill PM, Swann AC. Source: Psychological Assessment. 2003 June; 15(2): 184-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847778&dopt=Abstract

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Disability in depression and back pain: evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Author(s): Chwastiak LA, Von Korff M. Source: Journal of Clinical Epidemiology. 2003 June; 56(6): 507-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12873644&dopt=Abstract

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Discrepancy between subjective and objective sleep in patients with depression. Author(s): Tsuchiyama K, Nagayama H, Kudo K, Kojima K, Yamada K. Source: Psychiatry and Clinical Neurosciences. 2003 June; 57(3): 259-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753564&dopt=Abstract

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Do age of onset and course of illness define biologically distinct groups within atypical depression? Author(s): Stewart JW, Bruder GE, McGrath PJ, Quitkin FM. Source: Journal of Abnormal Psychology. 2003 May; 112(2): 253-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784835&dopt=Abstract

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Does age play a role in the structure of anxiety and depression in children and youths? An investigation of the tripartite model in three age cohorts. Author(s): Turner CM, Barrett PM. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 826-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924688&dopt=Abstract

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Does cognitive recovery after treatment of poststroke depression last? A 2-year follow-up of cognitive function associated with poststroke depression. Author(s): Narushima K, Chan KL, Kosier JT, Robinson RG. Source: The American Journal of Psychiatry. 2003 June; 160(6): 1157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777275&dopt=Abstract

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Dopamine and adenosine mediate substance P-induced depression of evoked IPSCs in the rat nucleus accumbens in vitro. Author(s): Kombian SB, Ananthalakshmi KV, Parvathy SS, Matowe WC. Source: The European Journal of Neuroscience. 2003 July; 18(2): 303-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887412&dopt=Abstract

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Early fluoxetine treatment of post-stroke depression--a three-month double-blind placebo-controlled study with an open-label long-term follow up. Author(s): Fruehwald S, Gatterbauer E, Rehak P, Baumhackl U. Source: Journal of Neurology. 2003 March; 250(3): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638027&dopt=Abstract

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Early improvement under mirtazapine and paroxetine predicts later stable response and remission with high sensitivity in patients with major depression. Author(s): Szegedi A, Muller MJ, Anghelescu I, Klawe C, Kohnen R, Benkert O. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 413-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716243&dopt=Abstract

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Economic costs of post-natal depression in a high-risk British cohort. Author(s): Petrou S, Cooper P, Murray L, Davidson LL. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2002 December; 181: 505-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12456521&dopt=Abstract

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Educational and organizational interventions to improve the management of depression in primary care: a systematic review. Author(s): Gilbody S, Whitty P, Grimshaw J, Thomas R. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3145-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813120&dopt=Abstract

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Effect of depression on stroke morbidity and mortality. Author(s): Ramasubbu R, Patten SB. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 May; 48(4): 250-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12776392&dopt=Abstract

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Effect of neuroticism, response style and information processing on depression severity in a clinically depressed sample. Author(s): Lam D, Smith N, Checkley S, Rijsdijk F, Sham P. Source: Psychological Medicine. 2003 April; 33(3): 469-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701667&dopt=Abstract

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Effect of reminiscence therapy on depression in older adults: a systematic review. Author(s): Hsieh HF, Wang JJ. Source: International Journal of Nursing Studies. 2003 May; 40(4): 335-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667510&dopt=Abstract

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Effect of serotonin 1A agonist tandospirone on depression symptoms in senile patients with dementia. Author(s): Masuda Y, Akagawa Y, Hishikawa Y. Source: Human Psychopharmacology. 2002 June; 17(4): 191-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404687&dopt=Abstract

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Effect of the Teaching Kids to Cope (TKC) program on outcomes of depression and coping among rural adolescents. Author(s): Puskar K, Sereika S, Tusaie-Mumford K. Source: Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc. 2003 April-June; 16(2): 7180. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12873069&dopt=Abstract

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Effective use of electroconvulsive therapy in late-life depression. Author(s): Flint AJ, Gagnon N. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 October; 47(8): 734-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420651&dopt=Abstract

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Effectiveness of chromium in atypical depression: a placebo-controlled trial. Author(s): Davidson JR, Abraham K, Connor KM, McLeod MN. Source: Biological Psychiatry. 2003 February 1; 53(3): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559660&dopt=Abstract

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Effectiveness of cognitive therapy for depression in a community mental health center: a benchmarking study. Author(s): Merrill KA, Tolbert VE, Wade WA. Source: Journal of Consulting and Clinical Psychology. 2003 April; 71(2): 404-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699035&dopt=Abstract

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Effectiveness of collaborative care depression treatment in Veterans' Affairs primary care. Author(s): Hedrick SC, Chaney EF, Felker B, Liu CF, Hasenberg N, Heagerty P, Buchanan J, Bagala R, Greenberg D, Paden G, Fihn SD, Katon W. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 2003 January; 18(1): 9-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534758&dopt=Abstract

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Effectiveness of informational support in reducing the severity of postnatal depression in Taiwan. Author(s): Heh SS, Fu YY. Source: Journal of Advanced Nursing. 2003 April; 42(1): 30-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641809&dopt=Abstract

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Effects of a depression education program on residents' knowledge, attitudes, and clinical skills. Author(s): Learman LA, Gerrity MS, Field DR, van Blaricom A, Romm J, Choe J. Source: Obstetrics and Gynecology. 2003 January; 101(1): 167-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517663&dopt=Abstract

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Effects of exercise on depression in old age. Author(s): Jagadheesan K, Chakraborty S, Sinha VK, Nizamie SH. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2002 December; 181: 532; Author Reply 532. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12456527&dopt=Abstract

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Effects of maternal depression on breast-feeding. Author(s): Taj R, Sikander KS. Source: J Pak Med Assoc. 2003 January; 53(1): 8-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666844&dopt=Abstract

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Effects of mirtazapine on sleep polygraphic variables in major depression. Author(s): Schittecatte M, Dumont F, Machowski R, Cornil C, Lavergne F, Wilmotte J. Source: Neuropsychobiology. 2002; 46(4): 197-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566938&dopt=Abstract

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Effects of perceived self-efficacy and functional status on depression in patients with chronic heart failure. Author(s): Tsay SL, Chao YF. Source: The Journal of Nursing Research : Jnr. 2002 December; 10(4): 271-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522740&dopt=Abstract

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Effects of rapid tryptophan depletion on sleep electroencephalogram and mood in subjects with partially remitted depression on bupropion. Author(s): Evans L, Golshan S, Kelsoe J, Rapaport M, Resovsky K, Sutton L, Gillin JC. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 December; 27(6): 1016-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464458&dopt=Abstract

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Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. Author(s): Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ, Czajkowski SM, DeBusk R, Hosking J, Jaffe A, Kaufmann PG, Mitchell P, Norman J, Powell LH, Raczynski JM, Schneiderman N; Enhancing Recovery in Coronary Heart Disease Patients Investigators (ENRICHD). Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3106-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813116&dopt=Abstract

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Efficacy and tolerability of oral and intramuscular S-adenosyl-L-methionine 1,4butanedisulfonate (SAMe) in the treatment of major depression: comparison with imipramine in 2 multicenter studies. Author(s): Delle Chiaie R, Pancheri P, Scapicchio P. Source: The American Journal of Clinical Nutrition. 2002 November; 76(5): 1172S-6S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418499&dopt=Abstract

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Efficacy and tolerability of Paroxetine 20 mg daily in the treatment of depression and depression associated anxiety. Author(s): Chaudhry HR, Qureshi Z, Tareen IA, Yazdani I. Source: J Pak Med Assoc. 2002 November; 52(11): 518-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585372&dopt=Abstract

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Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis. Author(s): MacGillivray S, Arroll B, Hatcher S, Ogston S, Reid I, Sullivan F, Williams B, Crombie I. Source: Bmj (Clinical Research Ed.). 2003 May 10; 326(7397): 1014. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742924&dopt=Abstract

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Efficacy of citalopram as a monotherapy or as an adjunctive treatment to estrogen therapy for perimenopausal and postmenopausal women with depression and vasomotor symptoms. Author(s): Soares CN, Poitras JR, Prouty J, Alexander AB, Shifren JL, Cohen LS. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 473-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716252&dopt=Abstract

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Efficacy of venlafaxine in major depression resistant to selective serotonin reuptake inhibitors. Author(s): Saiz-Ruiz J, Ibanez A, Diaz-Marsa M, Arias F, Padin J, Martin-Carrasco M, Montes JM, Ferrando L, Carrasco JL, Martin-Ballesteros E, Jorda L, Chamorro L. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 October; 26(6): 1129-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452535&dopt=Abstract

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Electro convulsive therapy in a pre-pubertal child with severe depression. Author(s): Russell PS, Tharyan P, Arun Kumar K, Cherian A. Source: Journal of Postgraduate Medicine. 2002 October-December; 48(4): 290-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571387&dopt=Abstract

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Electroconvulsive therapy for patients with major depression and probable Lewy body dementia. Author(s): Rasmussen KG Jr, Russell JC, Kung S, Rummans TA, Rae-Stuart E, O'Connor MK. Source: The Journal of Ect. 2003 June; 19(2): 103-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792460&dopt=Abstract

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Electroconvulsive therapy update: recognizing and treating psychotic depression. Author(s): Fink M. Source: The Journal of Clinical Psychiatry. 2003 March; 64(3): 232-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716262&dopt=Abstract

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Elevated agonist binding to alpha2-adrenoceptors in the locus coeruleus in major depression. Author(s): Ordway GA, Schenk J, Stockmeier CA, May W, Klimek V. Source: Biological Psychiatry. 2003 February 15; 53(4): 315-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12586450&dopt=Abstract

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Elevated plasma interleukin-6 (IL-6) and soluble IL-6 receptor concentrations in menopausal women with and without depression. Author(s): Ushiroyama T, Ikeda A, Ueki M. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2002 October; 79(1): 51-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399096&dopt=Abstract

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Elevated platelet vesicular monoamine transporter density in untreated patients diagnosed with major depression. Author(s): Zucker M, Aviv A, Shelef A, Weizman A, Rehavi M. Source: Psychiatry Research. 2002 November 15; 112(3): 251-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450634&dopt=Abstract

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Emerging evidence for a central epinephrine-innervated alpha 1-adrenergic system that regulates behavioral activation and is impaired in depression. Author(s): Stone EA, Lin Y, Rosengarten H, Kramer HK, Quartermain D. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 August; 28(8): 1387-99. Epub 2003 June 18. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813473&dopt=Abstract

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Emerging models of depression care: multi-level ('6 P') strategies. Author(s): Pincus HA, Hough L, Houtsinger JK, Rollman BL, Frank RG. Source: Int J Methods Psychiatr Res. 2003; 12(1): 54-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830310&dopt=Abstract

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Endocrine factors and postpartum depression. A selected review. Author(s): McCoy SJ, Beal JM, Watson GH. Source: J Reprod Med. 2003 June; 48(6): 402-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856509&dopt=Abstract

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Endotoxemic myocardial depression: a novel inducible nitric oxide synthase suppressant effect of albumin. Author(s): Kumar A, Kumar A. Source: Critical Care Medicine. 2003 January; 31(1): 324-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12545046&dopt=Abstract

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Energetic depression caused by mitochondrial dysfunction. Author(s): Gellerich FN, Trumbeckaite S, Chen Y, Deschauer M, M ller T, Zierz S. Source: Eur Cytokine Netw. 2002 October-December; 13(4): 395-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517722&dopt=Abstract

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Enhancement of serotonin uptake by cortisol: a possible link between stress and depression. Author(s): Tafet GE, Toister-Achituv M, Shinitzky M. Source: Cognitive, Affective & Behavioral Neuroscience. 2001 March; 1(1): 96-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467107&dopt=Abstract

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Enhancing neuronal plasticity and cellular resilience to develop novel, improved therapeutics for difficult-to-treat depression. Author(s): Manji HK, Quiroz JA, Sporn J, Payne JL, Denicoff K, A Gray N, Zarate CA Jr, Charney DS. Source: Biological Psychiatry. 2003 April 15; 53(8): 707-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706957&dopt=Abstract

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Entrapment and arrested fight and flight in depression: an exploration using focus groups. Author(s): Gilbert P, Gilbert J. Source: Psychology and Psychotherapy. 2003 June; 76(Pt 2): 173-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855063&dopt=Abstract

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Epidemiologic evidence on the comorbidity of depression and diabetes. Author(s): Eaton WW. Source: Journal of Psychosomatic Research. 2002 October; 53(4): 903-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377301&dopt=Abstract

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Epidemiology of comorbid coronary artery disease and depression. Author(s): Rudisch B, Nemeroff CB. Source: Biological Psychiatry. 2003 August 1; 54(3): 227-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893099&dopt=Abstract

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Epidemiology of major depression in a predominantly rural health region. Author(s): Patten SB, Stuart HL, Russell ML, Maxwell CJ, Arboleda-Florez J. Source: Social Psychiatry and Psychiatric Epidemiology. 2003 July; 38(7): 360-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12861441&dopt=Abstract

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Epidemiology of women and depression. Author(s): Kessler RC. Source: Journal of Affective Disorders. 2003 March; 74(1): 5-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646294&dopt=Abstract

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Epidural opioid analgesia and neonatal respiratory depression. Author(s): Kumar M, Paes B. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2003 July-August; 23(5): 425-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847541&dopt=Abstract

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Erectile dysfunction: prevalence and relationship to depression, alcohol abuse and panic disorder. Author(s): Okulate G, Olayinka O, Dogunro AS. Source: General Hospital Psychiatry. 2003 May-June; 25(3): 209-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748034&dopt=Abstract

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Escitalopram: efficacy and tolerability in the treatment of depression. Author(s): Baldwin DS. Source: Hosp Med. 2002 November; 63(11): 668-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12474611&dopt=Abstract

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Essentialist thinking about depression: evidence for polarized beliefs. Author(s): Haslam N. Source: Psychological Reports. 2002 December; 91(3 Pt 2): 1253-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12585546&dopt=Abstract

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Estrogen-mediated effects on depression and memory formation in females. Author(s): Shors TJ, Leuner B. Source: Journal of Affective Disorders. 2003 March; 74(1): 85-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646301&dopt=Abstract

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Ethical concerns associated with childhood depression. Author(s): Nelson EL. Source: Bioethics Forum. 2002; 18(3-4): 55-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744271&dopt=Abstract

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Ethnicity, depression, and suicide. Author(s): Munson MR. Source: The American Journal of Psychiatry. 2002 October; 159(10): 1794-5; Author Reply 1795. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359695&dopt=Abstract

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Etiology and treatment of postpartum depression. Author(s): Flores DL, Hendrick VC. Source: Current Psychiatry Reports. 2002 December; 4(6): 461-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441026&dopt=Abstract

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Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression. Author(s): Aubert RE, Fulop G, Xia F, Thiel M, Maldonato D, Woo C. Source: Am J Manag Care. 2003 May; 9(5): 374-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744299&dopt=Abstract

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Evaluation of dexamethasone suppression test in fibromyalgia patients with or without depression. Author(s): Ataoglu S, Ozcetin A, Yildiz O, Ataoglu A. Source: Swiss Medical Weekly : Official Journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology. 2003 April 19; 133(15-16): 241-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811674&dopt=Abstract

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Evaluation of freezing point depression osmolality for classifying random urine specimens defined as substituted under HHS/DOT criteria. Author(s): Cook JD, Hannon MW Sr, Vo T, Caplan YH. Source: Journal of Analytical Toxicology. 2002 October; 26(7): 424-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422996&dopt=Abstract

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Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Author(s): Quintana JM, Padierna A, Esteban C, Arostegui I, Bilbao A, Ruiz I. Source: Acta Psychiatrica Scandinavica. 2003 March; 107(3): 216-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580829&dopt=Abstract

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Everyday memory and laboratory memory tests: general function predictors in schizophrenia and remitted depression. Author(s): Fennig S, Mottes A, Ricter-Levin G, Treves I, Levkovitz Y. Source: The Journal of Nervous and Mental Disease. 2002 October; 190(10): 677-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409861&dopt=Abstract

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Evidence that the SSRI dose response in treating major depression should be reassessed: a meta-analysis. Author(s): Baker CB, Tweedie R, Duval S, Woods SW. Source: Depression and Anxiety. 2003; 17(1): 1-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577272&dopt=Abstract

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Evidence-based care for depression in Maine: dissemination of the Kaiser Permanente Nurse Telecare Program. Author(s): Pearson B, Katz SE, Soucie V, Hunkeler E, Meresman J, Rooney T, Amick BC 3rd. Source: The Psychiatric Quarterly. 2003 Spring; 74(1): 91-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602791&dopt=Abstract

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Evolved mechanisms in depression: the role and interaction of attachment and social rank in depression. Author(s): Sloman L, Gilbert P, Hasey G. Source: Journal of Affective Disorders. 2003 April; 74(2): 107-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706512&dopt=Abstract

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Excess mortality in depression: a meta-analysis of community studies. Author(s): Cuijpers P, Smit F. Source: Journal of Affective Disorders. 2002 December; 72(3): 227-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450639&dopt=Abstract

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Executive control deficit in depression: event-related potentials in a Go/Nogo task. Author(s): Kaiser S, Unger J, Kiefer M, Markela J, Mundt C, Weisbrod M. Source: Psychiatry Research. 2003 April 1; 122(3): 169-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694891&dopt=Abstract

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Exercise interventions for smokers with a history of alcoholism: exercise adherence rates and effect of depression on adherence. Author(s): Patten CA, Vickers KS, Martin JE, Williams CD. Source: Addictive Behaviors. 2003 June; 28(4): 657-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12726782&dopt=Abstract

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Exercise therapy for depression in middle-aged and older adults: predictors of early dropout and treatment failure. Author(s): Herman S, Blumenthal JA, Babyak M, Khatri P, Craighead WE, Krishnan KR, Doraiswamy PM. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2002 November; 21(6): 553-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12433007&dopt=Abstract

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Experimental autoimmune encephalomyelitis-associated behavioral syndrome as a model of 'depression due to multiple sclerosis'. Author(s): Pollak Y, Orion E, Goshen I, Ovadia H, Yirmiya R. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 533-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401467&dopt=Abstract

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Exploring psychological abuse in childhood: II. Association with other abuse and adult clinical depression. Author(s): Bifulco A, Moran PM, Baines R, Bunn A, Stanford K. Source: Bulletin of the Menninger Clinic. 2002 Summer; 66(3): 241-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448629&dopt=Abstract

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Expressed emotion, attributions and depression in mothers of children with problem behaviour. Author(s): Bolton C, Calam R, Barrowclough C, Peters S, Roberts J, Wearden A, Morris J. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2003 February; 44(2): 242-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587860&dopt=Abstract

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Facial pain, depression and stress - connections and directions. Author(s): Korszun A. Source: Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 2002 November; 31(10): 615-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406308&dopt=Abstract

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Factor analysis of the Hospital Anxiety and Depression Scale from a large cancer population. Author(s): Smith AB, Selby PJ, Velikova G, Stark D, Wright EP, Gould A, Cull A. Source: Psychology and Psychotherapy. 2002 June; 75(Pt 2): 165-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396762&dopt=Abstract

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Factor structure of the Beck Depression Inventory in a university sample. Author(s): Helm HW Jr, Boward MD. Source: Psychological Reports. 2003 February; 92(1): 53-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674257&dopt=Abstract

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Factor structure of the Cornell Scale for Depression in Dementia among Japanese poststroke patients. Author(s): Schreiner AS, Morimoto T. Source: International Journal of Geriatric Psychiatry. 2002 August; 17(8): 715-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211120&dopt=Abstract

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Factorial validity of the center for epidemiologic studies-depression (CES-D) scale in military peacekeepers. Author(s): Boisvert JA, McCreary DR, Wright KD, Asmundson GJ. Source: Depression and Anxiety. 2003; 17(1): 19-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577274&dopt=Abstract

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Factors associated with depression in a representative sample of 14 217 people aged 75 and over in the United Kingdom: results from the MRC trial of assessment and management of older people in the community. Author(s): Osborn DP, Fletcher AE, Smeeth L, Stirling S, Bulpitt CJ, Breeze E, Ng ES, Nunes M, Jones D, Tulloch A. Source: International Journal of Geriatric Psychiatry. 2003 July; 18(7): 623-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833307&dopt=Abstract

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Failed depression CQI project yields important lessons. Author(s): Levenson D. Source: Rep Med Guidel Outcomes Res. 2002 January 11; 13(1): 9-10, 12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416511&dopt=Abstract

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Failure of tibolone to potentiate the pharmacological effect of fluoxetine in postmenopausal major depression. Author(s): Berlanga C, Mendieta D, Alva G, del Carmen Lara M. Source: Journal of Women's Health (2002). 2003 January-February; 12(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639367&dopt=Abstract

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Family caregivers' sleep loss and depression over time. Author(s): Carter PA. Source: Cancer Nursing. 2003 August; 26(4): 253-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12886115&dopt=Abstract

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Family disruption in childhood and risk of adult depression. Author(s): Gilman SE, Kawachi I, Fitzmaurice GM, Buka SL. Source: The American Journal of Psychiatry. 2003 May; 160(5): 939-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727699&dopt=Abstract

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Family history, life events and the factorial structure of depression in a Nigerian sample of inpatients. Author(s): Ohaeri JU, Otote DI. Source: Psychopathology. 2002 July-August; 35(4): 210-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12239437&dopt=Abstract

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Fatigue and depression are associated with poor quality of life in ALS. Author(s): Lou JS, Reeves A, Benice T, Sexton G. Source: Neurology. 2003 January 14; 60(1): 122-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525733&dopt=Abstract

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Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community-dwelling adults. Author(s): Anderson KO, Getto CJ, Mendoza TR, Palmer SN, Wang XS, Reyes-Gibby CC, Cleeland CS. Source: Journal of Pain and Symptom Management. 2003 April; 25(4): 307-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691682&dopt=Abstract

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Fatigue in HIV/AIDS is associated with depression and subjective neurocognitive complaints but not neuropsychological functioning. Author(s): Millikin CP, Rourke SB, Halman MH, Power C. Source: J Clin Exp Neuropsychol. 2003 April; 25(2): 201-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12754678&dopt=Abstract

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Fatigue in multiple sclerosis: reciprocal relationships with physical disabilities and depression. Author(s): Schreurs KM, de Ridder DT, Bensing JM. Source: Journal of Psychosomatic Research. 2002 September; 53(3): 775-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217451&dopt=Abstract

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Fatigue, anxiety, and depression in long-term survivors of testicular cancer. Author(s): Fossa SD, Dahl AA, Loge JH. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 April 1; 21(7): 1249-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12663711&dopt=Abstract

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Favorable effect of milnacipran on depression induced by interferon-alpha. Author(s): Yoshida K, Higuchi H, Takahashi H, Shimizu T. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 2003 Spring; 15(2): 242-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724470&dopt=Abstract

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Feedback seeking in children and adolescents: associations with self-perceptions, attachment representations, and depression. Author(s): Cassidy J, Ziv Y, Mehta TG, Feeney BC. Source: Child Development. 2003 March-April; 74(2): 612-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705576&dopt=Abstract

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Fewer beta-endorphin expressing arcuate nucleus neurons and reduced betaendorphinergic innervation of paraventricular neurons in schizophrenics and patients with depression. Author(s): Bernstein HG, Krell D, Emrich HM, Baumann B, Danos P, Diekmann S, Bogerts B. Source: Cell Mol Biol (Noisy-Le-Grand). 2002; 48 Online Pub: Ol259-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643442&dopt=Abstract

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Fluoxetine augmentation with olanzapine for treatment of chronic resistant depression in an elderly patient: a case report. Author(s): Detweiler MB, Trinkle DB. Source: The Journal of Clinical Psychiatry. 2003 July; 64(7): 851-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12934994&dopt=Abstract

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Fluoxetine for acute treatment of depression in children and adolescents: a placebocontrolled, randomized clinical trial. Author(s): Emslie GJ, Heiligenstein JH, Wagner KD, Hoog SL, Ernest DE, Brown E, Nilsson M, Jacobson JG. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2002 October; 41(10): 1205-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364842&dopt=Abstract

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Fluvoxamine as effective as clomipramine against symptoms of severe depression: results from a multicentre, double-blind study. Author(s): Zohar J, Keegstra H, Barrelet L. Source: Human Psychopharmacology. 2003 March; 18(2): 113-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590404&dopt=Abstract

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Folate and depression. Author(s): Bjelland I, Ueland PM, Vollset SE. Source: Psychotherapy and Psychosomatics. 2003 March-April; 72(2): 59-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601222&dopt=Abstract

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Folate, vitamin B12, homocysteine, and the MTHFR 677C->T polymorphism in anxiety and depression: the Hordaland Homocysteine Study. Author(s): Bjelland I, Tell GS, Vollset SE, Refsum H, Ueland PM. Source: Archives of General Psychiatry. 2003 June; 60(6): 618-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796225&dopt=Abstract

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Frequency and heritability of depression symptomatology in the second half of life: evidence from Danish twins over 45. Author(s): Johnson W, McGue M, Gaist D, Vaupel JW, Christensen K. Source: Psychological Medicine. 2002 October; 32(7): 1175-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420887&dopt=Abstract

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From damaged nerves to masked depression: inevitability and hope in Latvian psychiatric narratives. Author(s): Skultans V. Source: Social Science & Medicine (1982). 2003 June; 56(12): 2421-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742605&dopt=Abstract

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From the editor--enhancing family coping with depression. Author(s): Thomas SP. Source: Issues in Mental Health Nursing. 2003 March; 24(2): 107. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12554422&dopt=Abstract

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Frontal white matter microstructure and treatment response of late-life depression: a preliminary study. Author(s): Alexopoulos GS, Kiosses DN, Choi SJ, Murphy CF, Lim KO. Source: The American Journal of Psychiatry. 2002 November; 159(11): 1929-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411231&dopt=Abstract

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Frontostriatal and limbic dysfunction in late-life depression. Author(s): Alexopoulos GS. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 November-December; 10(6): 687-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427577&dopt=Abstract

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Functional neuroimaging studies of the amygdala in depression. Author(s): Whalen PJ, Shin LM, Somerville LH, McLean AA, Kim H. Source: Semin Clin Neuropsychiatry. 2002 October; 7(4): 234-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382206&dopt=Abstract

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Functioning and interpersonal relationships as predictors of response in treatmentresistant depression. Author(s): Papakostas GI, Petersen T, Mischoulon D, Hughes ME, Spector AR, Alpert JE, Fava M, Nierenberg AA. Source: Comprehensive Psychiatry. 2003 January-February; 44(1): 44-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12524635&dopt=Abstract

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G protein beta3 subunit 825T allele is associated with depression in young, healthy subjects. Author(s): Exton MS, Artz M, Siffert W, Schedlowski M. Source: Neuroreport. 2003 March 3; 14(3): 531-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634518&dopt=Abstract

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Gabapentin augmentation therapy in bipolar depression. Author(s): Wang PW, Santosa C, Schumacher M, Winsberg ME, Strong C, Ketter TA. Source: Bipolar Disorders. 2002 October; 4(5): 296-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479661&dopt=Abstract

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Gender and depression: a study of severity and symptomatology of depressive disorders (ICD-10) in general practice. Author(s): Hildebrandt MG, Stage KB, Kragh-Soerensen P. Source: Acta Psychiatrica Scandinavica. 2003 March; 107(3): 197-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580826&dopt=Abstract

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Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies. Author(s): Angst J, Gamma A, Gastpar M, Lepine JP, Mendlewicz J, Tylee A; Depression Research in European Society Study. Source: European Archives of Psychiatry and Clinical Neuroscience. 2002 October; 252(5): 201-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12451460&dopt=Abstract

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Gender differences in rates of depression among undergraduates: measurement matters. Author(s): Grant K, Marsh P, Syniar G, Williams M, Addlesperger E, Kinzler MH, Cowman S. Source: Journal of Adolescence. 2002 December; 25(6): 613-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490179&dopt=Abstract

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Gender, ethnicity, and physician-patient communication about depression and anxiety in primary care. Author(s): Sleath B, Rubin RH. Source: Patient Education and Counseling. 2002 December; 48(3): 243-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477609&dopt=Abstract

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Generalized anxiety disorder in patients with major depression: is DSM-IV's hierarchy correct? Author(s): Zimmerman M, Chelminski I. Source: The American Journal of Psychiatry. 2003 March; 160(3): 504-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611832&dopt=Abstract

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Genetic linkage of region containing the CREB1 gene to depressive disorders in women from families with recurrent, early-onset, major depression. Author(s): Zubenko GS, Hughes HB 3rd, Maher BS, Stiffler JS, Zubenko WN, Marazita ML. Source: American Journal of Medical Genetics. 2002 December 8; 114(8): 980-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457397&dopt=Abstract

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Genetic segregation analysis of alcohol and other substance-use disorders in families with recurrent, early-onset major depression. Author(s): Maher BS, Marazita ML, Zubenko WN, Kaplan BB, Zubenko GS. Source: The American Journal of Drug and Alcohol Abuse. 2002 November; 28(4): 71131. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492266&dopt=Abstract

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Genetics of early-onset depression. Author(s): Smith D, Muir W, Blackwood D. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 April; 182: 363; Author Reply 364. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668415&dopt=Abstract

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Geriatric depression in Nigerian primary care attendees. Author(s): Sokoya OO, Baiyewu O. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 506-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789671&dopt=Abstract

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Geriatric nurse practitioner care guidelines: depression in older adults. Author(s): Gerstenlauer CJ, Maguire SR, Wooldridge L. Source: Geriatric Nursing (New York, N.Y.). 2003 May-June; 24(3): 185-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813438&dopt=Abstract

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Getting what you ask for: on the selectivity of depression rating scales. Author(s): Demyttenaere K, De Fruyt J. Source: Psychotherapy and Psychosomatics. 2003 March-April; 72(2): 61-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601223&dopt=Abstract

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Global burden of depression: the intersection of culture and medicine. Author(s): Scott J, Dickey B. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 August; 183: 92-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893658&dopt=Abstract

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GPs' perspectives on managing time in consultations with patients suffering from depression: a qualitative study. Author(s): Pollock K, Grime J. Source: Family Practice. 2003 June; 20(3): 262-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738694&dopt=Abstract

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Greater depression severity associated with less improvement in depressionassociated cognitive deficits in older subjects. Author(s): Taylor WD, Wagner HR, Steffens DC. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 September-October; 10(5): 632-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213698&dopt=Abstract

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Grief counselling and depression. Author(s): Campion-Smith C. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 January; 53(486): 61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12564284&dopt=Abstract

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Group interpersonal psychotherapy for depression in rural Uganda: a randomized controlled trial. Author(s): Bolton P, Bass J, Neugebauer R, Verdeli H, Clougherty KF, Wickramaratne P, Speelman L, Ndogoni L, Weissman M. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3117-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813117&dopt=Abstract

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Guideline adherence rates and interprofessional variation in a vignette study of depression. Author(s): Tiemeier H, de Vries WJ, van het Loo M, Kahan JP, Klazinga N, Grol R, Rigter H. Source: Quality & Safety in Health Care. 2002 September; 11(3): 214-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12486983&dopt=Abstract

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Guidelines recommend universal adult depression screening. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2002 June 28; 13(12): 1-2, 5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12506927&dopt=Abstract

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Health-related quality of life among patients with major depression. Author(s): Saarijarvi S, Salminen JK, Toikka T, Raitasalo R. Source: Nordic Journal of Psychiatry. 2002; 56(4): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12470316&dopt=Abstract

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Health-related quality of life and depression in an Italian sample of multiple sclerosis patients. Author(s): Patti F, Cacopardo M, Palermo F, Ciancio MR, Lopes R, Restivo D, Reggio A. Source: Journal of the Neurological Sciences. 2003 July 15; 211(1-2): 55-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767498&dopt=Abstract

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Health-related quality of life and depression in patients with chronic hepatitis C. Author(s): Gallegos-Orozco JF, Fuentes AP, Gerardo Argueta J, Perez-Pruna C, Hinojosa-Becerril C, Sixtos-Alonso MS, Cruz-Castellanos S, Gutierrez-Reyes G, OliveraMartinez MA, Gutierrez-Ruiz MC, Kershenobich D. Source: Archives of Medical Research. 2003 March-April; 34(2): 124-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700008&dopt=Abstract

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Helpless attributions and depression in adolescents: the roles of anxiety, event valence, and demographics. Author(s): Waschbusch DA, Sellers DP, LeBlanc M, Kelley ML. Source: Journal of Adolescence. 2003 April; 26(2): 169-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581725&dopt=Abstract

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Hemispheric asymmetry in the processing of emotional content in word meanings: the effect of current and past depression. Author(s): Atchley RA, Ilardi SS, Enloe A. Source: Brain and Language. 2003 January; 84(1): 105-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12537954&dopt=Abstract

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High incidence of depression in the primary care setting. Author(s): Emanuel SF, Holland JC, Bedno SA, Earles JE. Source: Military Medicine. 2002 October; 167(10): Iii-Iv. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392241&dopt=Abstract

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High serum TSH levels are associated with depression in the elderly. Author(s): Chueire VB, Silva ET, Perotta E, Romaldini JH, Ward LS. Source: Archives of Gerontology and Geriatrics. 2003 May-June; 36(3): 281-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849083&dopt=Abstract

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High-dimensional mapping of the hippocampus in depression. Author(s): Posener JA, Wang L, Price JL, Gado MH, Province MA, Miller MI, Babb CM, Csernansky JG. Source: The American Journal of Psychiatry. 2003 January; 160(1): 83-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505805&dopt=Abstract

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Higher incidence of depression preceding the onset of Parkinson's disease: a register study. Author(s): Leentjens AF, Van den Akker M, Metsemakers JF, Lousberg R, Verhey FR. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2003 April; 18(4): 414-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671948&dopt=Abstract

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Historical generations and psychology. The case of the Great Depression and World War II. Author(s): Rogler LH. Source: The American Psychologist. 2002 December; 57(12): 1013-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12613154&dopt=Abstract

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History of depression and smoking cessation outcome: a meta-analysis. Author(s): Hitsman B, Borrelli B, McChargue DE, Spring B, Niaura R. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 657-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924670&dopt=Abstract

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History of depression, angina, and quality of life after acute coronary syndromes. Author(s): Rumsfeld JS, Magid DJ, Plomondon ME, Sales AE, Grunwald GK, Every NR, Spertus JA. Source: American Heart Journal. 2003 March; 145(3): 493-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660673&dopt=Abstract

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HIV disease progression: depression, stress, and possible mechanisms. Author(s): Leserman J. Source: Biological Psychiatry. 2003 August 1; 54(3): 295-306. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893105&dopt=Abstract

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Home care nursing and detection of depression. Author(s): Blank MB, Kane CF. Source: Psychiatric Services (Washington, D.C.). 2003 June; 54(6): 909; Author Reply 90910. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12773611&dopt=Abstract

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Hopelessness and suicidal ideation in outpatients with treatment-resistant depression: prevalence and impact on treatment outcome. Author(s): Papakostas GI, Petersen T, Pava J, Masson E, Worthington JJ 3rd, Alpert JE, Fava M, Nierenberg AA. Source: The Journal of Nervous and Mental Disease. 2003 July; 191(7): 444-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891091&dopt=Abstract

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How could antidepressants worsen unipolar depression? Author(s): Benazzi F. Source: Psychotherapy and Psychosomatics. 2003 March-April; 72(2): 107-8; Author Reply 109. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601229&dopt=Abstract

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How does the Hospital and Anxiety and Depression Scale measure anxiety and depression in healthy subjects? Author(s): Caci H, Bayle FJ, Mattei V, Dossios C, Robert P, Boyer P. Source: Psychiatry Research. 2003 May 1; 118(1): 89-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759165&dopt=Abstract

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How long should drug treatment of depression last? Author(s): Fava GA, Ruini C, Tossani E. Source: The Medical Journal of Australia. 2003 May 19; 178(10): 526; Author Reply 526-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741948&dopt=Abstract

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How long should patients with psychotic depression stay on the antipsychotic medication? Author(s): Rothschild AJ, Duval SE. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 390-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716238&dopt=Abstract

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How to diagnose and treat depression. Author(s): Solnek BL, Seiter T. Source: The Nurse Practitioner. 2002 October; 27(10): 12-5, 19-23; Quiz 24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394584&dopt=Abstract

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How useful is the concept of somatization in cross-cultural studies of maternal depression? A contribution from the Mothers in a New Country (MINC) study. Author(s): Small R, Lumley J, Yelland J. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 2003 March; 24(1): 45-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685339&dopt=Abstract

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How well do automated performance measures assess guideline implementation for new-onset depression in the Veterans Health Administration? Author(s): Kramer TL, Owen RR, Cannon D, Sloan KL, Thrush CR, Williams DK, Austen MA. Source: Jt Comm J Qual Saf. 2003 September; 29(9): 479-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14513671&dopt=Abstract

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Hypergraphia, verbal aspontaneity and post-stroke depression secondary to right cyngulate and corpus callosum infarction. Author(s): Carota A, Annoni JM, Combremont P, Clarke S, Bogousslavsky J. Source: Journal of Neurology. 2003 April; 250(4): 508-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12760393&dopt=Abstract

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Hypomanic traits and response styles to depression. Author(s): Thomas J, Bentall RP. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2002 September; 41(Pt 3): 309-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396257&dopt=Abstract

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Hypothalamic-pituitary-adrenal axis function in patients with chronic depression. Author(s): Watson S, Gallagher P, Del-Estal D, Hearn A, Ferrier IN, Young AH. Source: Psychological Medicine. 2002 August; 32(6): 1021-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214783&dopt=Abstract

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Hypothalamic-pituitary-thyroid system activity during lithium augmentation therapy in patients with unipolar major depression. Author(s): Bschor T, Baethge C, Adli M, Lewitzka U, Eichmann U, Bauer M. Source: Journal of Psychiatry & Neuroscience : Jpn. 2003 May; 28(3): 210-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790161&dopt=Abstract

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Iatrogenic depression in the elderly. Results from a community-based study in the Netherlands. Author(s): Dhondt TD, Beekman AT, Deeg DJ, Van Tilburg W. Source: Social Psychiatry and Psychiatric Epidemiology. 2002 August; 37(8): 393-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195547&dopt=Abstract

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Identification of a claims data "signature" and economic consequences for treatment-resistant depression. Author(s): Corey-Lisle PK, Birnbaum HG, Greenberg PE, Marynchenko MB, Claxton AJ. Source: The Journal of Clinical Psychiatry. 2002 August; 63(8): 717-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197453&dopt=Abstract

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IDentify, Educate and Alert (IDEA) trial: an intervention to reduce postnatal depression. Author(s): Webster J, Linnane J, Roberts J, Starrenburg S, Hinson J, Dibley L. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 September; 110(9): 842-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14511967&dopt=Abstract

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Identifying depression in primary care: a comparison of different methods in a prospective cohort study. Author(s): Henkel V, Mergl R, Kohnen R, Maier W, Moller HJ, Hegerl U. Source: Bmj (Clinical Research Ed.). 2003 January 25; 326(7382): 200-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543837&dopt=Abstract

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Identifying physician-recognized depression from administrative data: consequences for quality measurement. Author(s): Spettell CM, Wall TC, Allison J, Calhoun J, Kobylinski R, Fargason R, Kiefe CI. Source: Health Services Research. 2003 August; 38(4): 1081-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12968818&dopt=Abstract

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Identifying possible depression in clinical research: ethical and outcome considerations for the investigator/clinician. Author(s): Clark PC, Deaton C, Dunbar SB. Source: Applied Nursing Research : Anr. 2003 February; 16(1): 53-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624863&dopt=Abstract

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Immunity in adolescents with major depression. Author(s): Schleifer SJ, Bartlett JA, Keller SE, Eckholdt HM, Shiflett SC, Delaney BR. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2002 September; 41(9): 1054-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218426&dopt=Abstract

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Impact of a primary care quality improvement intervention on use of psychotherapy for depression. Author(s): Jaycox LH, Miranda J, Meredith LS, Duan N, Benjamin B, Wells K. Source: Mental Health Services Research. 2003 June; 5(2): 109-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12801074&dopt=Abstract

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Impact of antidepressant discontinuation after acute bipolar depression remission on rates of depressive relapse at 1-year follow-up. Author(s): Altshuler L, Suppes T, Black D, Nolen WA, Keck PE Jr, Frye MA, McElroy S, Kupka R, Grunze H, Walden J, Leverich G, Denicoff K, Luckenbaugh D, Post R. Source: The American Journal of Psychiatry. 2003 July; 160(7): 1252-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832239&dopt=Abstract

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Impact of major depression on chronic medical illness. Author(s): Katon W, Ciechanowski P. Source: Journal of Psychosomatic Research. 2002 October; 53(4): 859-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377294&dopt=Abstract

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Impact of ongoing primary care intervention on long term outcomes in uninsured and insured patients with depression. Author(s): Smith JL, Rost KM, Nutting PA, Elliott CE, Dickinson LM. Source: Medical Care. 2002 December; 40(12): 1210-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12458303&dopt=Abstract

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Impact of primary care depression intervention on employment and workplace conflict outcomes: is value added? Author(s): Smith JL, Rost KM, Nutting PA, Libby AM, Elliott CE, Pyne JM. Source: The Journal of Mental Health Policy and Economics. 2002 March; 5(1): 43-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12529569&dopt=Abstract

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Impact of religious activity on depression and quality of life of chronic peritoneal dialysis patients in Taiwan. Author(s): Kao TW, Tsai DM, Wu KD, Shiah CJ, Hsieh BS, Chen WY. Source: J Formos Med Assoc. 2003 February; 102(2): 127-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709745&dopt=Abstract

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Impacting late life depression: integrating a depression intervention into primary care. Author(s): Oishi SM, Shoai R, Katon W, Callahan C, Unutzer J, Arean P, Callahan C, Della Penna R, Harpole L, Hegel M, Noel PH, Hoffing M, Hunkeler EM, Katon W, Levine S, Lin EH, Oddone E, Oishi S, Unutzer J, Williams J; Improving Mood: Promoting Access to Collaborative Treatment Investigators. Source: The Psychiatric Quarterly. 2003 Spring; 74(1): 75-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602790&dopt=Abstract

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Impaired repression at a 5-hydroxytryptamine 1A receptor gene polymorphism associated with major depression and suicide. Author(s): Lemonde S, Turecki G, Bakish D, Du L, Hrdina PD, Bown CD, Sequeira A, Kushwaha N, Morris SJ, Basak A, Ou XM, Albert PR. Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 2003 September 24; 23(25): 8788-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14507979&dopt=Abstract

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Implementing an office system to improve primary care management of depression. Author(s): Korsen N, Scott P, Dietrich AJ, Oxman T. Source: The Psychiatric Quarterly. 2003 Spring; 74(1): 45-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602788&dopt=Abstract

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Improved detection of depression in primary care through severity evaluation. Author(s): Nease DE, Klinkman MS, Volk RJ. Source: The Journal of Family Practice. 2002 December; 51(12): 1065-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540333&dopt=Abstract

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Improving Australians' depression literacy. Author(s): Parslow RA, Jorm AF. Source: The Medical Journal of Australia. 2002 October 7; 177 Suppl: S117-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358570&dopt=Abstract

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Improving primary care treatment of depression among patients with diabetes mellitus: the design of the pathways study. Author(s): Katon W, Von Korff M, Lin E, Simon G, Ludman E, Bush T, Walker E, Ciechanowski P, Rutter C. Source: General Hospital Psychiatry. 2003 May-June; 25(3): 158-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748028&dopt=Abstract

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Improving the care for depression in patients with comorbid medical illness. Author(s): Koike AK, Unutzer J, Wells KB. Source: The American Journal of Psychiatry. 2002 October; 159(10): 1738-45. Erratum In: Am J Psychiatry 2003 January; 160(1): 204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359681&dopt=Abstract

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Improving the detection and management of depression in primary care. Author(s): Gilbody SM, Whitty PM, Grimshaw JM, Thomas RE. Source: Quality & Safety in Health Care. 2003 April; 12(2): 149-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679514&dopt=Abstract

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Improving the detection of drug abuse, alcohol abuse, and depression in community health centers. Author(s): Olfson M, Tobin JN, Cassells A, Weissman M. Source: Journal of Health Care for the Poor and Underserved. 2003 August; 14(3): 386402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12955918&dopt=Abstract

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Inadequate treatment of depression after myocardial infarction. Author(s): Luutonen S, Holm H, Salminen JK, Risla A, Salokangas RK. Source: Acta Psychiatrica Scandinavica. 2002 December; 106(6): 434-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392486&dopt=Abstract

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Incidence and clinical course of major depression in patients with chronic hepatitis type C undergoing interferon-alpha therapy: a prospective study. Author(s): Horikawa N, Yamazaki T, Izumi N, Uchihara M. Source: General Hospital Psychiatry. 2003 January-February; 25(1): 34-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12583926&dopt=Abstract

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Incidence of senile dementia and depression in elderly population in Xicheng District, Beijing, an epidemiologic study. Author(s): Yan F, Li S, Liu J, Zhang W, Chen C, Liu M, Xu L, Li S, Shao J, Wu H, Wang Y, Liang K, Zhao C, Lei X. Source: Zhonghua Yi Xue Za Zhi. 2002 August 10; 82(15): 1025-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194791&dopt=Abstract

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Increased amygdala: hippocampal volume ratios associated with severity of anxiety in pediatric major depression. Author(s): MacMillan S, Szeszko PR, Moore GJ, Madden R, Lorch E, Ivey J, Banerjee SP, Rosenberg DR. Source: Journal of Child and Adolescent Psychopharmacology. 2003 Spring; 13(1): 65-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804127&dopt=Abstract

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Increased postoperative pain scores in chronic depression patients who take antidepressants. Author(s): Kudoh A, Katagai H, Takazawa T. Source: Journal of Clinical Anesthesia. 2002 September; 14(6): 421-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12393109&dopt=Abstract

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Infection, treatment and immune response in patients with bipolar disorder versus patients with major depression, schizophrenia or healthy controls. Author(s): Hinze-Selch D. Source: Bipolar Disorders. 2002; 4 Suppl 1: 81-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479687&dopt=Abstract

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Inflammatory proteins and depression in the elderly. Author(s): Tiemeier H, Hofman A, van Tuijl HR, Kiliaan AJ, Meijer J, Breteler MM. Source: Epidemiology (Cambridge, Mass.). 2003 January; 14(1): 103-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500057&dopt=Abstract

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Influence of a functional polymorphism within the angiotensin I-converting enzyme gene on partial sleep deprivation in patients with major depression. Author(s): Baghai TC, Schule C, Zwanzger P, Zill P, Ella R, Eser D, Deiml T, Minov C, Rupprecht R, Bondy B. Source: Neuroscience Letters. 2003 March 27; 339(3): 223-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633893&dopt=Abstract

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Influence of cognitive impairment, illness, gender, and African-American status on psychiatric ratings and staff recognition of depression. Author(s): Teresi JA, Abrams R, Holmes D, Ramirez M, Shapiro C, Eimicke JP. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 September-October; 10(5): 506-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213684&dopt=Abstract

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Influence of depression on patients satisfaction with the outcome of microsurgical "key-hole" vs classical discectomy: prospective matched-cohort study. Author(s): Ljubicic Bistrovic I, Ljubicic D, Ekl D, Penezic L, Mocenic D, Stancic MF. Source: Croatian Medical Journal. 2002 December; 43(6): 702-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476480&dopt=Abstract

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Influence of gender and hemispheric lateralization on heat pain perception in major depression. Author(s): Bar KJ, Greiner W, Letsch A, Kobele R, Sauer H. Source: Journal of Psychiatric Research. 2003 July-August; 37(4): 345-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765857&dopt=Abstract

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Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Author(s): Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, McClay J, Mill J, Martin J, Braithwaite A, Poulton R. Source: Science. 2003 July 18; 301(5631): 386-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12869766&dopt=Abstract

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Influence of sleep deprivation on neuroactive steroids in major depression. Author(s): Schule C, di Michele F, Baghai T, Romeo E, Bernardi G, Zwanzger P, Padberg F, Pasini A, Rupprecht R. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 March; 28(3): 577-81. Epub 2002 October 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629540&dopt=Abstract

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Inhibition of norepinephrine uptake in patients with major depression treated with paroxetine. Author(s): Gilmor ML, Owens MJ, Nemeroff CB. Source: The American Journal of Psychiatry. 2002 October; 159(10): 1702-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359676&dopt=Abstract

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In-hospital symptoms of depression do not predict mortality 3 years after myocardial infarction. Author(s): Lane D, Carroll D, Ring C, Beevers DG, Lip GY. Source: International Journal of Epidemiology. 2002 December; 31(6): 1179-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540719&dopt=Abstract

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Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features. Author(s): Dell'Osso L, Pini S, Cassano GB, Mastrocinque C, Seckinger RA, Saettoni M, Papasogli A, Yale SA, Amador XF. Source: Bipolar Disorders. 2002 October; 4(5): 315-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479664&dopt=Abstract

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Integrating mental health into primary health care in Nigeria: management of depression in a local government (district) area as a paradigm. Author(s): Odejide AO, Morakinyo JJ, Oshiname FO, Omigbodun O, Ajuwon AJ, Kola L. Source: Seishin Shinkeigaku Zasshi. 2002; 104(10): 802-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607921&dopt=Abstract

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Interaction between mother's and father's affection as a risk factor for anxiety and depression symptoms--evidence for increased risk in adults who rate their father as having been more affectionate than their mother. Author(s): Jorm AF, Dear KB, Rodgers B, Christensen H. Source: Social Psychiatry and Psychiatric Epidemiology. 2003 April; 38(4): 173-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12664227&dopt=Abstract

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Interferon beta1a and depression in secondary progressive MS: data from the SPECTRIMS Trial. Author(s): Patten SB, Metz LM; SPECTRIMS Study Group. Source: Neurology. 2002 September 10; 59(5): 744-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221168&dopt=Abstract

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Interferon beta-1a-induced depression and suicidal ideation in multiple sclerosis. Author(s): Lana-Peixoto MA, Teixeira AL Jr, Haase VG. Source: Arquivos De Neuro-Psiquiatria. 2002 September; 60(3-B): 721-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364937&dopt=Abstract

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Interleukin-18 and CD30 serum levels in patients with moderate-severe depression. Author(s): Merendino RA, Di Rosa AE, Di Pasquale G, Minciullo PL, Mangraviti C, Costantino A, Ruello A, Gangemi S. Source: Mediators of Inflammation. 2002 August; 11(4): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396479&dopt=Abstract

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Intermittent burst-firing weak (1 microTesla) magnetic fields reduce psychometric depression in patients who sustained closed head injuries: a replication and electroencephalographic validation. Author(s): Baker-Price L, Persinger MA. Source: Percept Mot Skills. 2003 June; 96(3 Pt 1): 965-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12831278&dopt=Abstract

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Interpersonal problems, personality pathology, and social adjustment after cognitive therapy for depression. Author(s): Vittengl JR, Clark LA, Jarrett RB. Source: Psychological Assessment. 2003 March; 15(1): 29-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674722&dopt=Abstract

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Interpersonal stress and depression in women. Author(s): Hammen C. Source: Journal of Affective Disorders. 2003 March; 74(1): 49-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646298&dopt=Abstract

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Is case-finding an inefficient way of addressing depression as a public health problem? Author(s): Coyne JC, Palmer SC, Sullivan PA. Source: Pharmacoepidemiology and Drug Safety. 2002 October-November; 11(7): 545-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462130&dopt=Abstract

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Is depression normal in human beings? A critique of the evolutionary perspective. Author(s): McLoughlin G. Source: International Journal of Mental Health Nursing. 2002 September; 11(3): 170-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12510594&dopt=Abstract

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Is depression taxonic, dimensional, or both? Author(s): Beach SR, Amir N. Source: Journal of Abnormal Psychology. 2003 May; 112(2): 228-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784832&dopt=Abstract

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Is exercise a good treatment for depression? Author(s): Miller MC. Source: The Harvard Mental Health Letter / from Harvard Medical School. 2003 June; 19(12): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12835136&dopt=Abstract

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Is late onset depression a prodrome to dementia? Author(s): Schweitzer I, Tuckwell V, O'Brien J, Ames D. Source: International Journal of Geriatric Psychiatry. 2002 November; 17(11): 997-1005. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404648&dopt=Abstract

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Is recurrent brief depression an expression of mood spectrum disorders in young people? Results of a large community sample. Author(s): Carta MG, Altamura AC, Hardoy MC, Pinna F, Medda S, Dell'Osso L, Carpiniello B, Angst J. Source: European Archives of Psychiatry and Clinical Neuroscience. 2003 June; 253(3): 149-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12904979&dopt=Abstract

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Is there a genetic relationship between alcoholism and depression? Author(s): Nurnberger JI Jr, Foroud T, Flury L, Meyer ET, Wiegand R. Source: Alcohol Research & Health : the Journal of the National Institute on Alcohol Abuse and Alcoholism. 2002; 26(3): 233-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875052&dopt=Abstract

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Is there a link between atypical and early-onset "unipolar" depression and bipolar II disorder? Author(s): Benazzi F. Source: Comprehensive Psychiatry. 2003 March-April; 44(2): 102-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658618&dopt=Abstract

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Is there a role for 5-HT1A agonists in the treatment of depression? Author(s): Blier P, Ward NM. Source: Biological Psychiatry. 2003 February 1; 53(3): 193-203. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559651&dopt=Abstract

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Is there a SSRI dose response in treating major depression? The case for re-analysis of current data and for enhancing future study design. Author(s): Baker CB, Woods SW. Source: Depression and Anxiety. 2003; 17(1): 10-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577273&dopt=Abstract

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Is there an association between life events, postnatal depression and thyroid dysfunction in thyroid antibody positive women? Author(s): Oretti RG, Harris B, Lazarus JH, Parkes AB, Crownshaw T. Source: The International Journal of Social Psychiatry. 2003 March; 49(1): 70-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12793517&dopt=Abstract

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Is there an increased risk of dying after depression? Author(s): Ensinck KT, Schuurman AG, van den Akker M, Metsemakers JF, Kester AD, Knottnerus JA, Buntinx F. Source: American Journal of Epidemiology. 2002 December 1; 156(11): 1043-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12446261&dopt=Abstract

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Is treatment-resistant depression a unique subtype of depression? Author(s): Fagiolini A, Kupfer DJ. Source: Biological Psychiatry. 2003 April 15; 53(8): 640-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706950&dopt=Abstract

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Ischemic basis for deep white matter hyperintensities in major depression: a neuropathological study. Author(s): Thomas AJ, O'Brien JT, Davis S, Ballard C, Barber R, Kalaria RN, Perry RH. Source: Archives of General Psychiatry. 2002 September; 59(9): 785-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215077&dopt=Abstract

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Ischemic stroke and depression. Author(s): Desmond DW, Remien RH, Moroney JT, Stern Y, Sano M, Williams JB. Source: Journal of the International Neuropsychological Society : Jins. 2003 March; 9(3): 429-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666767&dopt=Abstract

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It's just different in the country: postnatal depression and group therapy in a rural setting. Author(s): Lane B, Roufeil LM, Williams S, Tweedie R. Source: Soc Work Health Care. 2001; 34(3-4): 333-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243432&dopt=Abstract

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JAMA patient page. Depression. Author(s): Torpy JM, Lynm C, Glass RM. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3198. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813126&dopt=Abstract

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Kinematic analysis of handwriting movements in patients with Alzheimer's disease, mild cognitive impairment, depression and healthy subjects. Author(s): Schroter A, Mergl R, Burger K, Hampel H, Moller HJ, Hegerl U. Source: Dementia and Geriatric Cognitive Disorders. 2003; 15(3): 132-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584428&dopt=Abstract

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Knowledge about postpartum depression is family's responsibility. Author(s): Henderson BJ. Source: Pediatric Nursing. 2002 September-October; 28(5): 542. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12424995&dopt=Abstract

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Lack of age differences in the Beck Depression Inventory-II scores of clinically depressed adolescent outpatients. Author(s): Krefetz DG, Steer RA, Kumar G. Source: Psychological Reports. 2003 April; 92(2): 489-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785631&dopt=Abstract

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Lack of association between suicidal ideation and enhanced platelet 5-HT2A receptormediated calcium mobilization in cancer patients with depression. Author(s): Uchitomi Y, Kugaya A, Akechi T, Nakano T, Inagaki M, Matsuoka Y, Kagaya A, Yamawaki S. Source: Biological Psychiatry. 2002 December 15; 52(12): 1159-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488061&dopt=Abstract

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Lamotrigine as an augmentation agent in treatment-resistant depression. Author(s): Barbee JG, Jamhour NJ. Source: The Journal of Clinical Psychiatry. 2002 August; 63(8): 737-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197456&dopt=Abstract

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Lamotrigine augmentation in unipolar depression. Author(s): Rocha FL, Hara C. Source: International Clinical Psychopharmacology. 2003 March; 18(2): 97-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598821&dopt=Abstract

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Lamotrigine use in geriatric patients with bipolar depression. Author(s): Robillard M, Conn DK. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 October; 47(8): 767-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420655&dopt=Abstract

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Larger amygdala volumes in first depressive episode as compared to recurrent major depression and healthy control subjects. Author(s): Frodl T, Meisenzahl EM, Zetzsche T, Born C, Jager M, Groll C, Bottlender R, Leinsinger G, Moller HJ. Source: Biological Psychiatry. 2003 February 15; 53(4): 338-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12586453&dopt=Abstract

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Late-life depression and mental health services in primary care. Author(s): Wagenaar DB, Mickus MA, Gaumer KA, Colenda CC. Source: Journal of Geriatric Psychiatry and Neurology. 2002 Fall; 15(3): 134-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12230083&dopt=Abstract

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Late-life depression is associated with arterial stiffness: a population-based study. Author(s): Tiemeier H, Breteler MM, van Popele NM, Hofman A, Witteman JC. Source: Journal of the American Geriatrics Society. 2003 August; 51(8): 1105-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12890073&dopt=Abstract

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Late-life depression: its oral health significance. Author(s): Friedlander AH, Friedlander IK, Gallas M, Velasco E. Source: Int Dent J. 2003 February; 53(1): 41-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653339&dopt=Abstract

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Late-life depression: psychopathology, medical interventions, and dental implications. Author(s): Friedlander AH, Norman DC. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2002 October; 94(4): 404-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12374911&dopt=Abstract

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Late-life depression: rationalizing pharmacological treatment options. Author(s): Montgomery SA. Source: Gerontology. 2002 November-December; 48(6): 392-400. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12393956&dopt=Abstract

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Lateral asymmetries in the frontal brain: effects of depression and a family history of alcoholism in female adolescents. Author(s): Bauer LO, Hesselbrock VM. Source: Alcoholism, Clinical and Experimental Research. 2002 November; 26(11): 1662-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436054&dopt=Abstract

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Life after primary care depression quality improvement intervention. Author(s): Rost K. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 2002 October; 17(10): 811. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12390558&dopt=Abstract

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Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety. Author(s): Kendler KS, Hettema JM, Butera F, Gardner CO, Prescott CA. Source: Archives of General Psychiatry. 2003 August; 60(8): 789-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12912762&dopt=Abstract

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Life events and changes in the course of depression in young adults. Author(s): Friis RH, Wittchen HU, Pfister H, Lieb R. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2002 September; 17(5): 241-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381493&dopt=Abstract

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Life events, number of social relationships, and twelve-month naturalistic course of major depression in a community sample of women. Author(s): Wildes JE, Harkness KL, Simons AD. Source: Depression and Anxiety. 2002; 16(3): 104-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415534&dopt=Abstract

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Lifetime depressive and somatic symptoms as preclinical markers of late-onset depression. Author(s): Hein S, Bonsignore M, Barkow K, Jessen F, Ptok U, Heun R. Source: European Archives of Psychiatry and Clinical Neuroscience. 2003 February; 253(1): 16-21. Erratum In: Eur Arch Psychiatry Clin Neurosci. 2003 April; 253(2): 110. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12664308&dopt=Abstract

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Lifetime history of depression and carotid atherosclerosis in middle-aged women. Author(s): Jones DJ, Bromberger JT, Sutton-Tyrrell K, Matthews KA. Source: Archives of General Psychiatry. 2003 February; 60(2): 153-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578432&dopt=Abstract

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Lifetime physical and sexual abuse, substance abuse, depression, and suicide attempts among Native American women. Author(s): Bohn DK. Source: Issues in Mental Health Nursing. 2003 April-May; 24(3): 333-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623689&dopt=Abstract

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Lifetime symptoms of depression in Alzheimer's disease. Author(s): Heun R, Kockler M, Ptok U. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2003 March; 18(2): 63-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711401&dopt=Abstract

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Links in the chain of adversity following job loss: how financial strain and loss of personal control lead to depression, impaired functioning, and poor health. Author(s): Price RH, Choi JN, Vinokur AD. Source: Journal of Occupational Health Psychology. 2002 October; 7(4): 302-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396064&dopt=Abstract

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Literacy and comprehension of Beck Depression Inventory response alternatives. Author(s): Sentell TL, Ratcliff-Baird B. Source: Community Mental Health Journal. 2003 August; 39(4): 323-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12908646&dopt=Abstract

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Lithium augmentation in treatment-refractory unipolar depression. Author(s): Lee W, Cleare A. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 May; 182: 456; Author Reply 456-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724254&dopt=Abstract

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Lithium augmentation increases post-dexamethasone cortisol in the dexamethasone suppression test in unipolar major depression. Author(s): Bschor T, Baethge C, Adli M, Eichmann U, Ising M, Uhr M, MullerOerlinghausen B, Bauer M. Source: Depression and Anxiety. 2003; 17(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577277&dopt=Abstract

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Lithium augmentation increases the ACTH and cortisol response in the combined DEX/CRH test in unipolar major depression. Author(s): Bschor T, Adli M, Baethge C, Eichmann U, Ising M, Uhr M, Modell S, Kunzel H, Muller-Oerlinghausen B, Bauer M. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 September; 27(3): 470-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225704&dopt=Abstract

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Lithium augmentation therapy in refractory depression-update 2002. Author(s): Bauer M, Forsthoff A, Baethge C, Adli M, Berghofer A, Dopfmer S, Bschor T. Source: European Archives of Psychiatry and Clinical Neuroscience. 2003 June; 253(3): 132-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12904977&dopt=Abstract

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Lithium combinations in acute and maintenance treatment of unipolar and bipolar depression. Author(s): Fawcett JA. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 5: 32-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12720482&dopt=Abstract

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Living with heart failure: depression and quality of life in patients and spouses. Author(s): Martensson J, Dracup K, Canary C, Fridlund B. Source: The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation. 2003 April; 22(4): 460-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681424&dopt=Abstract

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Localization of age-associated white matter hyperintensities in late-life depression. Author(s): Taylor WD, MacFall JR, Steffens DC, Payne ME, Provenzale JM, Krishnan KR. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2003 May; 27(3): 539-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691791&dopt=Abstract

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Lone mothers, social exclusion and depression. Author(s): Targosz S, Bebbington P, Lewis G, Brugha T, Jenkins R, Farrell M, Meltzer H. Source: Psychological Medicine. 2003 May; 33(4): 715-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785473&dopt=Abstract

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Loneliness and depression in spousal caregivers of those with Alzheimer's disease versus non-caregiving spouses. Author(s): Beeson RA. Source: Archives of Psychiatric Nursing. 2003 June; 17(3): 135-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12840806&dopt=Abstract

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Loneliness, health and depression in older males. Author(s): Alpass FM, Neville S. Source: Aging & Mental Health. 2003 May; 7(3): 212-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775403&dopt=Abstract

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Long-lasting cognitive impairment in unipolar major depression: a 6-month followup study. Author(s): Hammar A, Lund A, Hugdahl K. Source: Psychiatry Research. 2003 May 30; 118(2): 189-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798984&dopt=Abstract

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Long-term depression of the human blink reflex. Author(s): Schorr A, Ellrich J. Source: Experimental Brain Research. Experimentelle Hirnforschung. Experimentation Cerebrale. 2002 December; 147(4): 549-53. Epub 2002 October 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444487&dopt=Abstract

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Low dosage tricyclic antidepressants for depression. Author(s): Furukawa T, McGuire H, Barbui C. Source: Cochrane Database Syst Rev. 2003; (3): Cd003197. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917952&dopt=Abstract

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Low dosage tricyclic antidepressants in depression. Evidence to change current guidelines is insufficient. Author(s): Ali IM. Source: Bmj (Clinical Research Ed.). 2003 March 1; 326(7387): 499; Author Reply 499. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617073&dopt=Abstract

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Low dosage tricyclic antidepressants in depression. Giving low dose tricyclics is not justified by evidence. Author(s): Jones HM. Source: Bmj (Clinical Research Ed.). 2003 March 1; 326(7387): 499; Author Reply 499. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12609953&dopt=Abstract

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Low dosage tricyclic antidepressants in depression. Non-superiority does not equal equivalence. Author(s): Martin JE. Source: Bmj (Clinical Research Ed.). 2003 March 1; 326(7387): 499; Author Reply 499. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617074&dopt=Abstract

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Low-density lipoprotein cholesterol and post-myocardial infarction depression. Author(s): Ziegelstein RC. Source: The American Journal of Cardiology. 2003 June 15; 91(12): 1532. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804755&dopt=Abstract

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Maintenance efficacy of divalproex in the prevention of bipolar depression. Author(s): Gyulai L, Bowden CL, McElroy SL, Calabrese JR, Petty F, Swann AC, Chou JC, Wassef A, Risch CS, Hirschfeld RM, Nemeroff CB, Keck PE Jr, Evans DL, Wozniak PJ. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 July; 28(7): 1374-82. Epub 2003 May 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784116&dopt=Abstract

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Major depression and conduct disorder in a twin sample: gender, functioning, and risk for future psychopathology. Author(s): Marmorstein NR, Iacono WG. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 February; 42(2): 225-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544183&dopt=Abstract

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Major depression in 6050 former drinkers: association with past alcohol dependence. Author(s): Hasin DS, Grant BF. Source: Archives of General Psychiatry. 2002 September; 59(9): 794-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215078&dopt=Abstract

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Major depression with ischemic heart disease: effects of paroxetine and nortriptyline on long-term heart rate variability measures. Author(s): Yeragani VK, Pesce V, Jayaraman A, Roose S. Source: Biological Psychiatry. 2002 September 1; 52(5): 418-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12242058&dopt=Abstract

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Major depression with ischemic heart disease: effects of paroxetine and nortriptyline on measures of nonlinearity and chaos of heart rate. Author(s): Yeragani VK, Roose S, Mallavarapu M, Radhakrishna RK, Pesce V. Source: Neuropsychobiology. 2002; 46(3): 125-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422059&dopt=Abstract

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Management of cancer symptoms: pain, depression, and fatigue. Author(s): Prog Neuropsychopharmacol Biol Psychiatry. 2002 Jun;26(5):1011-8 Source: Evid Rep Technol Assess (Summ). 2002 July; (61): 1-5. No Abstract Available. /entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12369251

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Management of major depression during pregnancy. Author(s): Hendrick V, Altshuler L. Source: The American Journal of Psychiatry. 2002 October; 159(10): 1667-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359670&dopt=Abstract

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Management of recurrent depression in primary care. Author(s): Fava GA, Ruini C, Sonino N. Source: Psychotherapy and Psychosomatics. 2003 January-February; 72(1): 3-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466632&dopt=Abstract

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Managing depression as a chronic disease: a randomised trial of ongoing treatment in primary care. Author(s): Rost K, Nutting P, Smith JL, Elliott CE, Dickinson M. Source: Bmj (Clinical Research Ed.). 2002 October 26; 325(7370): 934. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399343&dopt=Abstract

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Managing depression in primary care: another example of the inverse care law? Author(s): Chew-Graham CA, Mullin S, May CR, Hedley S, Cole H. Source: Family Practice. 2002 December; 19(6): 632-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12429666&dopt=Abstract

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Managing treatment-resistant major depression. Author(s): Nelson JC. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 1: 5-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625799&dopt=Abstract

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Marital distress, co-occurring depression, and marital therapy: a review. Author(s): Mead DE. Source: J Marital Fam Ther. 2002 July; 28(3): 299-314. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197153&dopt=Abstract

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Markers for depression in Parkinson's disease. Author(s): Leentjens AF, Lousberg R, Verhey FR. Source: Acta Psychiatrica Scandinavica. 2002 September; 106(3): 196-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197857&dopt=Abstract

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Maternal depression, paternal psychopathology, and adolescent diagnostic outcomes. Author(s): Brennan PA, Hammen C, Katz AR, Le Brocque RM. Source: Journal of Consulting and Clinical Psychology. 2002 October; 70(5): 1075-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12362958&dopt=Abstract

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Measurement issues in postpartum depression part 1: anxiety as a feature of postpartum depression. Author(s): Ross LE, Gilbert Evans SE, Sellers EM, Romach MK. Source: Archives of Women's Mental Health. 2003 February; 6(1): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715264&dopt=Abstract

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Measurement issues in postpartum depression part 2: assessment of somatic symptoms using the Hamilton Rating Scale for Depression. Author(s): Ross LE, Gilbert Evans SE, Sellers EM, Romach MK. Source: Archives of Women's Mental Health. 2003 February; 6(1): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715265&dopt=Abstract

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Measuring cognitive vulnerability to depression in adolescence: reliability, validity, and gender differences. Author(s): Hankin BL, Abramson LY. Source: Journal of Clinical Child and Adolescent Psychology : the Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 2002 December; 31(4): 491-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12402568&dopt=Abstract

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Measuring depression of elderly Chinese Americans: a replication study. Author(s): Lai DW. Source: Home Health Care Serv Q. 2003; 22(2): 69-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870713&dopt=Abstract

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Measuring outcomes in patients with depression or anxiety: an essential part of clinical practice. Author(s): Andersen-Dalheim H. Source: The Medical Journal of Australia. 2003 March 17; 178(6): 302-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12776735&dopt=Abstract

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Measuring outcomes in patients with depression or anxiety: an essential part of clinical practice. Author(s): Boettcher BM. Source: The Medical Journal of Australia. 2003 March 17; 178(6): 302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633494&dopt=Abstract

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Measuring outcomes in patients with depression or anxiety: an essential part of clinical practice. Author(s): Dinnen A. Source: The Medical Journal of Australia. 2003 January 6; 178(1): 48; Author Reply 48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492398&dopt=Abstract

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Measuring the quality of depression care in a large integrated health system. Author(s): Charbonneau A, Rosen AK, Ash AS, Owen RR, Kader B, Spiro A 3rd, Hankin C, Herz LR, Jo V Pugh M, Kazis L, Miller DR, Berlowitz DR. Source: Medical Care. 2003 May; 41(5): 669-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719691&dopt=Abstract

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Medical comorbidity and receipt of medical care by older homeless people with schizophrenia or depression. Author(s): Folsom DP, McCahill M, Bartels SJ, Lindamer LA, Ganiats TG, Jeste DV. Source: Psychiatric Services (Washington, D.C.). 2002 November; 53(11): 1456-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407275&dopt=Abstract

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Medication treatment for depression in children and adolescents. Author(s): Ryan ND. Source: Cns Spectr. 2003 April; 8(4): 283-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679743&dopt=Abstract

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Mefloquine-induced paranoid psychosis and subsequent major depression in a 25year-old student. Author(s): Dietz A, Frolich L. Source: Pharmacopsychiatry. 2002 September; 35(5): 200-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12237793&dopt=Abstract

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Melatonin response to atenolol administration in depression: indication of betaadrenoceptor dysfunction in a subtype of depression. Author(s): Paparrigopoulos T. Source: Acta Psychiatrica Scandinavica. 2002 December; 106(6): 440-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392487&dopt=Abstract

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Mental health and welfare transitions: depression and alcohol abuse in AFDC women. Author(s): Dooley D, Prause J. Source: American Journal of Community Psychology. 2002 December; 30(6): 787-813. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12385483&dopt=Abstract

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Mental health literacy of those with major depression and suicidal ideation: an impediment to help seeking. Author(s): Goldney RD, Fisher LJ, Wilson DH, Cheok F. Source: Suicide & Life-Threatening Behavior. 2002 Winter; 32(4): 394-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12501964&dopt=Abstract

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Meta-analysis of effects and side effects of low dosage tricyclic antidepressants in depression: systematic review. Author(s): Furukawa TA, McGuire H, Barbui C. Source: Bmj (Clinical Research Ed.). 2002 November 2; 325(7371): 991. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411354&dopt=Abstract

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Migraine, major depression, panic disorder, and personality traits in women aged 4074 years: a population-based study. Author(s): Mattsson P, Ekselius L. Source: Cephalalgia : an International Journal of Headache. 2002 September; 22(7): 54351. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12230596&dopt=Abstract

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Mineralocorticoid receptor function in major depression. Author(s): Young EA, Lopez JF, Murphy-Weinberg V, Watson SJ, Akil H. Source: Archives of General Psychiatry. 2003 January; 60(1): 24-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12511169&dopt=Abstract

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Mirtazapine for treatment-resistant depression: a preliminary report. Author(s): Wan DD, Kundhur D, Solomons K, Yatham LN, Lam RW. Source: Journal of Psychiatry & Neuroscience : Jpn. 2003 January; 28(1): 55-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587851&dopt=Abstract

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Modafinil in the treatment of depression with severe comorbid medical illness. Author(s): Schwartz TL, Leso L, Beale M, Ahmed R, Naprawa S. Source: Psychosomatics. 2002 July-August; 43(4): 336-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12189262&dopt=Abstract

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Modeling the spreading cortical depression wavefront. Author(s): Baysal U, Haueisen J. Source: Annals of the New York Academy of Sciences. 2002 October; 972: 127-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496007&dopt=Abstract

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Modulating limbic-cortical circuits in depression: targets of antidepressant treatments. Author(s): Mayberg HS. Source: Semin Clin Neuropsychiatry. 2002 October; 7(4): 255-68. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382208&dopt=Abstract

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Monitoring the response to rTMS in depression with visual analog scales. Author(s): Grunhaus L, Dolberg OT, Polak D, Dannon PN. Source: Human Psychopharmacology. 2002 October; 17(7): 349-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415554&dopt=Abstract

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Motherhood as a vulnerability factor in major depression: the role of negative pregnancy experiences. Author(s): Bernazzani O, Bifulco A. Source: Social Science & Medicine (1982). 2003 March; 56(6): 1249-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12600362&dopt=Abstract

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Mounting student depression taxing campus mental health services. Author(s): Voelker R. Source: Jama : the Journal of the American Medical Association. 2003 April 23-30; 289(16): 2055-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709447&dopt=Abstract

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MRI subcortical hyperintensities in old and very old depressed outpatients: the important role of age in late-life depression. Author(s): Salloway S, Correia S, Boyle P, Malloy P, Schneider L, Lavretsky H, Sackheim H, Roose S, Krishnan KR. Source: Journal of the Neurological Sciences. 2002 November 15; 203-204: 227-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417389&dopt=Abstract

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Multiple sclerosis, depression, and the risk of suicide. Author(s): Caine ED, Schwid SR. Source: Neurology. 2002 September 10; 59(5): 662-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221154&dopt=Abstract

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Mutuality as background music in women's lived experience of mental health and depression. Author(s): Hedelin B, Jonsson I. Source: Journal of Psychiatric and Mental Health Nursing. 2003 June; 10(3): 317-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755916&dopt=Abstract

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Narcissism and depression: MMPI-2 evidence for the continuum hypothesis in clinical samples. Author(s): Watson PJ, Sawrie SM, Greene RL, Arredondo R. Source: Journal of Personality Assessment. 2002 August; 79(1): 85-109. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12227670&dopt=Abstract

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National Institutes of Health State-of-the-Science Conference Statement: Symptom Management in Cancer: Pain, Depression, and Fatigue, July 15-17, 2002. Author(s): Patrick DL, Ferketich SL, Frame PS, Harris JJ, Hendricks CB, Levin B, Link MP, Lustig C, McLaughlin J, Ried LD, Turrisi AT 3rd, Unutzer J, Vernon SW; National Institutes of Health State-of-the-Science Panel. Source: Journal of the National Cancer Institute. 2003 August 6; 95(15): 1110-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902440&dopt=Abstract

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Nefazodone in psychotic unipolar and bipolar depression: a retrospective chart analysis and open prospective study on its efficacy and safety versus combined treatment with amitriptyline and haloperidol. Author(s): Grunze H, Marcuse A, Scharer LO, Born C, Walden J. Source: Neuropsychobiology. 2002; 46 Suppl 1: 31-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571431&dopt=Abstract

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Negative mood, depressive symptoms, and major depression after smoking cessation treatment in smokers with a history of major depressive disorder. Author(s): Kahler CW, Brown RA, Ramsey SE, Niaura R, Abrams DB, Goldstein MG, Mueller TI, Miller IW. Source: Journal of Abnormal Psychology. 2002 November; 111(4): 670-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428781&dopt=Abstract

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Neopterin production, tryptophan degradation, and mental depression--what is the link? Author(s): Widner B, Laich A, Sperner-Unterweger B, Ledochowski M, Fuchs D. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 590-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401473&dopt=Abstract

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Neurobiological effects of childhood abuse: implications for the pathophysiology of depression and anxiety. Author(s): Penza KM, Heim C, Nemeroff CB. Source: Archives of Women's Mental Health. 2003 February; 6(1): 15-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715261&dopt=Abstract

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Neurochemical aspects of susceptibility to depression. Author(s): Nathan PJ. Source: Jama : the Journal of the American Medical Association. 2003 September 10; 290(10): 1315-6; Author Reply 1316. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12966120&dopt=Abstract

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Neuroendocrine aspects of hypercortisolism in major depression. Author(s): Parker KJ, Schatzberg AF, Lyons DM. Source: Hormones and Behavior. 2003 January; 43(1): 60-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614635&dopt=Abstract

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Neuropathological evidence for ischemia in the white matter of the dorsolateral prefrontal cortex in late-life depression. Author(s): Thomas AJ, Perry R, Kalaria RN, Oakley A, McMeekin W, O'Brien JT. Source: International Journal of Geriatric Psychiatry. 2003 January; 18(1): 7-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12497551&dopt=Abstract

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Neuropeptide Y (NPY) and depression: from animal studies to the human condition. Author(s): Redrobe JP, Dumont Y, Quirion R. Source: Life Sciences. 2002 November 8; 71(25): 2921-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12384178&dopt=Abstract

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Neuropeptides and the hypothalamic-pituitary-adrenocortical (HPA) system: review of recent research strategies in depression. Author(s): Hatzinger M. Source: World J Biol Psychiatry. 2000 April; 1(2): 105-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607206&dopt=Abstract

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Neuropsychopharmacologic treatment of depression and other neuropsychiatric disorders in HIV-infected individuals. Author(s): Repetto MJ, Evans DL, Cruess DG, Gettes DR, Douglas SD, Petitto JM. Source: Cns Spectr. 2003 January; 8(1): 59-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627050&dopt=Abstract

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Neuroscience. Depression drugs' powers may rest on new neurons. Author(s): Vogel G. Source: Science. 2003 August 8; 301(5634): 757. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12907775&dopt=Abstract

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Neurosteroids in depression: a review. Author(s): van Broekhoven F, Verkes RJ. Source: Psychopharmacology. 2003 January; 165(2): 97-110. Epub 2002 November 06. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420152&dopt=Abstract

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Neurosurgery for intractable obsessive-compulsive disorder and depression: critical issues. Author(s): Greenberg BD, Price LH, Rauch SL, Friehs G, Noren G, Malone D, Carpenter LL, Rezai AR, Rasmussen SA. Source: Neurosurg Clin N Am. 2003 April; 14(2): 199-212. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856488&dopt=Abstract

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Neuroticism and depression. Author(s): McWilliams L. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 January; 182: 80; Author Reply 80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509326&dopt=Abstract

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Neuroticism and depression. Author(s): Hodgins S, Ellenbogen M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 January; 182: 79-80; Author Reply 80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509325&dopt=Abstract

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Neurotrophic effects of electroconvulsive therapy: a proton magnetic resonance study of the left amygdalar region in patients with treatment-resistant depression. Author(s): Michael N, Erfurth A, Ohrmann P, Arolt V, Heindel W, Pfleiderer B. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 April; 28(4): 720-5. Epub 2002 October 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655317&dopt=Abstract

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New approaches in managing bipolar depression. Author(s): Keck PE Jr, McElroy SL. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 1: 13-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625800&dopt=Abstract

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New approaches to managing psychotic depression. Author(s): Schatzberg AF. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 1: 19-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625801&dopt=Abstract

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New hope in the treatment of painful symptoms in depression. Author(s): Briley M. Source: Curr Opin Investig Drugs. 2003 January; 4(1): 42-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625027&dopt=Abstract

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New insights into the role of cortisol and the glucocorticoid receptor in severe depression. Author(s): Gold PW, Drevets WC, Charney DS. Source: Biological Psychiatry. 2002 September 1; 52(5): 381-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12242053&dopt=Abstract

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New perspectives in the acute treatment of bipolar depression. Author(s): Grunze H, Schlosser S, Walden J. Source: World J Biol Psychiatry. 2000 July; 1(3): 129-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607221&dopt=Abstract

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NIH releases statement on managing pain, depression, and fatigue in cancer. Author(s): Ressel GW; National Institutes of Health. Source: American Family Physician. 2003 January 15; 67(2): 423-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562162&dopt=Abstract

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Nitric oxide, stress, and depression. Author(s): McLeod TM, Lopez-Figueroa AL, Lopez-Figueroa MO. Source: Psychopharmacology Bulletin. 2001 Winter; 35(1): 24-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397868&dopt=Abstract

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Non diagnosed depression among the institutionalized population in a rural area. Author(s): Perez-Jara J, Lucia E, Mayo F, Leon JJ, Alvarez J, Frei F, Enguix A. Source: International Journal of Geriatric Psychiatry. 2002 October; 17(10): 974-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12325060&dopt=Abstract

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Non-peptidic CRF1 receptor antagonists for the treatment of anxiety, depression and stress disorders. Author(s): Kehne J, De Lombaert S. Source: Current Drug Targets. Cns and Neurological Disorders. 2002 October; 1(5): 46793. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12769601&dopt=Abstract

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Nonsomatic treatment of depression. Author(s): Sherrill JT, Kovacs M. Source: Child Adolesc Psychiatr Clin N Am. 2002 July; 11(3): 579-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12222084&dopt=Abstract

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Norepinephrine alters the expression of genes involved in neuronal sprouting and differentiation: relevance for major depression and antidepressant mechanisms. Author(s): Laifenfeld D, Klein E, Ben-Shachar D. Source: Journal of Neurochemistry. 2002 December; 83(5): 1054-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437576&dopt=Abstract

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Normal variation and abnormality: an empirical study of the liability distributions underlying depression and delinquency. Author(s): van den Oord EJ, Pickles A, Waldman ID. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2003 February; 44(2): 180-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587855&dopt=Abstract

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Normative data on cognitive measures of depression. Author(s): Dozois DJ, Covin R, Brinker JK. Source: Journal of Consulting and Clinical Psychology. 2003 February; 71(1): 71-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602427&dopt=Abstract

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Nortriptyline for treatment-resistant depression. Author(s): Nierenberg AA, Papakostas GI, Petersen T, Kelly KE, Iacoviello BM, Worthington JJ, Tedlow J, Alpert JE, Fava M. Source: The Journal of Clinical Psychiatry. 2003 January; 64(1): 35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590621&dopt=Abstract

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Obesity-depression associations in the population. Author(s): Faith MS, Matz PE, Jorge MA. Source: Journal of Psychosomatic Research. 2002 October; 53(4): 935-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377306&dopt=Abstract

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Obstructive sleep apnea and depression. Author(s): Baran AS, Richert AC. Source: Cns Spectr. 2003 February; 8(2): 120-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12612498&dopt=Abstract

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Occupational differences in levels of anxiety and depression: the Hordaland Health Study. Author(s): Sanne B, Mykletun A, Dahl AA, Moen BE, Tell GS; Hordaland Health Study. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2003 June; 45(6): 628-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802216&dopt=Abstract

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Occurrence and course of suicidality during short-term treatment of late-life depression. Author(s): Szanto K, Mulsant BH, Houck P, Dew MA, Reynolds CF 3rd. Source: Archives of General Psychiatry. 2003 June; 60(6): 610-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796224&dopt=Abstract

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Older community residents with depression: long-term treatment with sertraline. Randomised, double-blind, placebo-controlled study. Author(s): Wilson KC, Mottram PG, Ashworth L, Abou-Saleh MT. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 June; 182: 492-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777339&dopt=Abstract

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On the importance of anonymity in surveying medical student depression. Author(s): Myers M. Source: Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2003 Spring; 27(1): 19-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824116&dopt=Abstract

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On the role of menopause for sleep-endocrine alterations associated with major depression. Author(s): Antonijevic IA, Murck H, Frieboes RM, Uhr M, Steiger A. Source: Psychoneuroendocrinology. 2003 April; 28(3): 401-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12573305&dopt=Abstract

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On the role of serotonin in sleep regulation and depression. A commentary on "Neurobiological bases for the relation between sleep and depression" (J. Adrien). Author(s): Giedke H. Source: Sleep Medicine Reviews. 2003 February; 7(1): 101-2; Author Reply 103-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12586533&dopt=Abstract

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Onset of major depression during treatment for nicotine dependence. Author(s): Killen JD, Fortmann SP, Schatzberg A, Hayward C, Varady A. Source: Addictive Behaviors. 2003 April; 28(3): 461-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12628619&dopt=Abstract

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Open-label evaluation of venlafaxine sustained release in outpatients with generalized anxiety disorder with comorbid major depression or dysthymia: effectiveness, tolerability and predictors of response. Author(s): Perugi G, Frare F, Toni C, Ruffolo G, Torti C. Source: Neuropsychobiology. 2002; 46(3): 145-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422062&dopt=Abstract

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Optimizing outcomes in depression: focus on antidepressant compliance. Author(s): Keller MB, Hirschfeld RM, Demyttenaere K, Baldwin DS. Source: International Clinical Psychopharmacology. 2002 November; 17(6): 265-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409679&dopt=Abstract

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Oral versus written administration of the Geriatric Depression Scale. Author(s): Cannon BJ, Thaler T, Roos S. Source: Aging & Mental Health. 2002 November; 6(4): 418-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12425776&dopt=Abstract

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Outcomes of patients completing and not completing cognitive therapy for depression. Author(s): Cahill J, Barkham M, Hardy G, Rees A, Shapiro DA, Stiles WB, Macaskill N. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2003 June; 42(Pt 2): 133-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828803&dopt=Abstract

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Overcoming depression on the Internet (ODIN): a randomized controlled trial of an Internet depression skills intervention program. Author(s): Clarke G, Reid E, Eubanks D, O'Connor E, DeBar LL, Kelleher C, Lynch F, Nunley S. Source: Journal of Medical Internet Research [electronic Resource]. 2002 December; 4(3): E14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12554545&dopt=Abstract

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Overlap between emotional blunting, depression, and extrapyramidal symptoms in schizophrenia. Author(s): Muller M. Source: Schizophrenia Research. 2002 October 1; 57(2-3): 307. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12223263&dopt=Abstract

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Overview of existing research and information linking isotretinoin (accutane), depression, psychosis, and suicide. Author(s): O'Donnell J. Source: American Journal of Therapeutics. 2003 March-April; 10(2): 148-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629595&dopt=Abstract

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Overview: depression in the elderly. Author(s): Serby M, Yu M. Source: The Mount Sinai Journal of Medicine, New York. 2003 January; 70(1): 38-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12516008&dopt=Abstract

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Parental acceptance, postpartum depression, and maternal sensitivity: mediating and moderating processes. Author(s): Crockenberg SC, Leerkes EM. Source: Journal of Family Psychology : Jfp : Journal of the Division of Family Psychology of the American Psychological Association (Division 43). 2003 March; 17(1): 80-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666465&dopt=Abstract

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Parental care and personality in melancholic and nonmelancholic depression. Author(s): Whiffen VE, Parker GB, Wilhelm K, Mitchell PB, Malhi G. Source: The Journal of Nervous and Mental Disease. 2003 June; 191(6): 358-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826916&dopt=Abstract

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Parental depression, child mental health problems, and health care utilization. Author(s): Olfson M, Marcus SC, Druss B, Alan Pincus H, Weissman MM. Source: Medical Care. 2003 June; 41(6): 716-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12773837&dopt=Abstract

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Paroxetine in major depression. Author(s): Jureidini J, Tonkin A. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 May; 42(5): 514; Author Reply 514-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707552&dopt=Abstract

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Partial response as a predictor of outcome in geriatric depression. Author(s): Steffens DC, McQuoid DR, Krishnan KR. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2003 May-June; 11(3): 340-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724113&dopt=Abstract

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Past, present, and future directions for defining optimal treatment outcome in depression: remission and beyond. Author(s): Keller MB. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3152-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813121&dopt=Abstract

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Pathways to anaclitic and introjective depression. Author(s): Reis S, Grenyer BF. Source: Psychology and Psychotherapy. 2002 December; 75(Pt 4): 445-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626134&dopt=Abstract

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Persecutory ideation and depression in mild violence among incarcerated adult males. Author(s): Beal CA, Kroner DG, Weekes JR. Source: International Journal of Offender Therapy and Comparative Criminology. 2003 April; 47(2): 159-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12710362&dopt=Abstract

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Persistent pain and depression: a biopsychosocial perspective. Author(s): Campbell LC, Clauw DJ, Keefe FJ. Source: Biological Psychiatry. 2003 August 1; 54(3): 399-409. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893114&dopt=Abstract

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Personality and depression in women. Author(s): Widiger TA, Anderson KG. Source: Journal of Affective Disorders. 2003 March; 74(1): 59-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646299&dopt=Abstract

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Personality traits, depression and migraine in women: a longitudinal study. Author(s): Mongini F, Keller R, Deregibus A, Raviola F, Mongini T, Sancarlo M. Source: Cephalalgia : an International Journal of Headache. 2003 April; 23(3): 186-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12662185&dopt=Abstract

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Physical and sexual abuse, depression and alcohol use disorders in adolescents: onsets and outcomes. Author(s): Clark DB, De Bellis MD, Lynch KG, Cornelius JR, Martin CS. Source: Drug and Alcohol Dependence. 2003 January 24; 69(1): 51-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12536066&dopt=Abstract

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Physical symptoms of depression as a public health concern. Author(s): Sartorius N. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 7: 3-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755645&dopt=Abstract

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Physical symptoms of depression: unmet needs in special populations. Author(s): Stewart DE. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 7: 12-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755647&dopt=Abstract

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Physical symptoms of depression: unmet needs. Author(s): Greden JF. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 7: 5-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755646&dopt=Abstract

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Placebo-controlled studies in depression: necessary, ethical and feasible. Author(s): Baldwin D, Broich K, Fritze J, Kasper S, Westenberg H, Moller HJ. Source: European Archives of Psychiatry and Clinical Neuroscience. 2003 February; 253(1): 22-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12664309&dopt=Abstract

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Platelet 5-HT concentration and comorbid depression in war veterans with and without posttraumatic stress disorder. Author(s): Muck-Seler D, Pivac N, Jakovljevic M, Sagud M, Mihaljevic-Peles A. Source: Journal of Affective Disorders. 2003 July; 75(2): 171-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798257&dopt=Abstract

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Platelet surface glycoprotein expression in post-stroke depression: a preliminary study. Author(s): Cassidy EM, Walsh MT, O'Connor R, Condren RM, Ryan M, O'Keane V, Kenny D, Dinan T. Source: Psychiatry Research. 2003 May 30; 118(2): 175-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798982&dopt=Abstract

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Population attributable risk of major depression for suicidal ideation in a random and representative community sample. Author(s): Goldney RD, Dal Grande E, Fisher LJ, Wilson D. Source: Journal of Affective Disorders. 2003 May; 74(3): 267-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738045&dopt=Abstract

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Positive thinking in bereavement: is it related to depression, anxiety, or grief symptomatology? Author(s): Boelen PA, van den Bout J. Source: Psychological Reports. 2002 December; 91(3 Pt 1): 857-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530735&dopt=Abstract

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Possible predictors of response to fluvoxamine for depression. Author(s): Morishita S, Arita S. Source: Human Psychopharmacology. 2003 April; 18(3): 197-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672171&dopt=Abstract

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Postconcussive symptom report: the relative influence of head injury and depression. Author(s): Suhr JA, Gunstad J. Source: J Clin Exp Neuropsychol. 2002 December; 24(8): 981-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650225&dopt=Abstract

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Postdisaster emotional distress, depression and event-related variables: findings across child and adolescent developmental stages. Author(s): McDermott BM, Palmer LJ. Source: The Australian and New Zealand Journal of Psychiatry. 2002 December; 36(6): 754-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406117&dopt=Abstract

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Postnatal depression: working and learning with mothers. Author(s): Alabaster M. Source: Community Nurse. 2000 May; 6(4): 39-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778523&dopt=Abstract

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Postpartum depression among African-American women. Author(s): Amankwaa LC. Source: Issues in Mental Health Nursing. 2003 April-May; 24(3): 297-316. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623687&dopt=Abstract

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Postpartum depression predictors inventory--revised. Author(s): Beck CT. Source: Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses. 2003 February; 3(1): 47-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12882181&dopt=Abstract

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Postpartum depression screening scale: Spanish version. Author(s): Beck CT, Gable RK. Source: Nursing Research. 2003 September-October; 52(5): 296-306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14501544&dopt=Abstract

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Postpartum depression. Author(s): Blum LD. Source: The New England Journal of Medicine. 2003 March 27; 348(13): 1294. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660400&dopt=Abstract

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Postpartum depression: what pediatricians need to know. Author(s): Chaudron LH. Source: Pediatrics in Review / American Academy of Pediatrics. 2003 May; 24(5): 15461. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12728188&dopt=Abstract

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Poststroke depression. Author(s): Carota A, Bogousslavsky J. Source: Adv Neurol. 2003; 92: 435-45. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12760211&dopt=Abstract

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Poststroke depression: getting the full picture. Author(s): Turner-Stokes L. Source: Lancet. 2003 May 24; 361(9371): 1757-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781530&dopt=Abstract

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Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Author(s): Robinson RG. Source: Biological Psychiatry. 2003 August 1; 54(3): 376-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893112&dopt=Abstract

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Postsynaptic density-95 mimics and occludes hippocampal long-term potentiation and enhances long-term depression. Author(s): Stein V, House DR, Bredt DS, Nicoll RA. Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 2003 July 2; 23(13): 5503-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843250&dopt=Abstract

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Practical geriatrics: clinically significant nonmajor geriatric depression. Author(s): Lavretsky H, Kumar A. Source: Psychiatric Services (Washington, D.C.). 2003 March; 54(3): 297-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610234&dopt=Abstract

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Pragmatic evaluation of computer-aided self-help for anxiety and depression. Author(s): Marks IM, Mataix-Cols D, Kenwright M, Cameron R, Hirsch S, Gega L. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 July; 183: 57-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12835245&dopt=Abstract

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Pramipexole and pergolide in the treatment of depression in Parkinson's disease: a national multicentre prospective randomized study. Author(s): Rektorova I, Rektor I, Bares M, Dostal V, Ehler E, Fanfrdlova Z, Fiedler J, Klajblova H, Kulist'ak P, Ressner P, Svatova J, Urbanek K, Veliskova J. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2003 July; 10(4): 399-406. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823492&dopt=Abstract

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Predictors of depression and life satisfaction among spousal caregivers in hospice: application of a stress process model. Author(s): Haley WE, LaMonde LA, Han B, Burton AM, Schonwetter R. Source: Journal of Palliative Medicine. 2003 April; 6(2): 215-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854938&dopt=Abstract

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Predictors of response in depression. Author(s): Esposito K, Goodnick P. Source: The Psychiatric Clinics of North America. 2003 June; 26(2): 353-65. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778838&dopt=Abstract

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Predisposition to depression: the role of attachment. Author(s): Beatson J, Taryan S. Source: The Australian and New Zealand Journal of Psychiatry. 2003 April; 37(2): 21925. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656963&dopt=Abstract

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Premenstrual symptomatology, locus of control, anxiety and depression in women with normal menstrual cycles. Author(s): Lane T, Francis A. Source: Archives of Women's Mental Health. 2003 April; 6(2): 127-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12720063&dopt=Abstract

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Presence of atopy in first-degree relatives as a predictor of a female proband's depression: results from the Northern Finland 1966 Birth Cohort. Author(s): Timonen M, Jokelainen J, Herva A, Zitting P, Meyer-Rochow VB, Rasanen P. Source: The Journal of Allergy and Clinical Immunology. 2003 June; 111(6): 1249-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789225&dopt=Abstract

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Prevalence and correlates of DSM-IV major depression in an Australian national survey. Author(s): Wilhelm K, Mitchell P, Slade T, Brownhill S, Andrews G. Source: Journal of Affective Disorders. 2003 July; 75(2): 155-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798255&dopt=Abstract

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Prevalence of anxiety and depression among medical students of private university. Author(s): Inam SN, Saqib A, Alam E. Source: J Pak Med Assoc. 2003 February; 53(2): 44-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705482&dopt=Abstract

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Prevalence of depression among general hospital surgical inpatients. Author(s): Vaeroy H, Juell M, Hoivik B. Source: Nordic Journal of Psychiatry. 2003; 57(1): 13-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745787&dopt=Abstract

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Prevalence of depression and other psychiatric disorders among incarcerated youths. Author(s): Domalanta DD, Risser WL, Roberts RE, Risser JM. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 April; 42(4): 477-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649635&dopt=Abstract

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Prevalence of depression in patients with coronary artery disease in a tertiary care hospital in Pakistan. Author(s): Bokhari SS, Samad AH, Hanif S, Hadique S, Cheema MQ, Fazal MA, Gul M, Bukhari SS, Khan AS. Source: J Pak Med Assoc. 2002 September; 52(9): 436-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532585&dopt=Abstract

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Prevalence of major depression in deliberate self-harm individuals in Harare, Zimbabwe. Author(s): Chibanda D, Sebit MB, Acuda SW. Source: East Afr Med J. 2002 May; 79(5): 263-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638812&dopt=Abstract

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Prevalence of sub-threshold depression in elderly patients with chronic obstructive pulmonary disease. Author(s): Yohannes AM, Baldwin RC, Connolly MJ. Source: International Journal of Geriatric Psychiatry. 2003 May; 18(5): 412-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766917&dopt=Abstract

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Prevalence, etiology, and treatment of depression in Parkinson's disease. Author(s): McDonald WM, Richard IH, DeLong MR. Source: Biological Psychiatry. 2003 August 1; 54(3): 363-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893111&dopt=Abstract

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Prevalence, recognition and management of depression in primary care in Germany: the Depression 2000 study. Author(s): Wittchen HU, Pittrow D. Source: Human Psychopharmacology. 2002 June; 17 Suppl 1: S1-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404663&dopt=Abstract

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Prevention of relapse in residual depression by cognitive therapy: a controlled trial. Author(s): Paykel ES, Scott J, Teasdale JD, Johnson AL, Garland A, Moore R, Jenaway A, Cornwall PL, Hayhurst H, Abbott R, Pope M. Source: Archives of General Psychiatry. 1999 September; 56(9): 829-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12884889&dopt=Abstract

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Primary care attributes and care for depression among low-income African American women. Author(s): O'Malley AS, Forrest CB, Miranda J. Source: American Journal of Public Health. 2003 August; 93(8): 1328-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893623&dopt=Abstract

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Problematising depression: young people, mental health and suicidal behaviours. Author(s): Bennett S, Coggan C, Adams P. Source: Social Science & Medicine (1982). 2003 July; 57(2): 289-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765709&dopt=Abstract

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Prolactin response to fenfluramine administration in patients with unipolar and bipolar depression and healthy controls. Author(s): Sher L, Oquendo MA, Li S, Ellis S, Brodsky BS, Malone KM, Cooper TB, Mann JJ. Source: Psychoneuroendocrinology. 2003 May; 28(4): 559-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689612&dopt=Abstract

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Prolonged cortical electrical depression and diffuse vasospasm without ischemia in a case of severe hemiplegic migraine during pregnancy. Author(s): Gonzalez-Alegre P, Tippin J. Source: Headache. 2003 January; 43(1): 72-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864763&dopt=Abstract

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Prospective association between obesity and depression: evidence from the Alameda County Study. Author(s): Roberts RE, Deleger S, Strawbridge WJ, Kaplan GA. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 April; 27(4): 514-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12664085&dopt=Abstract

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Psychoendocrine antecedents of persistent first-episode major depression in adolescents: a community-based longitudinal enquiry. Author(s): Goodyer IM, Herbert J, Tamplin A. Source: Psychological Medicine. 2003 May; 33(4): 601-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785462&dopt=Abstract

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Psychological interventions for depression in adolescent and adult congenital heart disease. Author(s): Lip GY, Lane DA, Millane TA, Tayebjee MH. Source: Cochrane Database Syst Rev. 2003; (3): Cd004394. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12918013&dopt=Abstract

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Psychometric evaluation of the Chicago Multiscale Depression Inventory in multiple sclerosis patients. Author(s): Chang CH, Nyenhuis DL, Cella D, Luchetta T, Dineen K, Reder AT. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 March; 9(2): 160-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708812&dopt=Abstract

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Psychometric properties of the Beck Depression Inventory and the Zung Self Rating Depression Scale in adults with mental retardation. Author(s): Powell R. Source: Mental Retardation. 2003 April; 41(2): 88-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622525&dopt=Abstract

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Psychopharmacologic treatment of depression during pregnancy. Author(s): Gold LH. Source: Curr Womens Health Rep. 2003 June; 3(3): 236-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12734035&dopt=Abstract

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Psychosocial and vascular risk factors of depression in later life. Author(s): Oldehinkel AJ, Ormel J, Brilman EI, van den Berg MD. Source: Journal of Affective Disorders. 2003 May; 74(3): 237-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738042&dopt=Abstract

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Psychosocial aspects of diabetes with an emphasis on depression. Author(s): Harris MD. Source: Curr Diab Rep. 2003 February; 3(1): 49-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643146&dopt=Abstract

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Psychosocial assessment and management of depression and anxiety in pregnancy. Key aspects of antenatal care for general practice. Author(s): Austin MP. Source: Aust Fam Physician. 2003 March; 32(3): 119-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666348&dopt=Abstract

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Psychotic depression and mortality. Author(s): Vythilingam M, Chen J, Bremner JD, Mazure CM, Maciejewski PK, Nelson JC. Source: The American Journal of Psychiatry. 2003 March; 160(3): 574-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611843&dopt=Abstract

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Qualitative analysis of verbal fluency in depression. Author(s): Fossati P, Guillaume le B, Ergis AM, Allilaire JF. Source: Psychiatry Research. 2003 January 25; 117(1): 17-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581817&dopt=Abstract

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Qualitative study of patients' perceptions of the quality of care for depression in general practice. Author(s): Gask L, Rogers A, Oliver D, May C, Roland M. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 April; 53(489): 278-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12879827&dopt=Abstract

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Quality improvement report: Effect of a multifaceted approach to detecting and managing depression in primary care. Author(s): Scott J, Thorne A, Horn P. Source: Bmj (Clinical Research Ed.). 2002 October 26; 325(7370): 951-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399349&dopt=Abstract

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Quality of accommodation and risk of depression in later life: an analysis of prospective data from the Gospel Oak Project. Author(s): Stewart R, Prince M, Harwood R, Whitley R, Mann A. Source: International Journal of Geriatric Psychiatry. 2002 December; 17(12): 1091-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461756&dopt=Abstract

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Quality of life in OCD: differential impact of obsessions, compulsions, and depression comorbidity. Author(s): Masellis M, Rector NA, Richter MA. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 March; 48(2): 72-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655903&dopt=Abstract

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Quality of life in older adults receiving medications for anxiety, depression, or insomnia: findings from a community-based study. Author(s): Stein MB, Barrett-Connor E. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 September-October; 10(5): 568-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213691&dopt=Abstract

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Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. Author(s): Janardhan V, Bakshi R. Source: Journal of the Neurological Sciences. 2002 December 15; 205(1): 51-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409184&dopt=Abstract

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Questions raised by the cytokine hypothesis of depression. Author(s): de Beaurepaire R. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 610-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401476&dopt=Abstract

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Race, quality of depression care, and recovery from major depression in a primary care setting. Author(s): Rollman BL, Hanusa BH, Belnap BH, Gardner W, Cooper LA, Schulberg HC. Source: General Hospital Psychiatry. 2002 November-December; 24(6): 381-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490339&dopt=Abstract

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Randomized controlled trial of different models of care for nursing home residents with dementia complicated by depression or psychosis. Author(s): Brodaty H, Draper BM, Millar J, Low LF, Lie D, Sharah S, Paton H. Source: The Journal of Clinical Psychiatry. 2003 January; 64(1): 63-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590626&dopt=Abstract

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Rate of oxygen consumption in seasonal and non-seasonal depression. Author(s): Pinchasov BB, Grischin OV, Putilov AA. Source: World J Biol Psychiatry. 2002 April; 3(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479083&dopt=Abstract

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Rates and predictors of mortality in an aging, rural, community-based cohort: the role of depression. Author(s): Ganguli M, Dodge HH, Mulsant BH. Source: Archives of General Psychiatry. 2002 November; 59(11): 1046-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418938&dopt=Abstract

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Rationale and options for the long-term treatment of depression. Author(s): Keller MB. Source: Human Psychopharmacology. 2002 June; 17 Suppl 1: S43-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404670&dopt=Abstract

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Re: Prophylactic therapy with lithium in elderly patients with Unipolar Major Depression. Author(s): Jainer AK, Soni N, Onalaja D. Source: International Journal of Geriatric Psychiatry. 2003 April; 18(4): 353-4; Author Reply 354. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12673613&dopt=Abstract

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Recall bias and major depression lifetime prevalence. Author(s): Patten SB. Source: Social Psychiatry and Psychiatric Epidemiology. 2003 June; 38(6): 290-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799778&dopt=Abstract

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Recent developments in the psychobiology and pharmacotherapy of depression: optimising existing treatments and novel approaches for the future. Author(s): Farvolden P, Kennedy SH, Lam RW. Source: Expert Opinion on Investigational Drugs. 2003 January; 12(1): 65-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517255&dopt=Abstract

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Recognition of depression among elderly recipients of home care services. Author(s): Brown EL, McAvay G, Raue PJ, Moses S, Bruce ML. Source: Psychiatric Services (Washington, D.C.). 2003 February; 54(2): 208-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556602&dopt=Abstract

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Recognizing and meeting the needs of patients with mood disorders and comorbid medical illness: a consensus conference of the Depression and Bipolar Support Alliance. Author(s): Lewis L; Depression and Bipolar Support Alliance. Source: Biological Psychiatry. 2003 August 1; 54(3): 181-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893091&dopt=Abstract

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Recognizing and screening for postpartum depression in mothers of NICU infants. Author(s): Beck CT. Source: Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses. 2003 February; 3(1): 37-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12882180&dopt=Abstract

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Recovery from depression associated with Guillain Barre syndrome. Author(s): Gregory RJ. Source: Issues in Mental Health Nursing. 2003 March; 24(2): 129-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12554424&dopt=Abstract

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Recurrent brief depression--more investigations in clinical samples are now required. Author(s): Baldwin DS. Source: Psychological Medicine. 2003 April; 33(3): 383-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701659&dopt=Abstract

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Recurrent brief depression--past and future. Author(s): Pezawas L, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2003 February; 27(1): 75-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12551729&dopt=Abstract

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Regional cerebral blood flow in vascular depression assessed by 123I-IMP SPECT. Author(s): Kimura M, Shimoda K, Mizumura S, Tateno A, Fujito T, Mori T, Endo S. Source: Journal of Nippon Medical School = Nihon Ika Daigaku Zasshi. 2003 August; 70(4): 321-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12928712&dopt=Abstract

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Regulation of GRK 2 and 6, beta-arrestin-2 and associated proteins in the prefrontal cortex of drug-free and antidepressant drug-treated subjects with major depression. Author(s): Grange-Midroit M, Garcia-Sevilla JA, Ferrer-Alcon M, La Harpe R, Huguelet P, Guimon J. Source: Brain Research. Molecular Brain Research. 2003 March 17; 111(1-2): 31-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654503&dopt=Abstract

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Relapse of major depression after complete and partial remission during a 2-year follow-up. Author(s): Pintor L, Gasto C, Navarro V, Torres X, Fananas L. Source: Journal of Affective Disorders. 2003 February; 73(3): 237-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12547292&dopt=Abstract

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Relation of levels of serum lipoproteins to depression after acute myocardial infarction. Author(s): Strik JJ, Lousberg R, Crijns HJ, Maes M, Honig A. Source: The American Journal of Cardiology. 2002 December 15; 90(12): 1368-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480046&dopt=Abstract

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Relations of positive and negative affectivity to anxiety and depression in children: evidence from a latent variable longitudinal study. Author(s): Lonigan CJ, Phillips BM, Hooe ES. Source: Journal of Consulting and Clinical Psychology. 2003 June; 71(3): 465-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795571&dopt=Abstract

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Relationship among gender, depression, and needle sharing in a sample of injection drug users. Author(s): Johnson ME, Yep MJ, Brems C, Theno SA, Fisher DG. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2002 December; 16(4): 338-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503907&dopt=Abstract

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Relationship and differential validity of alexithymia and depression: a comparison of the Toronto Alexithymia and Self-Rating Depression Scales. Author(s): Muller J, Buhner M, Ellgring H. Source: Psychopathology. 2003 March-April; 36(2): 71-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766316&dopt=Abstract

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Relationship between anxiety/depression and nausea: causal or associative? Author(s): Jagadisha D. Source: General Hospital Psychiatry. 2003 January-February; 25(1): 52; Author Reply 53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12583930&dopt=Abstract

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Relationship between body-mass index and depressive symptoms in patients with major depression. Author(s): Berlin I, Lavergne F. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2003 March; 18(2): 85-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711405&dopt=Abstract

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Relationship between coping, cognitive dysfunction and depression in multiple sclerosis. Author(s): Arnett PA, Higginson CI, Voss WD, Randolph JJ, Grandey AA. Source: Clin Neuropsychol. 2002 August; 16(3): 341-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607147&dopt=Abstract

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Relationship between depression and work outcomes following liver transplantation: the nursing perspective. Author(s): Newton SE. Source: Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates. 2003 March-April; 26(2): 68-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682527&dopt=Abstract

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Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Author(s): Agelink MW, Boz C, Ullrich H, Andrich J. Source: Psychiatry Research. 2002 December 15; 113(1-2): 139-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467953&dopt=Abstract

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Relationship between self-reported depression and self-reported visual function in Latinos. Author(s): Paz SH, Globe DR, Wu J, Azen SP, Varma R; Los Angeles Latino Eye Study. Source: Archives of Ophthalmology. 2003 July; 121(7): 1021-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860807&dopt=Abstract

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Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Author(s): Musselman DL, Betan E, Larsen H, Phillips LS. Source: Biological Psychiatry. 2003 August 1; 54(3): 317-29. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893107&dopt=Abstract

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Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. Author(s): Turner BJ, Laine C, Cosler L, Hauck WW. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 2003 April; 18(4): 248-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709091&dopt=Abstract

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Relationships between depression, lifestyle and quality of life in the community dwelling elderly: a comparison between gender and age groups. Author(s): Demura S, Sato S. Source: Journal of Physiological Anthropology and Applied Human Science. 2003 May; 22(3): 159-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12808229&dopt=Abstract

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Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood. Author(s): Stein JA, Leslie MB, Nyamathi A. Source: Child Abuse & Neglect. 2002 October; 26(10): 1011-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12398858&dopt=Abstract

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Reliability and factor structure of the Brazilian version of the Center for Epidemiologic Studies-Depression. Author(s): da Silveira DX, Jorge MR. Source: Psychological Reports. 2002 December; 91(3 Pt 1): 865-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530737&dopt=Abstract

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Reliability and validity of the assessment of depression in general practice: the Short Depression Interview (SDI). Author(s): Terluin B, van Hout HP, van Marwijk HW, Ader HJ, van der Meer K, de Haan M, van Dyck R. Source: General Hospital Psychiatry. 2002 November-December; 24(6): 396-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490341&dopt=Abstract

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Religious coping and depression among spouses of people with lung cancer. Author(s): Abernethy AD, Chang HT, Seidlitz L, Evinger JS, Duberstein PR. Source: Psychosomatics. 2002 November-December; 43(6): 456-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444228&dopt=Abstract

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REM sleep latency and wakefulness in the first sleep cycle as markers of major depression: a controlled study vs. schizophrenia and normal controls. Author(s): Rotenberg VS, Shami E, Barak Y, Indursky P, Kayumov L, Mark M. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 October; 26(6): 1211-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452549&dopt=Abstract

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Reminiscence therapy for older women with depression. Effects of nursing intervention classification in assisted-living long-term care. Author(s): Jones ED. Source: Journal of Gerontological Nursing. 2003 July; 29(7): 26-33; Quiz 56-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874937&dopt=Abstract

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Remission of depression and the Texas Medication Algorithm Project. Author(s): Trivedi MH. Source: Manag Care Interface. 2003; Suppl B: 9-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12647607&dopt=Abstract

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Remission of major depression and obsessive-compulsive disorder after a single unilateral ECT. Author(s): Thomas SG, Kellner CH. Source: The Journal of Ect. 2003 March; 19(1): 50-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621279&dopt=Abstract

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Remission, residual symptoms, and nonresponse in the usual treatment of major depression in managed clinical practice. Author(s): Cuffel BJ, Azocar F, Tomlin M, Greenfield SF, Busch AB, Croghan TW. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 397-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716239&dopt=Abstract

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Reproductive senescence and depression revisited (again). Author(s): Kingsberg SA. Source: Menopause (New York, N.Y.). 2002 November-December; 9(6): 389-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439096&dopt=Abstract

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Research issues in the study of difficult-to-treat depression. Author(s): Rush AJ, Thase ME, Dube S. Source: Biological Psychiatry. 2003 April 15; 53(8): 743-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706958&dopt=Abstract

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Research on major depression: strategies and priorities. Author(s): Insel TR, Charney DS. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3167-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813123&dopt=Abstract

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Research to improve the quality of care for depression: alternatives to the simple randomized clinical trial. Author(s): TenHave TR, Coyne J, Salzer M, Katz I. Source: General Hospital Psychiatry. 2003 March-April; 25(2): 115-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676425&dopt=Abstract

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Researchers probe depression in children. Author(s): Voelker R. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3078-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813098&dopt=Abstract

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Residual cognitive impairment in late-life depression after a 12-month period followup. Author(s): Portella MJ, Marcos T, Rami L, Navarro V, Gasto C, Salamero M. Source: International Journal of Geriatric Psychiatry. 2003 July; 18(7): 571-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833300&dopt=Abstract

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Residual symptoms in depression: an emerging therapeutic target. Author(s): Fava GA, Fabbri S, Sonino N. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 October; 26(6): 1019-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452521&dopt=Abstract

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Residual symptoms in depression: can treatment be symptom-specific? Author(s): Menza M, Marin H, Opper RS. Source: The Journal of Clinical Psychiatry. 2003 May; 64(5): 516-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755653&dopt=Abstract

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Response to Annie Anargyros-Klinger's 'Depression and Leo Tolstoy'. Author(s): Symington N. Source: The International Journal of Psycho-Analysis. 2002 December; 83(Pt 6): 1438-41; Author Reply 1441-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521530&dopt=Abstract

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Response to ECT in major depression: are there differences between unipolar and bipolar depression? Author(s): Grunhaus L, Schreiber S, Dolberg OT, Hirshman S, Dannon PN. Source: Bipolar Disorders. 2002; 4 Suppl 1: 91-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479688&dopt=Abstract

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Review: Beta-blockers increase fatigue and sexual dysfunction but not depression after myocardial infarction. Author(s): Ko DT, Hebert PR, Krumholz HM. Source: Acp Journal Club. 2003 January-February; 138(1): 30; Author Reply 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12511138&dopt=Abstract

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Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Author(s): Cole MG, Dendukuri N. Source: The American Journal of Psychiatry. 2003 June; 160(6): 1147-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777274&dopt=Abstract

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Risk factors for depression in postnatal first year, in eastern Turkey. Author(s): Inandi T, Elci OC, Ozturk A, Egri M, Polat A, Sahin TK. Source: International Journal of Epidemiology. 2002 December; 31(6): 1201-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540723&dopt=Abstract

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Risk of postnatal depression after emergency delivery. Author(s): Koo V, Lynch J, Cooper S. Source: The Journal of Obstetrics and Gynaecology Research. 2003 August; 29(4): 246-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959147&dopt=Abstract

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Risk-taking sexual behaviour and self-reported depression in middle adolescence--a school-based survey. Author(s): Kosunen E, Kaltiala-Heino R, Rimpela M, Laippala P. Source: Child: Care, Health and Development. 2003 September; 29(5): 337-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12904241&dopt=Abstract

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Role of estrogen in the treatment of depression. Author(s): Grigoriadis S, Kennedy SH. Source: American Journal of Therapeutics. 2002 November-December; 9(6): 503-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12424508&dopt=Abstract

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Role of perfectionism and personality disorder features in response to brief treatment for depression. Author(s): Shahar G, Blatt SJ, Zuroff DC, Pilkonis PA. Source: Journal of Consulting and Clinical Psychology. 2003 June; 71(3): 629-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795586&dopt=Abstract

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Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Author(s): Mischoulon D, Fava M. Source: The American Journal of Clinical Nutrition. 2002 November; 76(5): 1158S-61S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420702&dopt=Abstract

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Rumination as a common mechanism relating depressive risk factors to depression. Author(s): Spasojevic J, Alloy LB. Source: Emotion (Washington, D.C.). 2001 March; 1(1): 25-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894809&dopt=Abstract

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S100B and response to treatment in major depression: a pilot study. Author(s): Arolt V, Peters M, Erfurth A, Wiesmann M, Missler U, Rudolf S, Kirchner H, Rothermundt M. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 2003 August; 13(4): 235-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12888182&dopt=Abstract

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Salivary cortisol patterns and cognitive speed in major depression: a comparison with allergic rhinitis and healthy control subjects. Author(s): den Hartog HM, Nicolson NA, Derix MM, van Bemmel AL, Kremer B, Jolles J. Source: Biological Psychology. 2003 April; 63(1): 1-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706961&dopt=Abstract

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Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment. Author(s): Lee AG, Beaver HA, Jogerst G, Daly JM. Source: Ophthalmology. 2003 April; 110(4): 651-7; Discussion 657. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689881&dopt=Abstract

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Screening for depression across the lifespan: a review of measures for use in primary care settings. Author(s): Sharp LK, Lipsky MS. Source: American Family Physician. 2002 September 15; 66(6): 1001-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358212&dopt=Abstract

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Screening for depression among neuro-otology patients with and without identifiable vestibular lesions. Author(s): Grunfeld EA, Gresty MA, Bronstein AM, Jahanshahi M. Source: International Journal of Audiology. 2003 April; 42(3): 161-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705781&dopt=Abstract

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Screening for depression in adults. Author(s): Das AK, Gross R, Weissman MM. Source: Annals of Internal Medicine. 2003 May 6; 138(9): 767; Author Reply 767-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729436&dopt=Abstract

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Screening for depression in adults. Author(s): Coyne JC, Palmer SC, Sullivan PA. Source: Annals of Internal Medicine. 2003 May 6; 138(9): 767; Author Reply 767-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729435&dopt=Abstract

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Screening for depression in chronic hemodialysis patients. Author(s): al-Hihi E, Awad A, Hagedorn A. Source: Mo Med. 2003 May-June; 100(3): 266-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847869&dopt=Abstract

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Screening for depression in general practice and related medical settings. Author(s): Hickie IB, Davenport TA, Ricci CS. Source: The Medical Journal of Australia. 2002 October 7; 177 Suppl: S111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358569&dopt=Abstract

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Screening for depression in medical care: pitfalls, alternatives, and revised priorities. Author(s): Palmer SC, Coyne JC. Source: Journal of Psychosomatic Research. 2003 April; 54(4): 279-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670603&dopt=Abstract

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Screening for depression in older people on medical wards: which cut-point should we use? Author(s): Cullum S, Nandhra H, Darley J, Todd C. Source: International Journal of Geriatric Psychiatry. 2003 April; 18(4): 358-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12673617&dopt=Abstract

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Screening for depression in primary care. Chosen tool makes little sense. Author(s): Brugha TS. Source: Bmj (Clinical Research Ed.). 2003 May 3; 326(7396): 982; Author Reply 982. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727745&dopt=Abstract

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Screening for depression in primary care. Scientific and statistical errors should have been picked up in peer review. Author(s): Plummer WP. Source: Bmj (Clinical Research Ed.). 2003 May 3; 326(7396): 982; Author Reply 982. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727777&dopt=Abstract

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Screening for depression in primary care. Study analysis and conclusions are flawed. Author(s): Fahey T, Sullivan F, MacGillivray S. Source: Bmj (Clinical Research Ed.). 2003 May 3; 326(7396): 982; Author Reply 982. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727748&dopt=Abstract

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Screening for depression. Author(s): Ferrini R, Clark B. Source: American Family Physician. 2003 April 1; 67(7): 1561-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12722858&dopt=Abstract

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Screening for depression. Author(s): McCahill ME. Source: American Family Physician. 2002 September 15; 66(6): 952, 955. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358221&dopt=Abstract

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Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects. Author(s): Schreiner AS, Hayakawa H, Morimoto T, Kakuma T. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 498-505. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789670&dopt=Abstract

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Screening for postpartum depression in an inner-city population. Author(s): Morris-Rush JK, Freda MC, Bernstein PS. Source: American Journal of Obstetrics and Gynecology. 2003 May; 188(5): 1217-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748483&dopt=Abstract

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Screening for poststroke depression in a Hong Kong rehabilitation hospital: impact of different raters. Author(s): Tang WK, Ungvari GS, Chiu HF, Sze KH, Chan AS, Leung TL. Source: The Journal of Nervous and Mental Disease. 2003 July; 191(7): 474-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891095&dopt=Abstract

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Self, friends, and lovers: structural relations among Beck Depression Inventory scores and perceived mate values. Author(s): Kirsner BR, Figueredo AJ, Jacobs WJ. Source: Journal of Affective Disorders. 2003 July; 75(2): 131-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798253&dopt=Abstract

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Self-exclusion from health care in women at high risk for postpartum depression. Author(s): Murray L, Woolgar M, Murray J, Cooper P. Source: Journal of Public Health Medicine. 2003 June; 25(2): 131-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12848402&dopt=Abstract

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Self-report bias and underreporting of depression on the BDI-II. Author(s): Hunt M, Auriemma J, Cashaw AC. Source: Journal of Personality Assessment. 2003 February; 80(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584064&dopt=Abstract

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Sensitivity and specificity of memory dysfunction in schizophrenia: a comparison with major depression. Author(s): Egeland J, Sundet K, Rund BR, Asbjornsen A, Hugdahl K, Landro NI, Lund A, Roness A, Stordal KI. Source: J Clin Exp Neuropsychol. 2003 February; 25(1): 79-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607174&dopt=Abstract

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Separate personality traits from states to predict depression. Author(s): Clark LA, Vittengl J, Kraft D, Jarrett RB. Source: Journal of Personality Disorders. 2003 April; 17(2): 152-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755328&dopt=Abstract

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Sertraline as monotherapy in the treatment of psychotic and nonpsychotic depression. Author(s): Simpson GM, El Sheshai A, Rady A, Kingsbury SJ, Fayek M. Source: The Journal of Clinical Psychiatry. 2003 August; 64(8): 959-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927014&dopt=Abstract

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Sertraline is more effective than imipramine in the treatment of non-melancholic depression: results from a multicentre, randomized study. Author(s): Baca E, Gonzalez de Chavez M, Garcia-Toro M, Perez-Arnau F, PorrasChavarino A. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2003 May; 27(3): 493-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691786&dopt=Abstract

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Serum cholesterol in treatment-resistant depression. Author(s): Papakostas GI, Petersen T, Sonawalla SB, Merens W, Iosifescu DV, Alpert JE, Fava M, Nierenberg AA. Source: Neuropsychobiology. 2003; 47(3): 146-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759558&dopt=Abstract

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Severity, chronicity, and timing of maternal depression and risk for adolescent offspring diagnoses in a community sample. Author(s): Hammen C, Brennan PA. Source: Archives of General Psychiatry. 2003 March; 60(3): 253-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622658&dopt=Abstract

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Short-term psychodynamic psychotherapy for depression: an examination of statistical, clinically significant, and technique-specific change. Author(s): Hilsenroth MJ, Ackerman SJ, Blagys MD, Baity MR, Mooney MA. Source: The Journal of Nervous and Mental Disease. 2003 June; 191(6): 349-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826915&dopt=Abstract

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Short-term use of estradiol for depression in perimenopausal and postmenopausal women: a preliminary report. Author(s): Cohen LS, Soares CN, Poitras JR, Prouty J, Alexander AB, Shifren JL. Source: The American Journal of Psychiatry. 2003 August; 160(8): 1519-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12900318&dopt=Abstract

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Should primary care physicians screen for depression? Author(s): Tesar GE. Source: Cleve Clin J Med. 2003 June; 70(6): 488-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828219&dopt=Abstract

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Shoulder EMG during depression raise in men with spinal cord injury: the influence of lesion level. Author(s): Newsam CJ, Lee AD, Mulroy SJ, Perry J. Source: J Spinal Cord Med. 2003 Spring; 26(1): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830971&dopt=Abstract

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Sleep disturbances and depression in the elderly in Japan. Author(s): Sukegawa T, Itoga M, Seno H, Miura S, Inagaki T, Saito W, Uegaki J, Miyaoka T, Momose I, Kasahara K, Oshiro R, Shimizu Y, Yasukawa R, Mihara T, Maeda T, Mizuno S, Tsubouchi K, Inami Y, Horiguchi J. Source: Psychiatry and Clinical Neurosciences. 2003 June; 57(3): 265-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753565&dopt=Abstract

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Sleep in depression and sleep deprivation: a brief conceptual review. Author(s): Holsboer-Trachsler E, Seifritz E. Source: World J Biol Psychiatry. 2000 October; 1(4): 180-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607213&dopt=Abstract

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Smoking related to anxiety and depression in Greek medical staff. Author(s): Tselebis A, Papaleftheris E, Balis E, Theotoka I, Ilias I. Source: Psychological Reports. 2003 April; 92(2): 529-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785636&dopt=Abstract

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Social change, globalization and transcultural psychiatry--some considerations from a study on women and depression. Author(s): Dech H, Ndetei DM, Machleidt W. Source: Seishin Shinkeigaku Zasshi. 2003; 105(1): 17-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701208&dopt=Abstract

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Social characteristics of seasonal affective disorder patients: comparison with suicide attempters with non-seasonal major depression and other mood disorder patients. Author(s): Pendse BP, Ojehagen A, Engstrom G, Traskman-Bendz L. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2003 February; 18(1): 36-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648896&dopt=Abstract

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Social roles, context and evolution in the origins of depression. Author(s): Brown GW. Source: Journal of Health and Social Behavior. 2002 September; 43(3): 255-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467252&dopt=Abstract

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Social stress and women's risk for recurrent depression. Author(s): Hammen C. Source: Archives of Women's Mental Health. 2003 February; 6(1): 9-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715260&dopt=Abstract

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Somatic symptoms for diagnosing major depression in cancer patients. Author(s): Akechi T, Nakano T, Akizuki N, Okamura M, Sakuma K, Nakanishi T, Yoshikawa E, Uchitomi Y. Source: Psychosomatics. 2003 May-June; 44(3): 244-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724506&dopt=Abstract

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Somatic symptoms in treatment-resistant depression. Author(s): Papakostas GI, Petersen T, Denninger J, Sonawalla SB, Mahal Y, Alpert JE, Nierenberg AA, Fava M. Source: Psychiatry Research. 2003 May 1; 118(1): 39-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759160&dopt=Abstract

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SSRIs in the treatment of depression in Parkinson's disease. Author(s): Leentjens AF, Vreeling FW, Luijckx GJ, Verhey FR. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 552-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789682&dopt=Abstract

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ST segment depression criteria and the prevalence of silent cardiac ischemia in hypertensives. Author(s): Boon D, van Goudoever J, Piek JJ, van Montfrans GA. Source: Hypertension. 2003 March; 41(3): 476-81. Epub 2003 February 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623946&dopt=Abstract

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Stability of retrospective reports in depression: traumatic events, past depressive episodes, and parental psychopathology. Author(s): Schraedley PK, Turner RJ, Gotlib IH. Source: Journal of Health and Social Behavior. 2002 September; 43(3): 307-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467255&dopt=Abstract

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Stress, depression and the activation of the immune system. Author(s): Leonard B. Source: World J Biol Psychiatry. 2000 January; 1(1): 17-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607229&dopt=Abstract

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Stress, social support and depression in single and married mothers. Author(s): Cairney J, Boyle M, Offord DR, Racine Y. Source: Social Psychiatry and Psychiatric Epidemiology. 2003 August; 38(8): 442-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12910340&dopt=Abstract

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Stressful neighborhoods and depression: a prospective study of the impact of neighborhood disorder. Author(s): Latkin CA, Curry AD. Source: Journal of Health and Social Behavior. 2003 March; 44(1): 34-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751309&dopt=Abstract

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Subjective memory complaints of family members of patients with Alzheimer's disease and depression. Author(s): Heun R, Kockler M, Ptok U. Source: Dementia and Geriatric Cognitive Disorders. 2003; 16(2): 78-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784031&dopt=Abstract

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Subjective memory impairment, cognitive function and depression--a community study in older Koreans. Author(s): Kim JM, Stewart R, Shin IS, Choi SK, Yoon JS. Source: Dementia and Geriatric Cognitive Disorders. 2003; 15(4): 218-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626855&dopt=Abstract

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Substance P serum levels are increased in major depression: preliminary results. Author(s): Bondy B, Baghai TC, Minov C, Schule C, Schwarz MJ, Zwanzger P, Rupprecht R, Moller HJ. Source: Biological Psychiatry. 2003 March 15; 53(6): 538-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12644359&dopt=Abstract

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Suicidal ideation and frontal lobe dysfunction: a study examining the relationship between clinical frontal lobe tests depression and suicidal ideation. Author(s): Belderbos S, Shah A. Source: International Journal of Geriatric Psychiatry. 2003 June; 18(6): 545-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789679&dopt=Abstract

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Suicide and major depression. Author(s): Wright G. Source: The American Journal of Psychiatry. 2003 June; 160(6): 1192-3; Author Reply 1193. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777294&dopt=Abstract

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Suitable dose and duration of fluvoxamine administration to treat depression. Author(s): Morishita S, Arita S. Source: Psychiatry and Clinical Neurosciences. 2003 April; 57(2): 177-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667164&dopt=Abstract

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Sylvia Plath and the depression continuum. Author(s): Ryle A. Source: Journal of the Royal Society of Medicine. 2003 September; 96(9): 471-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949209&dopt=Abstract

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Sylvia Plath and the depression continuum. Author(s): Cooper B. Source: Journal of the Royal Society of Medicine. 2003 June; 96(6): 296-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782699&dopt=Abstract

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Symptoms of depression and anxiety, and screening for mental disorders in migrainous patients. Author(s): Kowacs F, Socal MP, Ziomkowski SC, Borges-Neto VF, Toniolo DP, Francesconi CR, Chaves ML. Source: Cephalalgia : an International Journal of Headache. 2003 March; 23(2): 79-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12603363&dopt=Abstract

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Symptoms of depression as a risk factor for incident diabetes: findings from the National Health and Nutrition Examination Epidemiologic Follow-up Study, 19711992. Author(s): Carnethon MR, Kinder LS, Fair JM, Stafford RS, Fortmann SP. Source: American Journal of Epidemiology. 2003 September 1; 158(5): 416-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12936896&dopt=Abstract

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Symptoms of depression in older adults with multiple sclerosis (MS): comparison with a matched sample of younger adults. Author(s): Kneebone II, Dunmore EC, Evans E. Source: Aging & Mental Health. 2003 May; 7(3): 182-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775398&dopt=Abstract

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Targeting smokers at increased risk for relapse: treating women and those with a history of depression. Author(s): Smith SS, Jorenby DE, Leischow SJ, Nides MA, Rennard SI, Johnston JA, Jamerson B, Fiore MC, Baker TB. Source: Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco. 2003 February; 5(1): 99-109. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745511&dopt=Abstract

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The association between age and depression in the general population: a multivariate examination. Author(s): Stordal E, Mykletun A, Dahl AA. Source: Acta Psychiatrica Scandinavica. 2003 February; 107(2): 132-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534439&dopt=Abstract

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The association between depression and isotretinoin use in acne. Author(s): Ng CH, Schweitzer I. Source: The Australian and New Zealand Journal of Psychiatry. 2003 February; 37(1): 7884. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534661&dopt=Abstract

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The benefit of oestrogens and progestogens in postnatal depression. Author(s): Karuppaswamy J, Vlies R. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2003 July; 23(4): 341-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881067&dopt=Abstract

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The challenge of comorbid disorders in patients with depression. Author(s): Rosenthal MH. Source: J Am Osteopath Assoc. 2003 August; 103(8 Suppl 4): S10-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956252&dopt=Abstract

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The clinical profile of psychotic depression. Author(s): Samuel M, Varghese M. Source: The Australian and New Zealand Journal of Psychiatry. 2003 February; 37(1): 111. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534668&dopt=Abstract

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The core elements of neurosis: mixed anxiety-depression (cothymia) and personality disorder. Author(s): Tyrer P, Seivewright H, Johnson T. Source: Journal of Personality Disorders. 2003 April; 17(2): 129-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755326&dopt=Abstract

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The Danish PET/depression project: poor verbal fluency performance despite normal prefrontal activation in patients with major depression. Author(s): Videbech P, Ravnkilde B, Kristensen S, Egander A, Clemmensen K, Rasmussen NA, Gjedde A, Rosenberg R. Source: Psychiatry Research. 2003 May 1; 123(1): 49-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12738343&dopt=Abstract

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The dark days of postpartum depression. Primary care screening is essential. Author(s): Albert C. Source: Adv Nurse Pract. 2002 June; 10(6): 67-70. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400366&dopt=Abstract

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The degree of depression in Hamilton rating scale is correlated with the density of presynaptic serotonin transporters in 23 patients with Wilson's disease. Author(s): Eggers B, Hermann W, Barthel H, Sabri O, Wagner A, Hesse S. Source: Journal of Neurology. 2003 May; 250(5): 576-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12736737&dopt=Abstract

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The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems. Author(s): Nieuwenhuijsen K, de Boer AG, Verbeek JH, Blonk RW, van Dijk FJ. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I77-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782751&dopt=Abstract

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The Depression Anxiety Stress Scales (DASS): normative data and latent structure in a large non-clinical sample. Author(s): Crawford JR, Henry JD. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2003 June; 42(Pt 2): 111-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828802&dopt=Abstract

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The Depression-Arkansas scale: A validation study of a new brief depression scale in an HMO. Author(s): Walter LJ, Meresman JF, Kramer TL, Evans RB. Source: Journal of Clinical Psychology. 2003 April; 59(4): 465-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12652638&dopt=Abstract

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The economic burden of depression and the cost-effectiveness of treatment. Author(s): Wang PS, Simon G, Kessler RC. Source: Int J Methods Psychiatr Res. 2003; 12(1): 22-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830307&dopt=Abstract

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The economic burden of depression with painful symptoms. Author(s): Greenberg PE, Leong SA, Birnbaum HG, Robinson RL. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 7: 17-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755648&dopt=Abstract

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The effect of depression on social engagement in newly admitted Dutch nursing home residents. Author(s): Achterberg W, Pot AM, Kerkstra A, Ooms M, Muller M, Ribbe M. Source: The Gerontologist. 2003 April; 43(2): 213-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677078&dopt=Abstract

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The effect of peer support on postpartum depression: a pilot randomized controlled trial. Author(s): Dennis CL. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 March; 48(2): 115-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655910&dopt=Abstract

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The effects of psychotherapy, nefazodone, and their combination on subjective assessment of disturbed sleep in chronic depression. Author(s): Manber R, Rush AJ, Thase ME, Amow B, Klein D, Trivedi MH, Korenstein SG, Markowitz JC, Dunner DL, Munsaka M, Borian FE, Martin, Keller B. Source: Sleep. 2003 March 15; 26(2): 130-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12683470&dopt=Abstract

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The external validity of controlled clinical trials of psychotherapy for depression and anxiety: a naturalistic study. Author(s): Morrison KH, Bradley R, Westen D. Source: Psychology and Psychotherapy. 2003 June; 76(Pt 2): 109-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855059&dopt=Abstract

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The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Author(s): McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno A. Source: Archives of General Psychiatry. 2003 May; 60(5): 497-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742871&dopt=Abstract

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The impact of apathy and depression on quality of life in patients infected with HIV. Author(s): Tate D, Paul RH, Flanigan TP, Tashima K, Nash J, Adair C, Boland R, Cohen RA. Source: Aids Patient Care and Stds. 2003 March; 17(3): 115-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724007&dopt=Abstract

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The impact of synaptic depression following brain damage: a connectionist account of "access/refractory" and "degraded-store" semantic impairments. Author(s): Gotts SJ, Plaut DC. Source: Cognitive, Affective & Behavioral Neuroscience. 2002 September; 2(3): 187-213. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775185&dopt=Abstract

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The influence of social support and problematic support on optimism and depression in chronic illness: a prospective study evaluating self-esteem as a mediator. Author(s): Symister P, Friend R. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2003 March; 22(2): 123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12683732&dopt=Abstract

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The myth of reserpine-induced depression: role in the historical development of the monoamine hypothesis. Author(s): Baumeister AA, Hawkins MF, Uzelac SM. Source: Journal of the History of the Neurosciences. 2003 June; 12(2): 207-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12953623&dopt=Abstract

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The neuropsychology of depression: a literature review and preliminary model. Author(s): Shenal BV, Harrison DW, Demaree HA. Source: Neuropsychology Review. 2003 March; 13(1): 33-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691500&dopt=Abstract

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The perception of emotional chimeric faces in patients with depression, mania and unilateral brain damage. Author(s): Kucharska-Pietura K, David AS. Source: Psychological Medicine. 2003 May; 33(4): 739-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785476&dopt=Abstract

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The pilot study of a telephone disease management program for depression. Author(s): Datto CJ, Thompson R, Horowitz D, Disbot M, Oslin DW. Source: General Hospital Psychiatry. 2003 May-June; 25(3): 169-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748029&dopt=Abstract

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The prevalence and impact of large sudden improvements during adolescent therapy for depression: a comparison across cognitive-behavioral, family, and supportive therapy. Author(s): Gaynor ST, Weersing VR, Kolko DJ, Birmaher B, Heo J, Brent DA. Source: Journal of Consulting and Clinical Psychology. 2003 April; 71(2): 386-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699032&dopt=Abstract

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The prolactin response to fenfluramine in depression: effects of melancholia and baseline cortisol. Author(s): Mulder RT, Porter RJ, Joyce PR. Source: Journal of Psychopharmacology (Oxford, England). 2003 March; 17(1): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680745&dopt=Abstract

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The relationship between chronic pain, immune function, depression, and health behaviors. Author(s): Vines SW, Gupta S, Whiteside T, Dostal-Johnson D, Hummler-Davis A. Source: Biological Research for Nursing. 2003 July; 5(1): 18-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12886667&dopt=Abstract

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The relationship between homework compliance and treatment outcomes among older adult outpatients with mild-to-moderate depression. Author(s): Coon DW, Thompson LW. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2003 January-February; 11(1): 53-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12527540&dopt=Abstract

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The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain. Author(s): Ciechanowski P, Sullivan M, Jensen M, Romano J, Summers H. Source: Pain. 2003 August; 104(3): 627-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927635&dopt=Abstract

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The Spanish form of the Death Depression Scale. Author(s): Tomas-Sabado J, Gomez-Benito J. Source: Percept Mot Skills. 2003 February; 96(1): 49-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705509&dopt=Abstract

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The symptoms of atypical depression. Author(s): Benazzi F. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 June; 48(5): 350-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866347&dopt=Abstract

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The tripartite model of anxiety and depression: symptom structure in depressive and hypertensive patient groups. Author(s): Marshall GN, Sherbourne CD, Meredith LS, Camp P, Hays RD. Source: Journal of Personality Assessment. 2003 April; 80(2): 139-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700017&dopt=Abstract

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Therapeutic effects of milnacipran (serotonin noradrenalin reuptake inhibitor) on depression following mild and moderate traumatic brain injury. Author(s): Kanetani K, Kimura M, Endo S. Source: Journal of Nippon Medical School = Nihon Ika Daigaku Zasshi. 2003 August; 70(4): 313-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12928711&dopt=Abstract

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Therapeutic use of sleep deprivation in depression. Author(s): Giedke H, Schwarzler F. Source: Sleep Medicine Reviews. 2002 October; 6(5): 361-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12531127&dopt=Abstract

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Therapies for depression in Parkinson's disease. Author(s): Shabnam GN, Th C, Kho D, H R, Ce C. Source: Cochrane Database Syst Rev. 2003; (3): Cd003465. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917968&dopt=Abstract

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They wound, work and womanize to mask depression. Boys don't cry. Author(s): Tumolo J. Source: Adv Nurse Pract. 2003 June; 11(6): 79-81. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807062&dopt=Abstract

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Tianeptine and fluoxetine in major depression: a 6-week randomised double-blind study. Author(s): Novotny V, Faltus F. Source: Human Psychopharmacology. 2002 August; 17(6): 299-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404675&dopt=Abstract

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Traumatic brain injury: depression, neurogenesis, and medication management. Author(s): Perna RB, Rouselle A, Brennan P. Source: The Journal of Head Trauma Rehabilitation. 2003 March-April; 18(2): 201-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802228&dopt=Abstract

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Traumatic grief as a disorder distinct from bereavement-related depression and anxiety: a replication study with bereaved mental health care patients. Author(s): Boelen PA, van den Bout J, de Keijser J. Source: The American Journal of Psychiatry. 2003 July; 160(7): 1339-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832252&dopt=Abstract

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Treating bipolar depression. Author(s): Shelton RC. Source: The Journal of Family Practice. 2003 March; Suppl: S14-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676079&dopt=Abstract

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Treating childhood depression over videoconferencing. Author(s): Nelson EL, Barnard M, Cain S. Source: Telemedicine Journal and E-Health : the Official Journal of the American Telemedicine Association. 2003 Spring; 9(1): 49-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699607&dopt=Abstract

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Treating depression in Alzheimer disease: efficacy and safety of sertraline therapy, and the benefits of depression reduction: the DIADS. Author(s): Lyketsos CG, DelCampo L, Steinberg M, Miles Q, Steele CD, Munro C, Baker AS, Sheppard JM, Frangakis C, Brandt J, Rabins PV. Source: Archives of General Psychiatry. 2003 July; 60(7): 737-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860778&dopt=Abstract

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Treating depression in predominantly low-income young minority women: a randomized controlled trial. Author(s): Miranda J, Chung JY, Green BL, Krupnick J, Siddique J, Revicki DA, Belin T. Source: Jama : the Journal of the American Medical Association. 2003 July 2; 290(1): 5765. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12837712&dopt=Abstract

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Treating depression in primary care in low-income women in Santiago, Chile: a randomised controlled trial. Author(s): Araya R, Rojas G, Fritsch R, Gaete J, Rojas M, Simon G, Peters TJ. Source: Lancet. 2003 March 22; 361(9362): 995-1000. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660056&dopt=Abstract

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Treating treatment-resistant depression. Whether to switch, augment, or combine therapies. Author(s): Bailey KP. Source: Journal of Psychosocial Nursing and Mental Health Services. 2003 June; 41(6): 14-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812001&dopt=Abstract

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Treatment for Adolescents With Depression Study (TADS): rationale, design, and methods. Author(s): Treatment for Adolescents With Depression Study Team. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 May; 42(5): 531-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707557&dopt=Abstract

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Treatment of bipolar depression: current status, continued challenges, and the STEPBD approach. Author(s): Thase ME, Bhargava M, Sachs GS. Source: The Psychiatric Clinics of North America. 2003 June; 26(2): 495-518. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778844&dopt=Abstract

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Treatment of cytokine-induced depression. Author(s): Capuron L, Hauser P, Hinze-Selch D, Miller AH, Neveu PJ. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 575-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401471&dopt=Abstract

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Treatment of depression in patients with heart disease. Author(s): Roose SP. Source: Biological Psychiatry. 2003 August 1; 54(3): 262-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893102&dopt=Abstract

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Treatment of leuprolide-induced depression with intramuscular testosterone: a case report. Author(s): Freeman MP, Freeman SA. Source: The Journal of Clinical Psychiatry. 2003 March; 64(3): 341-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716284&dopt=Abstract

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Treatment of major depression and anxiety with the selective serotonin re-uptake enhancer tianeptine in the outpatient psychiatric care setting of India. Author(s): Sonawalla S, Chakraborty N, Parikh R. Source: J Indian Med Assoc. 2003 February; 101(2): 116-7, 124. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841497&dopt=Abstract

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Treatment of poststroke generalized anxiety disorder comorbid with poststroke depression: merged analysis of nortriptyline trials. Author(s): Kimura M, Tateno A, Robinson RG. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2003 May-June; 11(3): 320-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724111&dopt=Abstract

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Treatment-resistant depression: the patient perspective. Author(s): Lewis L, Hoofnagle L. Source: Biological Psychiatry. 2003 April 15; 53(8): 635-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706949&dopt=Abstract

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Trends in elderly patients' office visits for the treatment of depression according to physician specialty: 1985-1999. Author(s): Harman JS, Crystal S, Walkup J, Olfson M. Source: The Journal of Behavioral Health Services & Research. 2003 July-September; 30(3): 332-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875100&dopt=Abstract

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Unadjusted and adjusted prevalence of diagnosed depression in type 2 diabetes. Author(s): Nichols GA, Brown JB. Source: Diabetes Care. 2003 March; 26(3): 744-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610032&dopt=Abstract

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Understanding adolescent depression in ethnocultural context. Author(s): Choi H. Source: Ans. Advances in Nursing Science. 2002 December; 25(2): 71-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484642&dopt=Abstract

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Understanding changes in primary care clinicians' satisfaction from depression care activities during adoption of selective serotonin reuptake inhibitors. Author(s): Shye D, Brown JB, Mullooly JP, Nichols GA. Source: Am J Manag Care. 2002 November; 8(11): 963-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437311&dopt=Abstract

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Understanding depression in men. Author(s): Walters P, Tylee A. Source: Practitioner. 2003 July; 247(1648): 598-602. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12879565&dopt=Abstract

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Understanding team-based quality improvement for depression in primary care. Author(s): Rubenstein LV, Parker LE, Meredith LS, Altschuler A, dePillis E, Hernandez J, Gordon NP. Source: Health Services Research. 2002 August; 37(4): 1009-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236381&dopt=Abstract

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Understanding the causal relationship between patient-reported interpersonal and technical quality of care for depression. Author(s): Orlando M, Meredith LS. Source: Medical Care. 2002 August; 40(8): 696-704. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187183&dopt=Abstract

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Unexplained fatigue syndromes in a multinational primary care sample: specificity of definition and prevalence and distinctiveness from depression and generalized anxiety. Author(s): Skapinakis P, Lewis G, Mavreas V. Source: The American Journal of Psychiatry. 2003 April; 160(4): 785-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668371&dopt=Abstract

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Unmasking disease-specific cerebral blood flow abnormalities: mood challenge in patients with remitted unipolar depression. Author(s): Liotti M, Mayberg HS, McGinnis S, Brannan SL, Jerabek P. Source: The American Journal of Psychiatry. 2002 November; 159(11): 1830-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411216&dopt=Abstract

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Untreated depression and hippocampal volume loss. Author(s): Sheline YI, Gado MH, Kraemer HC. Source: The American Journal of Psychiatry. 2003 August; 160(8): 1516-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12900317&dopt=Abstract

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Urinary incontinence and depression in middle-aged United States women. Author(s): Nygaard I, Turvey C, Burns TL, Crischilles E, Wallace R. Source: Obstetrics and Gynecology. 2003 January; 101(1): 149-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517660&dopt=Abstract

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Use of a depression screening tool and a fluoxetine-based algorithm to improve the recognition and treatment of depression in cancer patients. A demonstration project. Author(s): Passik SD, Kirsh KL, Theobald D, Donaghy K, Holtsclaw E, Edgerton S, Dugan W. Source: Journal of Pain and Symptom Management. 2002 September; 24(3): 318-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12458113&dopt=Abstract

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Use of cognitive therapy for relapse prevention in chronic depression. Costeffectiveness study. Author(s): Scott J, Palmer S, Paykel E, Teasdale J, Hayhurst H. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 March; 182: 221-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611785&dopt=Abstract

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Use of paroxetine for the treatment of depression and anxiety disorders in the elderly: a review. Author(s): Bourin M. Source: Human Psychopharmacology. 2003 April; 18(3): 185-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672169&dopt=Abstract

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Use of the reasons for depression questionnaire with adolescents. Author(s): Fitzgerald JM, Richardson H. Source: Journal of Clinical Psychology. 2002 September; 58(9): 1045-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12209864&dopt=Abstract

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Valid assessment of the clinical features of depression by relatives appears to slip under the RADAR. Author(s): Parker G, Gladstone G, Mitchell P, Welham K, Malhi G, Loo C. Source: The Australian and New Zealand Journal of Psychiatry. 2003 February; 37(1): 926. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534663&dopt=Abstract

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Validation of the five-item geriatric depression scale in elderly subjects in three different settings. Author(s): Rinaldi P, Mecocci P, Benedetti C, Ercolani S, Bregnocchi M, Menculini G, Catani M, Senin U, Cherubini A. Source: Journal of the American Geriatrics Society. 2003 May; 51(5): 694-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752847&dopt=Abstract

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Validity of the beck depression inventory, hospital anxiety and depression scale, SCL-90, and hamilton depression rating scale as screening instruments for depression in stroke patients. Author(s): Aben I, Verhey F, Lousberg R, Lodder J, Honig A. Source: Psychosomatics. 2002 September-October; 43(5): 386-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12297607&dopt=Abstract

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Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Author(s): Benedict RH, Fishman I, McClellan MM, Bakshi R, Weinstock-Guttman B. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 August; 9(4): 393-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926845&dopt=Abstract

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Validity of the Depression-Arkansas (D-ARK) Scale: a tool for measuring major depressive disorder. Author(s): Smith GR, Kramer TL, Hollenberg JA, Mosley CL, Ross RL, Burnam A. Source: Mental Health Services Research. 2002 September; 4(3): 167-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12385569&dopt=Abstract

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Validity of the hospital anxiety and depression scale for use with patients with noncardiac chest pain. Author(s): Kuijpers PM, Denollet J, Lousberg R, Wellens HJ, Crijns H, Honig A. Source: Psychosomatics. 2003 July-August; 44(4): 329-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832599&dopt=Abstract

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Vascular disease, depression, and dementia. Author(s): Alexopoulos GS. Source: Journal of the American Geriatrics Society. 2003 August; 51(8): 1178-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12890087&dopt=Abstract

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Vascular risk to late-life depression: evidence from a longitudinal community study. Author(s): Hickie I, Simons L, Naismith S, Simons J, McCallum J, Pearson K. Source: The Australian and New Zealand Journal of Psychiatry. 2003 February; 37(1): 625. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534658&dopt=Abstract

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Vasomotor symptoms are associated with depression in perimenopausal women seeking primary care. Author(s): Joffe H, Hall JE, Soares CN, Hennen J, Reilly CJ, Carlson K, Cohen LS. Source: Menopause (New York, N.Y.). 2002 November-December; 9(6): 392-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439097&dopt=Abstract

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Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. Author(s): Kilpatrick DG, Ruggiero KJ, Acierno R, Saunders BE, Resnick HS, Best CL. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 692-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924674&dopt=Abstract

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Visual cortex: suppression by depression? Author(s): Mrsic-Flogel T, Hubener M. Source: Current Biology : Cb. 2002 August 20; 12(16): R547-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12194833&dopt=Abstract

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Visuo-motor coordination is normal in patients with major depression. Author(s): Hocherman S, Dimant A, Schwartz M. Source: Parkinsonism & Related Disorders. 2003 August; 9(6): 361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12853236&dopt=Abstract

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Vitamin B12, folate, and homocysteine in depression: the Rotterdam Study. Author(s): Tiemeier H, van Tuijl HR, Hofman A, Meijer J, Kiliaan AJ, Breteler MM. Source: The American Journal of Psychiatry. 2002 December; 159(12): 2099-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450964&dopt=Abstract

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What does the Keane PTSD scale of the MMPI measure? Repeated measurements in a group of patients with major depression. Author(s): Wetzel RD, Murphy GE, Simons A, Lustman P, North C, Yutzy S. Source: Psychological Reports. 2003 June; 92(3 Pt 1): 781-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841442&dopt=Abstract

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When adolescents disagree with their mothers: CBCL-YSR discrepancies related to maternal depression and adolescent self-esteem. Author(s): Berg-Nielsen TS, Vika A, Dahl AA. Source: Child: Care, Health and Development. 2003 May; 29(3): 207-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752611&dopt=Abstract

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When depression is the diagnosis, what happens to patients and are they satisfied? Author(s): Solberg LI, Fischer LR, Rush WA, Wei F. Source: Am J Manag Care. 2003 February; 9(2): 131-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597601&dopt=Abstract

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When does ST-segment depression in the presence of a narrow QRS tachycardia signify ischemia? Author(s): Thompson C, Tsiperfal A. Source: Progress in Cardiovascular Nursing. 2003 Winter; 18(1): 60-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624574&dopt=Abstract

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When joy becomes grief. Screening tools for postpartum depression. Author(s): Vieira T. Source: Awhonn Lifelines / Association of Women's Health, Obstetric and Neonatal Nurses. 2002 December; 6(6): 506-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593259&dopt=Abstract

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When should a trial of fluoxetine for major depression be declared failed? Author(s): Quitkin FM, Petkova E, McGrath PJ, Taylor B, Beasley C, Stewart J, Amsterdam J, Fava M, Rosenbaum J, Reimherr F, Fawcett J, Chen Y, Klein D. Source: The American Journal of Psychiatry. 2003 April; 160(4): 734-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668363&dopt=Abstract

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When the cradle falls II: The cost-effectiveness of treating postnatal depression in a psychiatric day hospital compared with routine primary care. Author(s): Boath E, Major K, Cox J. Source: Journal of Affective Disorders. 2003 April; 74(2): 159-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706517&dopt=Abstract

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Which depression screening tools should be used in palliative care? Author(s): Lloyd-Williams M, Spiller J, Ward J. Source: Palliative Medicine. 2003 January; 17(1): 40-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597464&dopt=Abstract

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Willingness to pay for depression treatment in primary care. Author(s): Unutzer J, Katon WJ, Russo J, Simon G, von Korff M, Lin E, Walker E, Ludman E, Bush T. Source: Psychiatric Services (Washington, D.C.). 2003 March; 54(3): 340-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610241&dopt=Abstract

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Wolf-Hirschhorn (4p-)syndrome in a near adult with major depression; successful treatment with citalopram. Author(s): Verhoeven WM, Moog U, Wagemans AM, Tuinier S. Source: Genet Couns. 2002; 13(3): 297-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416637&dopt=Abstract

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Women and depression: a millennial perspective. Author(s): Blehar MC, Keita GP. Source: Journal of Affective Disorders. 2003 March; 74(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646293&dopt=Abstract

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Women's conceptions of coping with major depression in daily life: a qualitative, salutogenic approach. Author(s): Skarsater I, Dencker K, Bergbom I, Haggstrom L, Fridlund B. Source: Issues in Mental Health Nursing. 2003 June; 24(4): 419-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746183&dopt=Abstract

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Work, social, and family disabilities of subjects with anxiety and depression. Author(s): Kennedy BL, Lin Y, Schwab JJ. Source: Southern Medical Journal. 2002 December; 95(12): 1424-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597311&dopt=Abstract

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Working memory and prefrontal cortex dysfunction: specificity to schizophrenia compared with major depression. Author(s): Barch DM, Sheline YI, Csernansky JG, Snyder AZ. Source: Biological Psychiatry. 2003 March 1; 53(5): 376-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614990&dopt=Abstract

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Workplace bullying and the risk of cardiovascular disease and depression. Author(s): Kivimaki M, Virtanen M, Vartia M, Elovainio M, Vahtera J, KeltikangasJarvinen L. Source: Occupational and Environmental Medicine. 2003 October; 60(10): 779-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14504368&dopt=Abstract

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World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorders. Part I: Treatment of bipolar depression. Author(s): Grunze H, Kasper S, Goodwin G, Bowden C, Baldwin D, Licht R, Vieta E, Moller HJ; World Federation of Societies of Biological Psychiatry Task Force on Treatment Guidelines for Bipolar Disorders. Source: World J Biol Psychiatry. 2002 July; 3(3): 115-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478876&dopt=Abstract

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CHAPTER 2. NUTRITION AND DEPRESSION Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and depression.

Finding Nutrition Studies on Depression The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “depression” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following is a typical result when searching for recently indexed consumer information on depression: •

Dieting, essential fatty acid intake, and depression. Author(s): University of Arizona College of Public Health, Tucson 85724, USA. Source: Bruinsma, K A Taren, D L Nutr-Revolume 2000 April; 58(4): 98-108 0029-6643

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Estrogen and perimenopausal depression. Source: Anonymous Harv-Womens-Health-Watch. 2000 December; 8(4): 7 1070-910X

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Lifetime prevalence of major depression and its effect on treatment outcome in obese type II diabetic patients. Author(s): Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania. Source: Marcus, M D Wing, R R Guare, J Blair, E H Jawad, A Diabetes-Care. 1992 February; 15(2): 253-5 0149-5992

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Mental health. Relieving depression. Source: Anonymous Harv-Womens-Health-Watch. 2000 February; 7(6): 4-5 1070-910X

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Natural hazards. Tonic or toxic? Americans are gobbling up nature's remedies for everything from obesity to depression. Source: Spake, A US-News-World-Repage 2001 February 12; 130(6): 42-9 0041-5537

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Nutrition and depression: the role of folate. Author(s): Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA. Source: Alpert, J E Fava, M Nutr-Revolume 1997 May; 55(5): 145-9 0029-6643

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St. John's wort for depression. Source: Anonymous Harv-Womens-Health-Watch. 2000 November; 8(3): 1 1070-910X

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Study shows St. John's wort ineffective for major depression. Source: Anonymous FDA-Consum. 2002 May-June; 36(3): 8 0362-1332

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Three concentrations of St. John's Wort effective against depression. Source: Morien, K. HerbalGram. Austin, TX : American Botanical Council and the Herb Research Foundation. 2000. (49) page 25-26. 0899-5648

The following information is typical of that found when using the “Full IBIDS Database” to search for “depression” (or a synonym): •

31P-MRS study of acetyl-L-carnitine treatment in geriatric depression: preliminary results. Author(s): Neurophysics Laboratory, Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. [email protected] Source: Pettegrew, Jay W Levine, Joseph Gershon, Samuel Stanley, Jeffrey A Servan Schreiber, David Panchalingam, Kanagasabai McClure, Richard J Bipolar-Disord. 2002 February; 4(1): 61-6 1398-5647

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Antidepressant activity of standardized extract of Bacopa monniera in experimental models of depression in rats. Author(s): Department of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Source: Sairam, K Dorababu, M Goel, R K Bhattacharya, S K Phytomedicine. 2002 April; 9(3): 207-11 0944-7113

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Anxiety, depression, and insomnia. Author(s): Department of Family Medicine, Louisiana State University Health Sciences Center, School of Medicine, 200 West Esplanade Avenue, Suite 510, Kenner, LA 70065, USA. [email protected] Source: Larzelere, M M Wiseman, P Prim-Care. 2002 June; 29(2): 339-60, vii 0095-4543

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APOE epsilon4 and low cholesterol as risks for depression in a biracial elderly community sample. Author(s): Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 277100001, USA. [email protected] Source: Blazer, D G Burchett, B B Fillenbaum, G G Am-J-Geriatr-Psychiatry. 2002 SepOctober; 10(5): 515-20 1064-7481

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Are tryptophan and 5-hydroxytryptophan effective treatments for depression? A meta-analysis. Author(s): School of Population Health, Department of Public Health, University of Queensland Medical School, Herston 4006, Australia. [email protected] Source: Shaw, K Turner, J Del March, C Aust-N-Z-J-Psychiatry. 2002 August; 36(4): 48891 0004-8674

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Blockade of NMDA-receptors or calcium-channels attenuates the ischaemia-evoked efflux of glutamate and phosphoethanolamine and depression of neuronal activity in rat organotypic hippocampal slice cultures. Author(s): Departement de pharmacologie/APSIC, centre medical universitaire, rue Michel-Servet 1, 1211 Geneve 4, Switzerland. Source: Robert, F Bert, L Stoppini, L C-R-Biol. 2002 April; 325(4): 495-504 1631-0691

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Calcineurin regulates induction of late phase of cerebellar long-term depression in rat cultured Purkinje neurons. Author(s): Department of Biophysics, Graduate School of Science, Kyoto University, Sakyo-ku, Kyoto 606-8502, Japan. Source: Fujii, H Hirano, T Eur-J-Neurosci. 2002 November; 16(9): 1777-88 0953-816X

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Cerebellar long-term synaptic depression requires PKC-mediated activation of CPI17, a myosin/moesin phosphatase inhibitor. Author(s): Center for Cell Signaling, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. Source: Eto, M Bock, R Brautigan, D L Linden, D J Neuron. 2002 December 19; 36(6): 1145-58 0896-6273

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Chronic inositol treatment reduces depression-like immobility of Flinders Sensitive Line rats in the forced swim test. Author(s): Beer Sheva Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. Source: Einat, Haim Belmaker, Robert H Zangen, Avraham Overstreet, D H Yadid, Gal Depress-Anxiety. 2002; 15(3): 148-51 1091-4269

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Clinical trials with hypericum extracts in patients with depression--results, comparisons, conclusions for therapy with antidepressant drugs. Author(s): [email protected] Source: Schulz, V Phytomedicine. 2002 July; 9(5): 468-74 0944-7113

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Control of lysine reactivity in four-helix bundle proteins by site-selective pKa depression: expanding the versatility of proteins by postsynthetic functionalization. Author(s): Department of Chemistry, Goteborg University, Sweden.

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Source: Andersson, L K Caspersson, M Baltzer, L Chemistry. 2002 August 16; 8(16): 3687-97 0947-6539 •

Depression and chronic diabetic foot disability. A case report of suicide. Author(s): Department of Orthopaedics and Podiatry, Loyola University Medical Center, 2160 South First Avenue, Maxwood, IL 60153, USA. Source: Walsh, S M Sage, R A Clin-Podiatr-Med-Surg. 2002 October; 19(4): 493-508 08918422

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Depression of fast excitatory synaptic transmission in large aspiny neurons of the neostriatum after transient forebrain ischemia. Author(s): Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. Source: Pang, Z P Deng, P Ruan, Y W Xu, Z C J-Neurosci. 2002 December 15; 22(24): 10948-57 1529-2401

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Depression of Saccharomyces cerevisiae invasive growth on non-glucose carbon sources requires the Snf1 kinase. Author(s): Department of Chemical Engineering, University of Wisconsin, Madison, Madison, WI 53706, USA. Source: Palecek, S P Parikh, A S Huh, J H Kron, S J Mol-Microbiol. 2002 July; 45(2): 45369 0950-382X

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Determination of the dose of agomelatine, a melatoninergic agonist and selective 5HT(2C) antagonist, in the treatment of major depressive disorder: a placebocontrolled dose range study. Author(s): Service Hospitalo Universitaire de Sante Mentale et de Therapeutique, Hopital Sainte Anne, Paris, France. [email protected] Source: Loo, H Hale, A D'haenen, H Int-Clin-Psychopharmacol. 2002 September; 17(5): 239-47 0268-1315

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Effect of manganese on guinea pig ventricle: initial depression and late augmentation of contractile force. Author(s): Department of Pharmacology, Toho University School of Pharmaceutical Sciences, Funabashi, Chiba, Japan. [email protected] Source: Tanaka, H Ishii, T Fujisaki, R Miyamoto, Y Tanaka, Y Aikawa, T Hirayama, W Kawanishi, T Shigenobu, K Biol-Pharm-Bull. 2002 March; 25(3): 323-6 0918-6158

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Effect of nicotine and nicotinic receptors on anxiety and depression. Author(s): Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06508, USA. Source: Picciotto, M R Brunzell, D H Caldarone, B J Neuroreport. 2002 July 2; 13(9): 1097-106 0959-4965

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Effects of U-50,488H, a kappa-opioid receptor agonist, on the learned helplessness model of depression in mice. Author(s): Department of Chemical Pharmacology, Faculty of Pharmacy, Meijo University, Japan. [email protected] Source: Ukai, M Suzuki, M Mamiya, T J-Neural-Transm. 2002 September; 109(9): 1221-5 0300-9564

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Exemplar: reversing respiratory depression. Source: Farland, A Nurs-N-Z. 2001 May; 7(4): 21 1173-2032

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Implications of self-administered St. John's wort for depression symptom management. Author(s): Marinette County Health & Human Service Department, University of Wisconsin-Madison School of Nursing, USA. [email protected] Source: Boehnlein, B Oakley, L D J-Am-Acad-Nurse-Pract. 2002 October; 14(10): 443-8 1041-2972

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Involvement of decreased myo-inositol transport in lipopolysaccharide-induced depression of phosphoinositide hydrolysis in vascular smooth muscle. Author(s): Department of Hygiene and Preventive Medicine, School of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, Japan. Source: Sotoda, Yoko Negoro, Munetaka Wakabayashi, Ichiro FEBS-Lett. 2002 May 22; 519(1-3): 227-30 0014-5793

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Involvement of N-methyl-D-aspartate receptors for the Ptychodiscus brevis toxininduced depression of monosynaptic and polysynaptic reflexes in neonatal rat spinal cord in vitro. Author(s): Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, 221005, Varanasi, India. Source: Singh, J N Deshpande, S B Neuroscience. 2002; 115(4): 1189-97 0306-4522

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Journal writing as a complementary therapy for reactive depression: a rehabilitation teaching program. Author(s): School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA. Source: Smith, C E Holcroft, C Rebeck, S L Thompson, N C Werkowitch, M RehabilNurs. 2000 Sep-October; 25(5): 170-6 0278-4807

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Kindling enhances kainate receptor-mediated depression of GABAergic inhibition in rat granule cells. Author(s): Departments of Neurology and Physiology, Reed Neurological Research Center, UCLA School of Medicine, Los Angeles, CA 90095- 1769, USA. [email protected] Source: Behr, J Gebhardt, C Heinemann, U Mody, I Eur-J-Neurosci. 2002 September; 16(5): 861-7 0953-816X

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Late life depression. Author(s): Institute of Clinical Neuroscience Sahlgrenska, University Hospital Molndal, Sweden. Source: Gottfries, C G Eur-Arch-Psychiatry-Clin-Neurosci. 2001; 251 Suppl 2: II57-61 0940-1334

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Long-term depression and long-term potentiation in horizontal connections of the barrel cortex. Author(s): Department of Molecular and Cellular Neurobiology, Nencki Institute of Experimental Biology, 3 Pasteur St., 02-093 Warsaw, Poland. Source: Urban, J Kossut, M Hess, G Eur-J-Neurosci. 2002 November; 16(9): 1772-6 0953816X

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Naltrexone in the treatment of heroin dependence: relationship with depression and risk of overdose. Author(s): Turning Point Alcohol and Drug Centre, Fitzroy, Victoria, Australia. [email protected] Source: Ritter, A J Aust-N-Z-J-Psychiatry. 2002 April; 36(2): 224-8 0004-8674

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Neocortical long-term potentiation and long-term depression: site of expression investigated by infrared-guided laser stimulation. Author(s): Department of Clinical Neuropharmacology, Max-Planck-Institute of Psychiatry, 80804 Munich, Germany. [email protected] Source: Eder, M Zieglgansberger, W Dodt, H U J-Neurosci. 2002 September 1; 22(17): 7558-68 1529-2401

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Optical imaging of long-term depression in the mouse cerebellar cortex in vivo. Author(s): Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota 55455, USA. Source: Gao, W Dunbar, R L Chen, G Reinert, K C Oberdick, J Ebner, T J J-Neurosci. 2003 March 1; 23(5): 1859-66 1529-2401

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Panic attack in a context of comorbid anxiety and depression in a Tibetan refugee. Author(s): Department of Social Medicine, Harvard Medical School, Boston, MA 02115, USA. Source: Jacobson, E Cult-Med-Psychiatry. 2002 June; 26(2): 259-79 0165-005X

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Role of selenium depletion in the etiopathogenesis of depression in patient with alcoholism. Source: Sher, L Med-Hypotheses. 2002 September; 59(3): 330-3 0306-9877

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S-adenosylmethionine and depression. Source: Nguyen, Minh Gregan, Angel Aust-Fam-Physician. 2002 April; 31(4): 339-43 0300-8495

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Sex hormones and their impact on dementia and depression: a clinical perspective. Author(s): Department of Psychiatry and Behavioural Science, University of Western Australia, Perth, WA 6847, Australia. [email protected] Source: Almeida, O P Barclay, L Expert-Opin-Pharmacother. 2001 April; 2(4): 527-35 1465-6566

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Sleep-wake effects of yohimbine and atropine in rats with a clomipramine-based model of depression. Author(s): Sleep Research Laboratory, Department of Psychiatry and Behavioral Neuroscience, Boston University School of Medicine, 715 Albany Street, Boston, MA 02118, USA. Source: Mavanji, V Datta, S Neuroreport. 2002 September 16; 13(13): 1603-6 0959-4965

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Spreading depression: imaging and blockade in the rat neocortical brain slice. Author(s): Department of Anatomy and Cell Biology, Queen's University, Kingston, Ontario K7L 3N6, Canada. Source: Anderson, T R Andrew, R D J-Neurophysiol. 2002 November; 88(5): 2713-25 0022-3077

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The role of noradrenaline and selective noradrenaline reuptake inhibition in depression. Author(s): Department of Pharmaceutical Sciences, University of Modena and Reggio Emilia, Modena, Italy. [email protected] Source: Brunello, N Mendlewicz, J Kasper, S Leonard, B Montgomery, S Nelson, J Paykel, E Versiani, M Racagni, G Eur-Neuropsychopharmacol. 2002 October; 12(5): 46175 0924-977X

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Thyroid hormone augmentation with levothyroxine in bipolar depression. Author(s): Department of Psychiatry and Psychotherapy, Charite, Humbo dt Univers ty Berlin, Germany. Source: Bauer, M Bipolar-Disord. 2002; 4 Suppl 1: 109-10 1398-5647

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Topiramate in treatment-resistant depression and binge-eating disorder. Author(s): Behavior Neurobiology Research Group, Neuroscience Laboratory, Biomedical Research Institute, Porto Alegre, PUC-RS, Brazil. [email protected] Source: Schmidt do Prado Lima, P A Bacaltchuck, J Bipolar-Disord. 2002 August; 4(4): 271-3 1398-5647

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Treatment of depression in idiopathic Parkinson's disease. Source: Anonymous Mov-Disord. 2002; 17 Suppl 4: S112-9 0885-3185

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Use of aromatherapy with hospice patients to decrease pain, anxiety, and depression and to promote an increased sense of well-being. Author(s): Department of Nursing, University of Nevada, Las Vegas, USA. Source: Louis, M Kowalski, S D Am-J-Hosp-Palliat-Care. 2002 Nov-December; 19(6): 381-6 1049-9091

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World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorders. Part I: Treatment of bipolar depression. Author(s): Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstrasse 7, 80336 Munich, Germany. [email protected] Source: Grunze, H Kasper, S Goodwin, G Bowden, C Baldwin, D Licht, R Vieta, E Moller, H J World-J-Biol-Psychiatry. 2002 July; 3(3): 115-24 1562-2975

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMD®Health: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html

The following is a specific Web list relating to depression; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation (some Web sites are subscription based): •

Vitamins Folic Acid Source: Healthnotes, Inc. www.healthnotes.com Folic Acid Source: Integrative Medicine Communications; www.drkoop.com Folic acid Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,887,00.html Niacin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Pantothenic acid Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,882,00.html Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Pyridoxine Alternative names: Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com

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Riboflavin Source: Integrative Medicine Communications; www.drkoop.com Thiamin (vitamin B Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10060,00.html Thiamine Source: Integrative Medicine Communications; www.drkoop.com Vitamin B Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html Vitamin B complex Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,962,00.html Vitamin B1 (Thiamine) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B12 Source: Healthnotes, Inc. www.healthnotes.com Vitamin B12 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B2 (Riboflavin) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B6 Source: Healthnotes, Inc. www.healthnotes.com Vitamin B6 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B6 (Pyridoxine) Alternative names: Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B9 (Folic Acid) Alternative names: Folate, Folic Acid Source: Integrative Medicine Communications; www.drkoop.com

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Vitamin C Source: Healthnotes, Inc. www.healthnotes.com Vitamin D Source: Healthnotes, Inc. www.healthnotes.com Vitamin E Source: Healthnotes, Inc. www.healthnotes.com Vitamin K Alternative names: Menadione, Menaphthone, Menaquinone, Phylloquinone Source: Integrative Medicine Communications; www.drkoop.com •

Minerals Acetyl-L-Carnitine Source: Healthnotes, Inc. www.healthnotes.com Aluminum, Calcium, and Magnesium-Containing Preparations Source: Integrative Medicine Communications; www.drkoop.com Biotin Source: Healthnotes, Inc. www.healthnotes.com Calcium Source: Healthnotes, Inc. www.healthnotes.com Calcium Source: Integrative Medicine Communications; www.drkoop.com Calcium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,884,00.html Calcium Acetate Source: Healthnotes, Inc. www.healthnotes.com Calcium/magnesium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,937,00.html Carnitine Source: Prima Communications, Inc.www.personalhealthzone.com Chromium Source: Healthnotes, Inc. www.healthnotes.com Copper Source: Healthnotes, Inc. www.healthnotes.com

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Fluoxetine Source: Healthnotes, Inc. www.healthnotes.com Folate Source: Integrative Medicine Communications; www.drkoop.com Folate Source: Prima Communications, Inc.www.personalhealthzone.com Gabapentin Source: Healthnotes, Inc. www.healthnotes.com Iron Source: Healthnotes, Inc. www.healthnotes.com Iron Source: Prima Communications, Inc.www.personalhealthzone.com Lecithin and choline Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10040,00.html Lecithin/Phosphatidylcholine/Choline Source: Healthnotes, Inc. www.healthnotes.com Magnesium Source: Healthnotes, Inc. www.healthnotes.com Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Naproxen/Naproxen Sodium Source: Healthnotes, Inc. www.healthnotes.com Paroxetine Source: Healthnotes, Inc. www.healthnotes.com Potassium-Sparing Diuretics Source: Integrative Medicine Communications; www.drkoop.com Selenium Source: Healthnotes, Inc. www.healthnotes.com Selenium Source: Integrative Medicine Communications; www.drkoop.com

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Selenium Source: Prima Communications, Inc.www.personalhealthzone.com Selenium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10055,00.html Vanadium Alternative names: Vanadate, Vanadyl Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Healthnotes, Inc. www.healthnotes.com •

Food and Diet Bluefish Source: Healthnotes, Inc. www.healthnotes.com Coffee Source: Healthnotes, Inc. www.healthnotes.com Fasting Diet Source: Healthnotes, Inc. www.healthnotes.com Gluten-Free Diet Source: Healthnotes, Inc. www.healthnotes.com Low-Fat Recipes Index Source: Healthnotes, Inc. www.healthnotes.com Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Omega-3 Fatty Acids Source: Integrative Medicine Communications; www.drkoop.com Omega-3 fatty acids Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,992,00.html Pumpkin Seeds Source: Healthnotes, Inc. www.healthnotes.com Pumpkin seeds Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,176,00.html

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Salmon Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,102,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND DEPRESSION Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to depression. At the conclusion of this chapter, we will provide additional sources.

The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “depression” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •

S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease Source: Rockville, MD: Agency for Healthcare Research and Quality. 2002. 6 p. Contact: Available from National Center for Complementary and Alternative Medicine Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898. (888) 644-6226; INTERNATIONAL PHONE: (301) 519-3153; TTY: (866) 464-3615; FAX: (866) 464-3616; EMAIL: [email protected]. PRICE: Free. Publication Number: D175. Summary: This evidence report/technology assessment summary from the Agency for Healthcare Research and Quality (AHRQ) provides a review of the published literature on the use of S-adenosyl-L-methionine (SAMe) for the treatment of osteoarthritis, depression, and liver disease (cholestasis of pregnancy). The literature review is used to evaluate evidence for the efficacy of SAMe. The summary includes a description of the methodology, including the search strategy; selection criteria; and data collection and

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analysis. The findings are then discussed followed by an overview of future research on the topic. Information is also given on when and where the full report will be available. 1 reference.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to depression and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “depression” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to depression: •

A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Author(s): Peet M, Horrobin DF. Source: Archives of General Psychiatry. 2002 October; 59(10): 913-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365878&dopt=Abstract

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A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Author(s): Marangell LB, Martinez JM, Zboyan HA, Kertz B, Kim HF, Puryear LJ. Source: The American Journal of Psychiatry. 2003 May; 160(5): 996-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727707&dopt=Abstract

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A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression. Author(s): Holtzheimer PE 3rd, Russo J, Avery DH. Source: Psychopharmacology Bulletin. 2001 Autumn; 35(4): 149-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397863&dopt=Abstract

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A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Author(s): Grunhaus L, Schreiber S, Dolberg OT, Polak D, Dannon PN. Source: Biological Psychiatry. 2003 February 15; 53(4): 324-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12586451&dopt=Abstract

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A survey of herbal use in children with attention-deficit-hyperactivity disorder or depression. Author(s): Cala S, Crismon ML, Baumgartner J.

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Source: Pharmacotherapy. 2003 February; 23(2): 222-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587812&dopt=Abstract •

Acute and chronic effects of citalopram on cerebral glucose metabolism in geriatric depression. Author(s): Smith GS, Kramer E, Hermann CR, Goldberg S, Ma Y, Dhawan V, Barnes A, Chaly T, Belakhleff A, Laghrissi-Thode F, Greenwald B, Eidelberg D, Pollock BG. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 November-December; 10(6): 715-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427580&dopt=Abstract

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Add-on rTMS for treatment of depression: a pilot study using stereotaxic coilnavigation according to PET data. Author(s): Herwig U, Lampe Y, Juengling FD, Wunderlich A, Walter H, Spitzer M, Schonfeldt-Lecuona C. Source: Journal of Psychiatric Research. 2003 July-August; 37(4): 267-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765849&dopt=Abstract

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Alternative treatments for depression: empirical support and relevance to women. Author(s): Manber R, Allen JJ, Morris MM. Source: The Journal of Clinical Psychiatry. 2002 July; 63(7): 628-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12143922&dopt=Abstract

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An open pilot study of nefazodone in depression with anger attacks: relationship between clinical response and receptor binding. Author(s): Mischoulon D, Dougherty DD, Bottonari KA, Gresham RL, Sonawalla SB, Fischman AJ, Fava M. Source: Psychiatry Research. 2002 December 30; 116(3): 151-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477599&dopt=Abstract

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An open-label pilot study of St. John's wort in juvenile depression. Author(s): Findling RL, McNamara NK, O'Riordan MA, Reed MD, Demeter CA, Branicky LA, Blumer JL. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 August; 42(8): 908-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874492&dopt=Abstract

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Anxiety and depression. Natural mood remedies. Author(s): Miller MC. Source: Newsweek. 2002 December 2; 140(23): 70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12501517&dopt=Abstract

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Anxiety, depression, and insomnia. Author(s): Larzelere MM, Wiseman P. Source: Primary Care. 2002 June; 29(2): 339-60, Vii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12391715&dopt=Abstract

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Arterial endothelial function is impaired in treated depression. Author(s): Broadley AJ, Korszun A, Jones CJ, Frenneaux MP. Source: Heart (British Cardiac Society). 2002 November; 88(5): 521-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381649&dopt=Abstract

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Average sunrise time predicts depression prevalence. Author(s): Olders H. Source: Journal of Psychosomatic Research. 2003 August; 55(2): 99-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12932507&dopt=Abstract

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Benefits of infant massage for mothers with postnatal depression. Author(s): Glover V, Onozawa K, Hodgkinson A. Source: Seminars in Neonatology : Sn. 2002 December; 7(6): 495-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614602&dopt=Abstract

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Biological effects of stannous chloride, a substance that can produce stimulation or depression of the central nervous system. Author(s): Silva CR, Oliveira MB, Melo SF, Dantas FJ, de Mattos JC, Bezerra RJ, Caldeira-de-Araujo A, Duatti A, Bernardo-Filho M. Source: Brain Research Bulletin. 2002 November 30; 59(3): 213-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431751&dopt=Abstract

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Care for women with postpartum depression: “N*U*R*S*E” approach. Author(s): Sichel D, Driscoll JW. Source: Journal of Midwifery & Women's Health. 2002 September-October; 47(5): 392. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361354&dopt=Abstract

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Changes in regional cerebral blood flow with venlafaxine in the treatment of major depression. Author(s): Davies J, Lloyd KR, Jones IK, Barnes A, Pilowsky LS. Source: The American Journal of Psychiatry. 2003 February; 160(2): 374-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562589&dopt=Abstract

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Clinical and biochemical observations during treatment of depression with electroacupuncture: a pilot study. Author(s): Pohl A, Nordin C.

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Source: Human Psychopharmacology. 2002 October; 17(7): 345-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415553&dopt=Abstract •

Clinical trials with hypericum extracts in patients with depression--results, comparisons, conclusions for therapy with antidepressant drugs. Author(s): Schulz V. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2002 July; 9(5): 468-74. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12222670&dopt=Abstract

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Comment on “Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial”. Author(s): Kellner CH, Husain M, Petrides G, Fink M, Rummans T. Source: Biological Psychiatry. 2002 November 15; 52(10): 1032-3; Discussion 1033. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437944&dopt=Abstract

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Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild to moderate depression: a double-blind, randomized trial. Author(s): Akhondzadeh S, Kashani L, Fotouhi A, Jarvandi S, Mobaseri M, Moin M, Khani M, Jamshidi AH, Baghalian K, Taghizadeh M. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2003 February; 27(1): 123-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12551734&dopt=Abstract

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Cytokines and depression. Author(s): Clow A. Source: Int Rev Neurobiol. 2002; 52: 255-73. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12498107&dopt=Abstract

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Depression and HIV infection: impact on immune function and disease progression. Author(s): Cruess DG, Petitto JM, Leserman J, Douglas SD, Gettes DR, Ten Have TR, Evans DL. Source: Cns Spectr. 2003 January; 8(1): 52-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627049&dopt=Abstract

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Depression and quality of life: results of a follow-up study. Author(s): Angermeyer MC, Holzinger A, Matschinger H, Stengler-Wenzke K. Source: The International Journal of Social Psychiatry. 2002 September; 48(3): 189-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413247&dopt=Abstract

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Depression in cancer: new developments regarding diagnosis and treatment. Author(s): Raison CL, Miller AH.

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Source: Biological Psychiatry. 2003 August 1; 54(3): 283-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893104&dopt=Abstract •

Depression in children and adolescents. Author(s): Hazell P. Source: American Family Physician. 2003 February 1; 67(3): 577-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12588080&dopt=Abstract

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Depression in patients with heart failure: physiologic effects, incidence, and relation to mortality. Author(s): Thomas SA, Friedmann E, Khatta M, Cook LK, Lann AL. Source: Aacn Clinical Issues. 2003 February; 14(1): 3-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574698&dopt=Abstract

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Depression, anxiety and quality of life: outcome 9 months after facial cosmetic surgery. Author(s): Meningaud JP, Benadiba L, Servant JM, Herve C, Bertrand JC, Pelicier Y. Source: Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery. 2003 February; 31(1): 46-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553927&dopt=Abstract

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Depression: the challenge for all healthcare professionals. Author(s): Moore K, McLaughlin D. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2003 March 12-18; 17(26): 45-52; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677820&dopt=Abstract

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Developing a culture-specific tool to assess postnatal depression in the Indian community. Author(s): Mantle F. Source: British Journal of Community Nursing. 2003 April; 8(4): 176-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732834&dopt=Abstract

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Diagnosis and management of depression in primary care: a clinical update and review. Author(s): Remick RA. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 November 26; 167(11): 1253-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12451082&dopt=Abstract

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Differential brain metabolic predictors of response to paroxetine in obsessivecompulsive disorder versus major depression. Author(s): Saxena S, Brody AL, Ho ML, Zohrabi N, Maidment KM, Baxter LR Jr.

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Source: The American Journal of Psychiatry. 2003 March; 160(3): 522-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611834&dopt=Abstract •

Diseases of the mind and brain: depression: a disease of the mind, brain, and body. Author(s): Gold PW, Charney DS. Source: The American Journal of Psychiatry. 2002 November; 159(11): 1826. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411213&dopt=Abstract

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Does religious psychotherapy improve anxiety and depression in religious adults? A review of randomized controlled studies. Author(s): Berry D. Source: Int J Psychiatr Nurs Res. 2002 October; 8(1): 875-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12448875&dopt=Abstract

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Double-blind controlled investigation of bilateral prefrontal transcranial magnetic stimulation for the treatment of resistant major depression. Author(s): Loo CK, Mitchell PB, Croker VM, Malhi GS, Wen W, Gandevia SC, Sachdev PS. Source: Psychological Medicine. 2003 January; 33(1): 33-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12537034&dopt=Abstract

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Dysfunctional attitudes and 5-HT2 receptors during depression and self-harm. Author(s): Meyer JH, McMain S, Kennedy SH, Korman L, Brown GM, DaSilva JN, Wilson AA, Blak T, Eynan-Harvey R, Goulding VS, Houle S, Links P. Source: The American Journal of Psychiatry. 2003 January; 160(1): 90-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505806&dopt=Abstract

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Effect of agomelatine in the chronic mild stress model of depression in the rat. Author(s): Papp M, Gruca P, Boyer PA, Mocaer E. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 April; 28(4): 694-703. Epub 2002 October 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655314&dopt=Abstract

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Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing. Author(s): Llorente AM, Jensen CL, Voigt RG, Fraley JK, Berretta MC, Heird WC. Source: American Journal of Obstetrics and Gynecology. 2003 May; 188(5): 1348-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748510&dopt=Abstract

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Effects of animal-assisted therapy on patients' anxiety, fear, and depression before ECT. Author(s): Barker SB, Pandurangi AK, Best AM.

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Source: The Journal of Ect. 2003 March; 19(1): 38-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12621276&dopt=Abstract •

Effects of antidepressant pharmacotherapy after repetitive transcranial magnetic stimulation in major depression: an open follow-up study. Author(s): Schule C, Zwanzger P, Baghai T, Mikhaiel P, Thoma H, Moller HJ, Rupprecht R, Padberg F. Source: Journal of Psychiatric Research. 2003 March-April; 37(2): 145-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842168&dopt=Abstract

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Efficacy of repetitive transcranial magnetic stimulation in depression: a review of the evidence. Author(s): Aarre TF, Dahl AA, Johansen JB, Kjonniksen I, Neckelmann D. Source: Nordic Journal of Psychiatry. 2003; 57(3): 227-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775299&dopt=Abstract

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Efficacy of St. John's wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial. Author(s): Lecrubier Y, Clerc G, Didi R, Kieser M. Source: The American Journal of Psychiatry. 2002 August; 159(8): 1361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12153829&dopt=Abstract

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Focal brain stimulation with repetitive transcranial magnetic stimulation (rTMS): implications for the neural circuitry of depression. Author(s): Lisanby SH. Source: Psychological Medicine. 2003 January; 33(1): 7-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12537031&dopt=Abstract

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Glucose metabolic response to total sleep deprivation, recovery sleep, and acute antidepressant treatment as functional neuroanatomic correlates of treatment outcome in geriatric depression. Author(s): Smith GS, Reynolds CF 3rd, Houck PR, Dew MA, Ma Y, Mulsant BH, Pollock BG. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 September-October; 10(5): 561-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213690&dopt=Abstract

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Implications of self-administered St. John's wort for depression symptom management. Author(s): Boehnlein B, Oakley LD.

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Source: Journal of the American Academy of Nurse Practitioners. 2002 October; 14(10): 443-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12426801&dopt=Abstract •

Internet support groups for depression: a 1-year prospective cohort study. Author(s): Houston TK, Cooper LA, Ford DE. Source: The American Journal of Psychiatry. 2002 December; 159(12): 2062-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450957&dopt=Abstract

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Lack of a therapeutic effect of a 2-week sub-threshold transcranial magnetic stimulation course for treatment-resistant depression. Author(s): Boutros NN, Gueorguieva R, Hoffman RE, Oren DA, Feingold A, Berman RM. Source: Psychiatry Research. 2002 December 30; 113(3): 245-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559481&dopt=Abstract

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Left dorso-lateral repetitive transcranial magnetic stimulation affects cortical excitability and functional connectivity, but does not impair cognition in major depression. Author(s): Shajahan PM, Glabus MF, Steele JD, Doris AB, Anderson K, Jenkins JA, Gooding PA, Ebmeier KP. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 June; 26(5): 945-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369271&dopt=Abstract

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Left prefrontal transcranial magnetic stimulation (TMS) treatment of depression in bipolar affective disorder: a pilot study of acute safety and efficacy. Author(s): Nahas Z, Kozel FA, Li X, Anderson B, George MS. Source: Bipolar Disorders. 2003 February; 5(1): 40-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656937&dopt=Abstract

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Linking chronic pain and depression. Author(s): Gray E. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2001 March 7-13; 15(25): 33-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211823&dopt=Abstract

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Long term depression of human nociceptive skin senses induced by thin fibre stimulation. Author(s): Nilsson HJ, Psouni E, Schouenborg J. Source: European Journal of Pain (London, England). 2003; 7(3): 225-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12725845&dopt=Abstract

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Long-term depression induced by sensory deprivation during cortical map plasticity in vivo. Author(s): Allen CB, Celikel T, Feldman DE. Source: Nature Neuroscience. 2003 March; 6(3): 291-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577061&dopt=Abstract

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Major depression in patients with substance use disorders: relationship to 12-Step self-help involvement and substance use outcomes. Author(s): Kelly JF, McKellar JD, Moos R. Source: Addiction (Abingdon, England). 2003 April; 98(4): 499-508. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653819&dopt=Abstract

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Mechanism of action of St John's wort in depression : what is known? Author(s): Butterweck V. Source: Cns Drugs. 2003; 17(8): 539-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775192&dopt=Abstract

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Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment. Author(s): Mayberg HS. Source: British Medical Bulletin. 2003; 65: 193-207. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697626&dopt=Abstract

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Neural mechanism of propofol anesthesia in severe depression: a positron emission tomographic study. Author(s): Ogawa K, Uema T, Motohashi N, Nishikawa M, Takano H, Hiroki M, Imabayashi E, Ohnishi T, Inoue T, Takayama Y, Takeda M, Matsuda H, Andoh T, Yamada Y. Source: Anesthesiology. 2003 May; 98(5): 1101-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12717131&dopt=Abstract

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Neurobiological bases for the relation between sleep and depression. Author(s): Adrien J. Source: Sleep Medicine Reviews. 2002 October; 6(5): 341-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12531125&dopt=Abstract

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Neurobiology: The importance of depression. Author(s): Stevens CF. Source: Nature. 2003 January 2; 421(6918): 29-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12511938&dopt=Abstract

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Neurocognitive effects of repetitive transcranial magnetic stimulation in severe major depression.

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Author(s): Martis B, Alam D, Dowd SM, Hill SK, Sharma RP, Rosen C, Pliskin N, Martin E, Carson V, Janicak PG. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 June; 114(6): 1125-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804681&dopt=Abstract •

Omega-3 fatty acids for depression in pregnancy. Author(s): Chiu CC, Huang SY, Shen WW, Su KP. Source: The American Journal of Psychiatry. 2003 February; 160(2): 385. Erratum In: Am J Psychiatry. 2003 April; 160(4): 810. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562593&dopt=Abstract

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Panic attack in a context of comorbid anxiety and depression in a Tibetan refugee. Author(s): Jacobson E. Source: Culture, Medicine and Psychiatry. 2002 June; 26(2): 259-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211327&dopt=Abstract

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Pathways linking depression, adiposity, and inflammatory markers in healthy young adults. Author(s): Miller GE, Freedland KE, Carney RM, Stetler CA, Banks WA. Source: Brain, Behavior, and Immunity. 2003 August; 17(4): 276-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12831830&dopt=Abstract

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Patient attitudes regarding causes of depression: implications for psychoeducation. Author(s): Srinivasan J, Cohen NL, Parikh SV. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 August; 48(7): 493-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12971021&dopt=Abstract

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Plasma concentrations of neuroactive steroids before and after repetitive transcranial magnetic stimulation (rTMS) in major depression. Author(s): Padberg F, di Michele F, Zwanzger P, Romeo E, Bernardi G, Schule C, Baghai TC, Ella R, Pasini A, Rupprecht R. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 November; 27(5): 874-8. Erratum In: Neuropsychopharmacology. 2003 March; 28(3): 610-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431862&dopt=Abstract

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Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Author(s): Tiemeier H, van Tuijl HR, Hofman A, Kiliaan AJ, Breteler MM.

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Source: The American Journal of Clinical Nutrition. 2003 July; 78(1): 40-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12816769&dopt=Abstract •

Postpartum depression, culture and African-American women. Author(s): Amankwaa LC. Source: J Cult Divers. 2003 Spring; 10(1): 23-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12776544&dopt=Abstract

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Prefrontal cortex transcranial magnetic stimulation does not change local diffusion: a magnetic resonance imaging study in patients with depression. Author(s): Li X, Nahas Z, Lomarev M, Denslow S, Shastri A, Bohning DE, George MS. Source: Cogn Behav Neurol. 2003 June; 16(2): 128-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799599&dopt=Abstract

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Psycho-neuro-immunological treatment of hepatocellular carcinoma with major depression--a single case report. Author(s): Jozuka H, Jozuka E, Suzuki M, Takeuchi S, Takatsu Y. Source: Current Medical Research and Opinion. 2003; 19(1): 59-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661782&dopt=Abstract

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Receptor and transporter imaging studies in schizophrenia, depression, bulimia and Tourette's disorder--implications for psychopharmacology. Author(s): Kasper S, Tauscher J, Willeit M, Stamenkovic M, Neumeister A, Kufferle B, Barnas C, Stastny J, Praschak-Rieder N, Pezawas L, de Zwaan M, Quiner S, Pirker W, Asenbaum S, Podreka I, Brucke T. Source: World J Biol Psychiatry. 2002 July; 3(3): 133-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478878&dopt=Abstract

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Regional brain metabolic correlates of alpha-methylparatyrosine-induced depressive symptoms: implications for the neural circuitry of depression. Author(s): Bremner JD, Vythilingam M, Ng CK, Vermetten E, Nazeer A, Oren DA, Berman RM, Charney DS. Source: Jama : the Journal of the American Medical Association. 2003 June 18; 289(23): 3125-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813118&dopt=Abstract

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Relaxation and imagery for anxiety and depression control in community patients with advanced cancer. Author(s): Sloman R. Source: Cancer Nursing. 2002 December; 25(6): 432-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464834&dopt=Abstract

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Repetitive transcranial magnetic stimulation (rTMS) in major depression: relation between efficacy and stimulation intensity. Author(s): Padberg F, Zwanzger P, Keck ME, Kathmann N, Mikhaiel P, Ella R, Rupprecht P, Thoma H, Hampel H, Toschi N, Moller HJ. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 October; 27(4): 638-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377400&dopt=Abstract

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Repetitive transcranial magnetic stimulation : does it have potential in the treatment of depression? Author(s): Padberg F, Moller HJ. Source: Cns Drugs. 2003; 17(6): 383-403. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12696999&dopt=Abstract

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Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis. Author(s): Martin JL, Barbanoj MJ, Schlaepfer TE, Thompson E, Perez V, Kulisevsky J. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 June; 182: 480-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777338&dopt=Abstract

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Repetitive transcranial magnetic stimulation treatment of comorbid posttraumatic stress disorder and major depression. Author(s): Rosenberg PB, Mehndiratta RB, Mehndiratta YP, Wamer A, Rosse RB, Balish M. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 2002 Summer; 14(3): 270-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12154150&dopt=Abstract

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Self-administered treatment in stepped-care models of depression treatment. Author(s): Scogin FR, Hanson A, Welsh D. Source: Journal of Clinical Psychology. 2003 March; 59(3): 341-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12579549&dopt=Abstract

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Six-month depression relapse rates among women treated with acupuncture. Author(s): Gallagher SM, Allen JJ, Hitt SK, Schnyer RN, Manber R. Source: Complementary Therapies in Medicine. 2001 December; 9(4): 216-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12184348&dopt=Abstract

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Somatization, anxiety and depression in a drug-free residential therapeutic community. Author(s): Metrikin AS, Galanter M, Dermatis H, Bunt G.

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Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003 January-February; 12(1): 60-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623741&dopt=Abstract •

Songwriting and digital video production interventions for pediatric patients undergoing bone marrow transplantation, part I: an analysis of depression and anxiety levels according to phase of treatment. Author(s): Robb SL, Ebberts AG. Source: Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses. 2003 January-February; 20(1): 2-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569430&dopt=Abstract

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St John's wort and depression. Author(s): Cott J, Wisner KL. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 448; Author Reply 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132966&dopt=Abstract

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St John's wort and depression. Author(s): Linde K, Melchart D, Mulrow CD, Berner M. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 447-8; Author Reply 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132965&dopt=Abstract

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St John's wort and depression. Author(s): Volp A. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 447; Author Reply 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132964&dopt=Abstract

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St John's wort and depression. Author(s): Spielmans GI. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 446-7; Author Reply 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132963&dopt=Abstract

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St John's wort and depression. Author(s): Wheatley D. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 446; Author Reply 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132962&dopt=Abstract

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St John's wort and depression. Author(s): Jonas W. Source: Jama : the Journal of the American Medical Association. 2002 July 24-31; 288(4): 446; Author Reply 448-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12132961&dopt=Abstract

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St John's wort as treatment for depression. Author(s): Oppel L. Source: Can Fam Physician. 2002 August; 48: 1290; Author Reply 1290. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12228953&dopt=Abstract

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St John's wort for the treatment of depression. Author(s): Shelton RC. Source: Lancet. Neurology. 2002 September; 1(5): 275. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849421&dopt=Abstract

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St. John's wort for depression. Author(s): Ogletree RL Jr, Ross BS, Strong RK. Source: Adv Nurse Pract. 2001 August; 9(8): 30-1, 70. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420462&dopt=Abstract

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Structural and energetic processes related to P300: LORETA findings in depression and effects of antidepressant drugs. Author(s): Anderer P, Saletu B, Semlitsch HV, Pascual-Marqui RD. Source: Methods Find Exp Clin Pharmacol. 2002; 24 Suppl D: 85-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12575474&dopt=Abstract

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Synaptic depression in the localization of sound. Author(s): Cook DL, Schwindt PC, Grande LA, Spain WJ. Source: Nature. 2003 January 2; 421(6918): 66-70. Erratum In: Nature. May 8; 423(6936): 197. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12511955&dopt=Abstract

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The acceptability of a culturally-tailored depression education videotape to African Americans. Author(s): Primm AB, Cabot D, Pettis J, Vu HT, Cooper LA. Source: Journal of the National Medical Association. 2002 November; 94(11): 1007-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12443007&dopt=Abstract

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The combined dexamethasone-CRH test before and after repetitive transcranial magnetic stimulation (rTMS) in major depression.

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Author(s): Zwanzger P, Baghai TC, Padberg F, Ella R, Minov C, Mikhaiel P, Schule C, Thoma H, Rupprecht R. Source: Psychoneuroendocrinology. 2003 April; 28(3): 376-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12573303&dopt=Abstract •

The effect of a history of alcohol dependence in adult major depression. Author(s): Rae AM, Joyce PR, Luty SE, Mulder RT. Source: Journal of Affective Disorders. 2002 August; 70(3): 281-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12128240&dopt=Abstract

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The efficacy and safety of bilateral rTMS in medication-resistant depression. Author(s): Cohen CI, Amassian VE, Akande B, Maccabee PJ. Source: The Journal of Clinical Psychiatry. 2003 May; 64(5): 613-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755672&dopt=Abstract

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The role of alternative medicine in treating postnatal depression. Author(s): Mantle F. Source: Complementary Therapies in Nursing & Midwifery. 2002 November; 8(4): 197203. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463609&dopt=Abstract

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Thyroid hormone augmentation with levothyroxine in bipolar depression. Author(s): Bauer M. Source: Bipolar Disorders. 2002; 4 Suppl 1: 109-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479694&dopt=Abstract

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Transcranial direct current stimulation: a new treatment for depression? Author(s): Nitsche MA. Source: Bipolar Disorders. 2002; 4 Suppl 1: 98-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479691&dopt=Abstract

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Transcranial magnetic stimulation in patients with bipolar depression: a double blind, controlled study. Author(s): Dolberg OT, Dannon PN, Schreiber S, Grunhaus L. Source: Bipolar Disorders. 2002; 4 Suppl 1: 94-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479689&dopt=Abstract

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Transcranial magnetic stimulation in the treatment of depression. Author(s): Gershon AA, Dannon PN, Grunhaus L. Source: The American Journal of Psychiatry. 2003 May; 160(5): 835-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727683&dopt=Abstract

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Treating depression comorbid with anxiety--results of an open, practice-oriented study with St John's wort WS 5572 and valerian extract in high doses. Author(s): Muller D, Pfeil T, von den Driesch V. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2003; 10 Suppl 4: 25-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807339&dopt=Abstract

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Treatment-resistant depression: new therapies on the horizon. Author(s): Trivedi MH. Source: Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists. 2003 March; 15(1): 59-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839433&dopt=Abstract

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Treatments for depression: wisdom imparted from treatments discarded. Author(s): Overholser JC. Source: International Journal of Psychiatry in Medicine. 2002; 32(4): 317-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12779182&dopt=Abstract

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Troponin T and quantitative ST-segment depression offer complementary prognostic information in the risk stratification of acute coronary syndrome patients. Author(s): Kaul P, Newby LK, Fu Y, Hasselblad V, Mahaffey KW, Christenson RH, Harrington RA, Ohman EM, Topol EJ, Califf RM, Van de Werf F, Armstrong PW; PARAGON-B Investigators. Source: Journal of the American College of Cardiology. 2003 February 5; 41(3): 371-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12575962&dopt=Abstract

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Use of aromatherapy with hospice patients to decrease pain, anxiety, and depression and to promote an increased sense of well-being. Author(s): Louis M, Kowalski SD. Source: Am J Hosp Palliat Care. 2002 November-December; 19(6): 381-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12442972&dopt=Abstract

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Vagal tone as an indicator of treatment response in major depression. Author(s): Chambers AS, Allen JJ. Source: Psychophysiology. 2002 November; 39(6): 861-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462513&dopt=Abstract

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Volunteering and depression: the role of psychological and social resources in different age groups. Author(s): Musick MA, Wilson J. Source: Social Science & Medicine (1982). 2003 January; 56(2): 259-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473312&dopt=Abstract

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What Does ECS Stand for? Repetitive Transcranial Magnetic Stimulation in Depression. Volume 2, Number 3, Part 2 (June 1, 2001), pages S21-S29. Author(s): Nahas Z, Li X, Chae JH, Oliver NC, Anderson B, Kapp B, George MS. Source: Epilepsy & Behavior : E&B. 2001 August; 2(4): 375. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12609217&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMD®Health: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to depression; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation (some Web sites are subscription based): •

General Overview Age-Related Cognitive Decline Source: Healthnotes, Inc. www.healthnotes.com AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Alcohol Withdrawal Source: Healthnotes, Inc. www.healthnotes.com

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Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Alzheimer's Disease Source: Healthnotes, Inc. www.healthnotes.com Alzheimer's Disease Source: Integrative Medicine Communications; www.drkoop.com Alzheimer's Disease, Non-Alzheimer's Dementia, and Normal Age-Related Memory Loss Source: Prima Communications, Inc.www.personalhealthzone.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Anxiety Source: Healthnotes, Inc. www.healthnotes.com Anxiety Source: Integrative Medicine Communications; www.drkoop.com Anxiety and Panic Attacks Source: Prima Communications, Inc.www.personalhealthzone.com Asthma Source: Healthnotes, Inc. www.healthnotes.com Autism Source: Healthnotes, Inc. www.healthnotes.com Back Pain, Low Source: Integrative Medicine Communications; www.drkoop.com Bipolar Disorder Source: Healthnotes, Inc. www.healthnotes.com Blood Pressure, High Source: Integrative Medicine Communications; www.drkoop.com Blood Sugar, Low Source: Integrative Medicine Communications; www.drkoop.com Bone Loss Source: Integrative Medicine Communications; www.drkoop.com Breast Cancer Source: Healthnotes, Inc. www.healthnotes.com

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Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Burns Source: Integrative Medicine Communications; www.drkoop.com Cancer, Colorectal Source: Integrative Medicine Communications; www.drkoop.com Cancer, Prostate Source: Integrative Medicine Communications; www.drkoop.com Candida/Yeast Hypersensitivity Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Cardiovascular Disease Overview Source: Healthnotes, Inc. www.healthnotes.com Celiac Disease Source: Healthnotes, Inc. www.healthnotes.com Cholesterol, High Source: Integrative Medicine Communications; www.drkoop.com Chronic Candidiasis Source: Healthnotes, Inc. www.healthnotes.com Chronic Fatigue Syndrome Source: Healthnotes, Inc. www.healthnotes.com Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.drkoop.com Chronic Obstructive Pulmonary Disease Source: Healthnotes, Inc. www.healthnotes.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Constipation Source: Integrative Medicine Communications; www.drkoop.com Dementia Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Healthnotes, Inc. www.healthnotes.com Depression Source: Integrative Medicine Communications; www.drkoop.com

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Depression Source: Integrative Medicine Communications; www.drkoop.com Depression (Mild to Moderate) Source: Prima Communications, Inc.www.personalhealthzone.com Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Eating Disorders Source: Healthnotes, Inc. www.healthnotes.com Eating Disorders, Anorexia Source: Integrative Medicine Communications; www.drkoop.com Eating Disorders, Bulimia Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Integrative Medicine Communications; www.drkoop.com Fatigue, Chronic Syndrome Source: Integrative Medicine Communications; www.drkoop.com Fibromyalgia Source: Healthnotes, Inc. www.healthnotes.com Fibromyalgia Source: Integrative Medicine Communications; www.drkoop.com Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.drkoop.com Headache, Tension Source: Integrative Medicine Communications; www.drkoop.com Heartburn Source: Integrative Medicine Communications; www.drkoop.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Support Source: Healthnotes, Inc. www.healthnotes.com

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Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hyperparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypochondriasis Source: Integrative Medicine Communications; www.drkoop.com Hypoglycemia Source: Healthnotes, Inc. www.healthnotes.com Hypoglycemia Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Healthnotes, Inc. www.healthnotes.com Hypothyroidism Source: Integrative Medicine Communications; www.drkoop.com Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.drkoop.com Insomnia Source: Integrative Medicine Communications; www.drkoop.com Insomnia Source: Prima Communications, Inc.www.personalhealthzone.com Irritable Bowel Syndrome Source: Healthnotes, Inc. www.healthnotes.com Irritable Bowel Syndrome Source: Integrative Medicine Communications; www.drkoop.com Lactose Intolerance Source: Healthnotes, Inc. www.healthnotes.com Low Back Pain Source: Integrative Medicine Communications; www.drkoop.com Low Blood Sugar Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com

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Malabsorption Source: Healthnotes, Inc. www.healthnotes.com Manic depression Source: Integrative Medicine Communications; www.drkoop.com Menopausal Symptoms (Other Than Osteoporosis) Source: Prima Communications, Inc.www.personalhealthzone.com Menopause Source: Healthnotes, Inc. www.healthnotes.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Menstruation, Absence of Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc. www.healthnotes.com Miscarriage Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com Pain Source: Healthnotes, Inc. www.healthnotes.com Parathyroid, Overactive Source: Integrative Medicine Communications; www.drkoop.com Parkinson's Disease Source: Healthnotes, Inc. www.healthnotes.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Photodermatitis Source: Integrative Medicine Communications; www.drkoop.com PMS Source: Integrative Medicine Communications; www.drkoop.com PMS Alternative names: Premenstrual Stress Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.drkoop.com

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Premenstrual Syndrome Source: Healthnotes, Inc. www.healthnotes.com Premenstrual Syndrome Source: Integrative Medicine Communications; www.drkoop.com Prostate Cancer Source: Integrative Medicine Communications; www.drkoop.com Prostatitis Source: Healthnotes, Inc. www.healthnotes.com PTSD Source: Integrative Medicine Communications; www.drkoop.com Recurrent Ear Infections Source: Healthnotes, Inc. www.healthnotes.com Schizophrenia Source: Healthnotes, Inc. www.healthnotes.com Seasonal Affective Disorder Source: Healthnotes, Inc. www.healthnotes.com Seizure Disorders Source: Integrative Medicine Communications; www.drkoop.com Senile Dementia Source: Integrative Medicine Communications; www.drkoop.com Serum Sickness Source: Integrative Medicine Communications; www.drkoop.com Sexual Dysfunction Source: Integrative Medicine Communications; www.drkoop.com Shingles and Postherpetic Neuralgia Source: Healthnotes, Inc. www.healthnotes.com Skin Disorders, Photodermatitis Source: Integrative Medicine Communications; www.drkoop.com Sleeplessness Source: Integrative Medicine Communications; www.drkoop.com Spastic Colon Source: Integrative Medicine Communications; www.drkoop.com Spontaneous Abortion Source: Integrative Medicine Communications; www.drkoop.com

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Stress Source: Integrative Medicine Communications; www.drkoop.com Stroke Source: Integrative Medicine Communications; www.drkoop.com Sunburn Source: Integrative Medicine Communications; www.drkoop.com Swallowing, Difficulty Source: Integrative Medicine Communications; www.drkoop.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Tension Headache Source: Healthnotes, Inc. www.healthnotes.com Tension Headache Source: Integrative Medicine Communications; www.drkoop.com Thyroid, Underactive Source: Integrative Medicine Communications; www.drkoop.com Ulcerative Colitis Source: Integrative Medicine Communications; www.drkoop.com Weight Loss and Obesity Source: Healthnotes, Inc. www.healthnotes.com •

Alternative Therapy Acupuncture Source: Healthnotes, Inc. www.healthnotes.com Acupuncture Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,663,00.html Aromatherapy Source: Integrative Medicine Communications; www.drkoop.com Aromatherapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,664,00.html Ayurveda Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,672,00.html

348 Depression

Bach flower remedies Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,673,00.html Biofeedback Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Body oriented emotional release psychotherapy Alternative names: Neo-Reichian emotional release work Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html Colon therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,682,00.html Color therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,683,00.html Crystal healing Alternative names: crystal therapeutics crystal therapy crystal work Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Dance therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,687,00.html Detoxification therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10119,00.html Guided imagery Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,699,00.html Herbal Medicine Source: Integrative Medicine Communications; www.drkoop.com

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Homeopathy Source: Integrative Medicine Communications; www.drkoop.com Homeopathy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,703,00.html Light therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,713,00.html Magnet therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,715,00.html Massage Source: Integrative Medicine Communications; www.drkoop.com Massage therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,716,00.html Meditation Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.html Music therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,719,00.html Native American medicine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,721,00.html Naturopathy Source: Integrative Medicine Communications; www.drkoop.com Prayer Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,728,00.html

350 Depression

Psychic Self-Defense Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/p.html Qigong Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,729,00.html Reiki Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,731,00.html Repressed memory therapy Alternative names: RMT Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Tai Chi Source: Integrative Medicine Communications; www.drkoop.com Therapeutic touch Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,739,00.html Traditional Chinese Medicine Source: Integrative Medicine Communications; www.drkoop.com Writing therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,745,00.html Yoga Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,746,00.html

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•

Chinese Medicine Chenxiang Alternative names: Chinese Eaglewood Wood; Lignum Aquilariae Resinatum Source: Chinese Materia Medica Fuke Tongjing Wan Alternative names: Fuke Tongjing Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Fuke%20Tongjing%20Wan&m h=10&sb=---&view_records=View+Records Gansui Alternative names: Gansui Root; Radix Kansui Source: Chinese Materia Medica Hehuanhua Alternative names: Albizia Flower; Flos Albiziae Source: Chinese Materia Medica Mabo Alternative names: Puff-ball; Lasiosphaera seu Calvatia Source: Chinese Materia Medica Meihua Alternative names: Plum Flower; Flos Mume Source: Chinese Materia Medica Muli Alternative names: Oyster Shell; Concha Ostreae Source: Chinese Materia Medica Muxiang Alternative names: Slender Dutchmanspipe Root; Qingmuxiang; Radix Aristolochiae Source: Chinese Materia Medica Nanshashen Alternative names: Fourleaf Ladybell Root; Radix Adenophorae Source: Chinese Materia Medica Naolejing Alternative names: Naolejing Syrup Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Naolejing&mh=10&sb=--&view_records=View+Records

352 Depression

Shixiang Zhitong Wan Alternative names: Shixiang Zhitong Pills; Shixiang Zhitong Wan
(Shi Xiang Zhi Tong Wan) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Shixiang%20Zhitong%20Wan &mh=10&sb=---&view_records=View+Records Tumuxiang Alternative names: Inula Root; Radix Inulae Source: Chinese Materia Medica Walengzi Alternative names: Arc Shell; Concha Arcae Source: Chinese Materia Medica Zhebeimu Alternative names: Thunberg Fritillary Bulb; Zhebeimu (Zhe Bei Mu); Bulbus Fritillariae Thunbergii Source: Chinese Materia Medica Zhimu Alternative names: Common Anemarrhena Rhizome; Rhizoma Anemarrhenae Source: Chinese Materia Medica •

Homeopathy Actaea racemosa Source: Healthnotes, Inc. www.healthnotes.com Arsenicum album Source: Healthnotes, Inc. www.healthnotes.com Aurum metallicum Source: Healthnotes, Inc. www.healthnotes.com Calcarea carbonica Source: Healthnotes, Inc. www.healthnotes.com Causticum Source: Healthnotes, Inc. www.healthnotes.com Cimicifuga Source: Healthnotes, Inc. www.healthnotes.com Ignatia Source: Healthnotes, Inc. www.healthnotes.com Kali phosophoricum Source: Healthnotes, Inc. www.healthnotes.com

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Natrum carbonicum Source: Healthnotes, Inc. www.healthnotes.com Natrum muriaticum Source: Healthnotes, Inc. www.healthnotes.com Phosphorus Source: Healthnotes, Inc. www.healthnotes.com Pulsatilla Source: Healthnotes, Inc. www.healthnotes.com Sepia Source: Healthnotes, Inc. www.healthnotes.com Staphysagria Source: Healthnotes, Inc. www.healthnotes.com •

Herbs and Supplements 5-HTP Source: Integrative Medicine Communications; www.drkoop.com 5-HTP (5-Hydroxytryptophan) Source: Prima Communications, Inc.www.personalhealthzone.com 5-Hydroxytryptophan Source: Healthnotes, Inc. www.healthnotes.com 5-Hydroxytryptophan (5-HTP) Source: Integrative Medicine Communications; www.drkoop.com Aesculus Alternative names: Horse Chestnut; Aesculus hippocastanum L. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org ALA Source: Integrative Medicine Communications; www.drkoop.com Allopurinol Source: Healthnotes, Inc. www.healthnotes.com Alpha-Linolenic Acid (ALA) Source: Integrative Medicine Communications; www.drkoop.com Amino Acids Overview Source: Healthnotes, Inc. www.healthnotes.com Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com

354 Depression

Antibiotic Combination: Sulfa Drugs Source: Integrative Medicine Communications; www.drkoop.com Anticonvulsants Source: Healthnotes, Inc. www.healthnotes.com Antidepressants Source: Healthnotes, Inc. www.healthnotes.com Antituberculosis Agents Source: Integrative Medicine Communications; www.drkoop.com Arnica Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,753,00.html Asian Ginseng Alternative names: Panax ginseng Source: Integrative Medicine Communications; www.drkoop.com Astragalus mem Alternative names: Huang-Qi; Astragalus membranaceus Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Astragalus sp Alternative names: Vetch, Rattlepod, Locoweed; Astragalus sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Ava Source: Integrative Medicine Communications; www.drkoop.com Barbiturates Source: Integrative Medicine Communications; www.drkoop.com Berberis Alternative names: Barberry; Berberis sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Beta-Carotene Source: Prima Communications, Inc.www.personalhealthzone.com Bisphosphonate Derivatives Source: Integrative Medicine Communications; www.drkoop.com Black Cohosh Source: Prima Communications, Inc.www.personalhealthzone.com Black cohosh Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10009,00.html

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Brahmi Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Bupropion Source: Healthnotes, Inc. www.healthnotes.com Caprylic acid Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10111,00.html Cardiac Glycosides Source: Integrative Medicine Communications; www.drkoop.com Celecoxib Source: Healthnotes, Inc. www.healthnotes.com CELERY SEED Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Centella Source: Integrative Medicine Communications; www.drkoop.com Centella asiatica Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Cephalosporins Source: Integrative Medicine Communications; www.drkoop.com Chamaemelum nobile Source: Integrative Medicine Communications; www.drkoop.com Chamomile, Roman Alternative names: Chamaemelum nobile Source: Integrative Medicine Communications; www.drkoop.com Chasteberry Source: Prima Communications, Inc.www.personalhealthzone.com

356 Depression

Chasteberry Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,767,00.html Citalopram Source: Healthnotes, Inc. www.healthnotes.com Clozapine Source: Healthnotes, Inc. www.healthnotes.com Cyclosporine Alternative names: Neoral, Sandimmune Source: Prima Communications, Inc.www.personalhealthzone.com Damiana Alternative names: Turnera diffusa Source: Healthnotes, Inc. www.healthnotes.com Damiana Source: Prima Communications, Inc.www.personalhealthzone.com DAMIANA Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Dehydroepiandrosterone (DHEA) Source: Healthnotes, Inc. www.healthnotes.com Dehydroepiandrosterone (DHEA) Source: Integrative Medicine Communications; www.drkoop.com DHA Source: Integrative Medicine Communications; www.drkoop.com DHEA Source: Integrative Medicine Communications; www.drkoop.com DHEA (Dehydroepiandrosterone) Source: Prima Communications, Inc.www.personalhealthzone.com Diclofenac Source: Healthnotes, Inc. www.healthnotes.com DMAE Source: Healthnotes, Inc. www.healthnotes.com DMAE Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10023,00.html

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Docosahexaenoic Acid Source: Healthnotes, Inc. www.healthnotes.com Docosahexaenoic Acid (DHA) Source: Integrative Medicine Communications; www.drkoop.com English Lavendar Source: Integrative Medicine Communications; www.drkoop.com Ephedra Alternative names: Ephedra sinensis, Ma huang Source: Integrative Medicine Communications; www.drkoop.com Ephedra (Ma huang) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,777,00.html Ephedra sinensis Source: Integrative Medicine Communications; www.drkoop.com Estrogens (Combined) Source: Healthnotes, Inc. www.healthnotes.com Etodolac Source: Healthnotes, Inc. www.healthnotes.com Eugenia Clove Alternative names: Cloves; Eugenia sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Flurbiprofen Source: Healthnotes, Inc. www.healthnotes.com Fluvoxamine Source: Healthnotes, Inc. www.healthnotes.com Forskolin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10025,00.html French Lavendar Source: Integrative Medicine Communications; www.drkoop.com GABA (Gamma-Amino Butyric Acid) Source: Healthnotes, Inc. www.healthnotes.com Garcinia cambogia Alternative names: Citrin, Gambooge Source: Alternative Medicine Foundation, Inc. www.amfoundation.org

358 Depression

Gentamicin Source: Healthnotes, Inc. www.healthnotes.com Ginger Alternative names: Zingiber officinale Source: Integrative Medicine Communications; www.drkoop.com Ginger Source: Prima Communications, Inc.www.personalhealthzone.com Ginkgo Alternative names: Ginkgo biloba Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Ginkgo Source: Prima Communications, Inc.www.personalhealthzone.com GINKGO Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Ginkgo biloba Source: Healthnotes, Inc. www.healthnotes.com Ginkgo Biloba Alternative names: Maidenhair Tree Source: Integrative Medicine Communications; www.drkoop.com Ginkgo Biloba Source: Integrative Medicine Communications; www.drkoop.com Ginkgo biloba Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,788,00.html Ginseng (Panax) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10029,00.html Ginseng, Asian Alternative names: Panax ginseng Source: Integrative Medicine Communications; www.drkoop.com Glimepiride Source: Healthnotes, Inc. www.healthnotes.com Glutamic Acid Source: Healthnotes, Inc. www.healthnotes.com

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Glutamine Source: Prima Communications, Inc.www.personalhealthzone.com Glutamine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10030,00.html Glutathione Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,854,00.html Gotu Kola Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Green Tea Alternative names: Camellia sinensis Source: Healthnotes, Inc. www.healthnotes.com Histamine H2 Antagonists Source: Integrative Medicine Communications; www.drkoop.com HOPS Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Hydantoin Derivatives Source: Integrative Medicine Communications; www.drkoop.com Hydrocotyle Source: Integrative Medicine Communications; www.drkoop.com Hypericum perforatum Alternative names: St. John's Wort Source: Integrative Medicine Communications; www.drkoop.com Hypericum perforatum Source: Integrative Medicine Communications; www.drkoop.com Ibuprofen Source: Healthnotes, Inc. www.healthnotes.com Indapamide Source: Healthnotes, Inc. www.healthnotes.com Indian Pennywort Source: Integrative Medicine Communications; www.drkoop.com

360 Depression

Indomethacin Source: Healthnotes, Inc. www.healthnotes.com Inhalant, Systemic, and Topical Corticosteroids Source: Integrative Medicine Communications; www.drkoop.com Inositol Source: Healthnotes, Inc. www.healthnotes.com Inositol Source: Prima Communications, Inc.www.personalhealthzone.com Jamaica Dogwood Alternative names: Piscidia erythrina, Piscidia piscipula Source: Integrative Medicine Communications; www.drkoop.com Kava Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Kava Kava Alternative names: Piper methysticum, Ava Source: Integrative Medicine Communications; www.drkoop.com Ketoprofen Source: Healthnotes, Inc. www.healthnotes.com Ketorolac Source: Healthnotes, Inc. www.healthnotes.com Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Klamathweed Alternative names: St. John's Wort Source: Integrative Medicine Communications; www.drkoop.com Kochia Alternative names: Summer Cypress, Fireweed; Kochia scoparia (L.) Schrad Source: Alternative Medicine Foundation, Inc. www.amfoundation.org KOLA Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Lavandula Alternative names: Lavender; Lavandula sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org

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Lavandula angustifolia Source: Integrative Medicine Communications; www.drkoop.com Lavender Alternative names: Lavandula officinalis Source: Healthnotes, Inc. www.healthnotes.com Lavender Alternative names: Lavandula angustifolia, English Lavendar, French Lavendar Source: Integrative Medicine Communications; www.drkoop.com LAVENDER Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Lavender Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,799,00.html Lecithin Source: Prima Communications, Inc.www.personalhealthzone.com Lepidium sp Alternative names: Cress; Lepidium sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Levodopa/Carbidopa Alternative names: Sinemet Source: Prima Communications, Inc.www.personalhealthzone.com Lithium Source: Healthnotes, Inc. www.healthnotes.com Loop Diuretics Source: Integrative Medicine Communications; www.drkoop.com L-Tyrosine Source: Healthnotes, Inc. www.healthnotes.com Ma huang Source: Integrative Medicine Communications; www.drkoop.com Macrolides Source: Integrative Medicine Communications; www.drkoop.com Maidenhair Tree Alternative names: Ginkgo Biloba Source: Integrative Medicine Communications; www.drkoop.com

362 Depression

Maidenhair Tree Source: Integrative Medicine Communications; www.drkoop.com Marsh Pennywort Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Matricaria Alternative names: Chamomile; Matricaria chamomilla Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Melaleuca Alternative names: Tea Tree Oil; Melaleuca alternifolia Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Melatonin Source: Healthnotes, Inc. www.healthnotes.com Melatonin Source: Integrative Medicine Communications; www.drkoop.com Melatonin Source: Prima Communications, Inc.www.personalhealthzone.com Melatonin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,804,00.html Melissa Source: Prima Communications, Inc.www.personalhealthzone.com Menadione Source: Integrative Medicine Communications; www.drkoop.com Menaphthone Source: Integrative Medicine Communications; www.drkoop.com Menaquinone Source: Integrative Medicine Communications; www.drkoop.com Mentha Alternative names: Pennyroyal; Mentha/Hedeoma pulegium Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Mentha x piperita Source: Integrative Medicine Communications; www.drkoop.com

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Metoclopramide Source: Healthnotes, Inc. www.healthnotes.com Milk thistle Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10044,00.html Mirtazapine Source: Healthnotes, Inc. www.healthnotes.com Mixed Amphetamines Source: Healthnotes, Inc. www.healthnotes.com Monophasic, Biphasic, and Triphasic Preparations Source: Integrative Medicine Communications; www.drkoop.com Nabumetone Source: Healthnotes, Inc. www.healthnotes.com NADH Source: Healthnotes, Inc. www.healthnotes.com NADH Source: Prima Communications, Inc.www.personalhealthzone.com Nefazodone Source: Healthnotes, Inc. www.healthnotes.com Non-steroidal Anti-Inflammatory Drugs Source: Healthnotes, Inc. www.healthnotes.com OAT Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Oral Contraceptives Source: Healthnotes, Inc. www.healthnotes.com Oxaprozin Source: Healthnotes, Inc. www.healthnotes.com Panax Alternative names: Ginseng; Panax ginseng Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Panax ginseng Source: Integrative Medicine Communications; www.drkoop.com Penicillin Derivatives Source: Integrative Medicine Communications; www.drkoop.com

364 Depression

Peppermint Alternative names: Mentha x piperita Source: Integrative Medicine Communications; www.drkoop.com Perphenazine Source: Healthnotes, Inc. www.healthnotes.com Phenelzine Source: Healthnotes, Inc. www.healthnotes.com Phenylalanine Source: Healthnotes, Inc. www.healthnotes.com Phenylalanine Source: Integrative Medicine Communications; www.drkoop.com Phenylalanine Source: Prima Communications, Inc.www.personalhealthzone.com Phosphatidylserine Source: Healthnotes, Inc. www.healthnotes.com Phosphatidylserine Source: Prima Communications, Inc.www.personalhealthzone.com Phosphatidylserine (PS) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,813,00.html Phylloquinone Source: Integrative Medicine Communications; www.drkoop.com Piper methysticum Source: Integrative Medicine Communications; www.drkoop.com Piper nigrum Alternative names: Black Pepper Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Piroxicam Source: Healthnotes, Inc. www.healthnotes.com Piscidia erythrina Source: Integrative Medicine Communications; www.drkoop.com Piscidia piscipula Source: Integrative Medicine Communications; www.drkoop.com

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PMS Herbal combination Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,947,00.html Pregnenolone Source: Healthnotes, Inc. www.healthnotes.com Pregnenolone Source: Prima Communications, Inc.www.personalhealthzone.com Progesterone Source: Healthnotes, Inc. www.healthnotes.com Pumpkin Alternative names: Cucurbita pepo, Cucurbita maxima Source: Healthnotes, Inc. www.healthnotes.com Quinolones Source: Integrative Medicine Communications; www.drkoop.com Rofecoxib Source: Healthnotes, Inc. www.healthnotes.com Roman Chamomile Alternative names: Chamaemelum nobile Source: Integrative Medicine Communications; www.drkoop.com Rosemary Alternative names: Rosmarinus officinalis Source: Integrative Medicine Communications; www.drkoop.com ROSEMARY Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Rosmarinus officinalis Source: Integrative Medicine Communications; www.drkoop.com Ruta Alternative names: Rue; Ruta graveolens L. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org S-Adenosylmethionine (SAMe) Source: Integrative Medicine Communications; www.drkoop.com Salsalate Source: Healthnotes, Inc. www.healthnotes.com SAMe Source: Healthnotes, Inc. www.healthnotes.com

366 Depression

SAMe Source: Integrative Medicine Communications; www.drkoop.com SAMe (S-Adenosylmethionine) Source: Prima Communications, Inc.www.personalhealthzone.com SAMe (S-adenosylmethionine) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,818,00.html Selegiline Source: Healthnotes, Inc. www.healthnotes.com Sertraline Source: Healthnotes, Inc. www.healthnotes.com St. John's Wort Alternative names: Hypericum perforatum Source: Healthnotes, Inc. www.healthnotes.com St. John's Wort Alternative names: Hypericum perforatum, Klamathweed Source: Integrative Medicine Communications; www.drkoop.com St. John's Wort Alternative names: Hypericum perforatum Source: Integrative Medicine Communications; www.drkoop.com St. John's Wort Source: Prima Communications, Inc.www.personalhealthzone.com ST. JOHN'S WORT Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca St. John's wort Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,824,00.html Sulindac Source: Healthnotes, Inc. www.healthnotes.com Terminalia Alternative names: Myrobalans; Terminalia arjuna Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Tetracycline Derivatives Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 367

Thioridazine Source: Healthnotes, Inc. www.healthnotes.com Trazodone Source: Healthnotes, Inc. www.healthnotes.com Tricyclic Antidepressants Source: Healthnotes, Inc. www.healthnotes.com Tyrosine Source: Integrative Medicine Communications; www.drkoop.com Tyrosine Source: Prima Communications, Inc.www.personalhealthzone.com Valerian Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html Valeriana Alternative names: Valerian; Valeriana officinalis Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Valproic Acid Source: Healthnotes, Inc. www.healthnotes.com Vanadate Source: Integrative Medicine Communications; www.drkoop.com Vanadyl Source: Integrative Medicine Communications; www.drkoop.com Venlafaxine Source: Healthnotes, Inc. www.healthnotes.com Vervain Alternative names: Verbena officinalis Source: Healthnotes, Inc. www.healthnotes.com WILD INDIGO Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Yohimbe Alternative names: Pausinystalia yohimbe Source: Healthnotes, Inc. www.healthnotes.com Yohimbe Source: Prima Communications, Inc.www.personalhealthzone.com

368 Depression

Zingiber Alternative names: Ginger; Zingiber officinale Roscoe Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Zingiber officinale Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

369

CHAPTER 4. DISSERTATIONS ON DEPRESSION Overview In this chapter, we will give you a bibliography on recent dissertations relating to depression. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “depression” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on depression, we have not necessarily excluded nonmedical dissertations in this bibliography.

Dissertations on Depression ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to depression. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Aggressive Behavior, Moral Judgment, and Depression in 11--13 Year Old Hispanic Boys by Lopez, Robert F. Phd from St. John's University (new York), 2002, 130 pages http://wwwlib.umi.com/dissertations/fullcit/3037896

•

Agrarian Experimentation and Failure in Depression Mississippi: New Deal and Socialism, the Tupelo Homesteads and the Delta and Providence Cooperative Farms (mississippi) by Smith, Fred C. Ma from Mississippi State University, 2002, 145 pages http://wwwlib.umi.com/dissertations/fullcit/1410619

•

Agricultural Depression in the 1920's: Economic Fact or Statistical Artifact? by Johnson, H. Thomas, Phd from The University of Wisconsin - Madison, 1969, 253 pages http://wwwlib.umi.com/dissertations/fullcit/7003570

370 Depression

•

Agriculture's Second Great Depression of the Twentieth Century: Federal Policy and the Agricultural Economy of the 82-county Primary Memphis Trade Region (pmtr) between 1969 and 1987 (tennessee, Kentucky, Missouri, Arkansas, Mississippi) by Campbell, Timothy Richard, Phd from The University of Memphis, 1995, 307 pages http://wwwlib.umi.com/dissertations/fullcit/9535140

•

Alcoholism and Depression in Women by Turner, Sandra G., Phd from Rutgers the State University of New Jersey - New Brunswick, 1987, 116 pages http://wwwlib.umi.com/dissertations/fullcit/8803523

•

Alfred Adler's Individual Psychology and Theory of Depression: a Synthesis in Retrospect by Taub, Rena R., Dsw from Yeshiva University, 1984, 127 pages http://wwwlib.umi.com/dissertations/fullcit/8502735

•

Alternative Birth Settings and Post-partum Depression: a Comparative Analysis by Falahi-kharaghani, Roya, Phd from Southern Illinois University at Carbondale, 1990, 317 pages http://wwwlib.umi.com/dissertations/fullcit/9129821

•

A California Middletown: the Social History of San Jose in the Depression. by Matthews, Glenna Christine, Phd from Stanford University, 1977, 270 pages http://wwwlib.umi.com/dissertations/fullcit/7712667

•

A Causal Model of Adolescent Depression (depression) by Brage, Diane Grace, Phd from The University of Nebraska - Lincoln, 1990, 169 pages http://wwwlib.umi.com/dissertations/fullcit/9121911

•

A Comparative Analysis between the Financial Instability Hypothesis and the Monetary Theory of Deep Depressions for the Interwar Period: a Non-nested Test of Hypothesis (business Cycles, Economic Fluctuations, Debt Deflation) by Gomez, Richard James, Phd from University of California, Davis, 1986, 277 pages http://wwwlib.umi.com/dissertations/fullcit/8621493

•

A Comparison between Mothers of Failure-to-thrive and Thriving Infants on Measures of Social Support, Stress, Depression, Anxiety, Intergenerational Factors, and Mother-infant Interaction (nonorganic, Maltreatment, Psychosocial Ftt, Nutritional Abuse, Neg by O'regan, Mary K. W., Dsw from The University of Utah, 1985, 549 pages http://wwwlib.umi.com/dissertations/fullcit/8527097

•

A Comparison of Adult Children of Alcoholic Families with Adult Children from Nonalcoholic Families on Depression, Self-esteem, and Anxiety (adult Children of Alcoholics) by Dodd, David Tennyson, Ii, Phd from University of North Texas, 1990, 75 pages http://wwwlib.umi.com/dissertations/fullcit/9114107

•

A Comparison of Agoraphobics, Anxiety Neurotics, and Depressive Neurotics Using the Mmpi and the Beck Depression Inventory by Jasin, Susan Elizabeth, Phd from Temple University, 1981, 155 pages http://wwwlib.umi.com/dissertations/fullcit/8210578

•

A Comparison of Depression, Stress and Self-image between Younger and Older Adolescent Mothers by Kitzrow, Martha Anne, Phd from Oregon State University, 1990, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9032675

•

A Comparison of Effectiveness of Group Assertive Training and Self-esteem Enhancement Group Therapy in Decreasing Anxiety, Depression and Aggression

Dissertations 371

While Concurrently Increasing Assertiveness and Self-esteem by Martinez, Manuel, Phd from University of Colorado at Boulder, 1981, 152 pages http://wwwlib.umi.com/dissertations/fullcit/8200805 •

A Comparison of Health Care Aide's and Self-perceptions of Physical Functioning in Elderly Patients with Depression and Dementia by Pivarnik, Neil Charles, Edd from Columbia University Teachers College, 1989, 98 pages http://wwwlib.umi.com/dissertations/fullcit/9013571

•

A Comparison of High and Low General Levels of Reinforcement on Self-reported Depression, Anger, and Somatic Symptoms in Female Spousal Caregivers of Alzheimer Patients and Spouses of Healthy Men by Souder, J. Elaine, Phd from Boston College, 1987, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8903997

•

A Comparison of Individual and Group Therapy on Self-concept and Depression of Patients with Spinal Cord Injury. by Riggin, Ona Ziehli, Edd from Memphis State University, 1976, 149 pages http://wwwlib.umi.com/dissertations/fullcit/7629243

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A Comparison of Perceived Locus of Control and Depression in Persian Muslim Immigrants by Alai, Mojtaba, Phd from United States International University, 1994, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9502362

•

A Comparison of the Conversation Involvement of Nonlonely and Chronically Lonely Individuals (communication, Shyness, Depression) by Bell, Robert Alan, Phd from The University of Texas at Austin, 1984, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8508249

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A Comparison of the Effectiveness of Group Therapy on Divorce Adjustment and Depression for Separated and Divorced Persons by Barlow, Larry Oliver, Phd from The Florida State University, 1982, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8229144

•

A Comparison of the Effects of Life Review and Reminiscence Group Counseling on Depression, Life Satisfaction and Self-esteem of Older Persons by Capps, Harry Edward, Phd from Wayne State University, 1998, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9827192

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A Comparison of the Levels of Physical Activity, Self-esteem, and Depression among Sheltered Battered Women, Nonsheltered Battered Women, and Nonbattered Women by Bozeman, Tina Michelle; Da from Middle Tennessee State University, 2001, 94 pages http://wwwlib.umi.com/dissertations/fullcit/3030575

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A Comparison of the Psychological Effects of Hemodialysis and Continuous Ambulatory Peritoneal Dialysis (anxiety, Depression, Sickness Impact) by Bauer, Barbara Gruger, Phd from University of Missouri - Columbia, 1984, 135 pages http://wwwlib.umi.com/dissertations/fullcit/8425607

•

A Comparison of Three Approaches to Reduce Marital Problems and Symptoms of Depression (china) by Huang, Mei-kuei; Phd from University of Florida, 2001, 183 pages http://wwwlib.umi.com/dissertations/fullcit/3039774

•

A Comparison of Three Diagnostic Procedures for Identifying Depression in Children and Adolescents: Clinical Diagnoses, a Structured Interview and a

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Depression Rating Scale by Pellegrino, Joseph Ferdinando, Phd from University of Virginia, 1992, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9324847 •

A Comparison of Video-tape and Programmed Instruction As Training Devices to Discriminate the Emotion Commonly Referred to As Depression by Di Mattia, Dominic Joseph, Edd from University of Massachusetts, 1970, 145 pages http://wwwlib.umi.com/dissertations/fullcit/7024266

•

A Competitive Business: the Ideologies, Cultures, and Practices of Men's and Women's College Sports during the Depression by Austin, Bradley Ellis; Phd from The Ohio State University, 2001, 329 pages http://wwwlib.umi.com/dissertations/fullcit/3022439

•

A Confirmatory and Exploratory Analysis of Exner's Comprehensive System: a Crossvalidation of the Affect Cluster and Depression Index by Piacentini, Teresa Marie; Phd from Fairleigh Dickinson University, 2002, 265 pages http://wwwlib.umi.com/dissertations/fullcit/3041692

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A Cross-cultural Study on Depression among Foreign Graduate Students from Six Selected Areas by Liu, Zaida Vega, Edd from Peabody College for Teachers of Vanderbilt University, 1985, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8517423

•

A Cross-cultural Study on the Role of Social Networks and Acculturation in the Physical and Psychological Functioning of Chinese Students (physical Functioning, Depression) by Davis, Cynthia Lynne, Phd from University of California, Los Angeles, 1993, 160 pages http://wwwlib.umi.com/dissertations/fullcit/9408215

•

A Developmental View of Depression in Children: the Relationship of Symptomatology to Age by Price, Susan Karyl, Phd from University of Minnesota, 1988, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8911022

•

A Field Assessment of the Relationships among Interpersonal Communication Competence, Social Support, and Depression among Caregivers for Individuals with Alzheimer's Disease by Query, Jim L., Jr., Phd from Ohio University, 1990, 245 pages http://wwwlib.umi.com/dissertations/fullcit/9030057

•

A Gentle Reconstruction: Depression Post Office Murals and Southern Culture by Beckham, Sue Bridwell, Phd from University of Minnesota, 1984, 343 pages http://wwwlib.umi.com/dissertations/fullcit/8424666

•

'a Good Many Shrewd Knocks': the Faces of Depression in the Life and Art of Virginia Woolf by Pogell, Sarah C. Phd from Washington University, 2001, 296 pages http://wwwlib.umi.com/dissertations/fullcit/3032736

•

A Grotesque Spectacle: American Theatre of the Great Depression As Cultural History by Fearnow, Mark Allen, Phd from Indiana University, 1990, 208 pages http://wwwlib.umi.com/dissertations/fullcit/9107275

•

A Laboratory Test of the Expanded Hopelessness Theory of Depression: towards a Clearer Understanding of the Relationship between Inferential Feedback, Depressive Symptoms, and Depressogenic Inferences by De Fronzo, Roseanne; Phd from Drexel University College of Nursing and Health Professions, 2002, 145 pages http://wwwlib.umi.com/dissertations/fullcit/3061997

Dissertations 373

•

A Life Review Intervention with Elderly Subjects Assessing for Impact on Depression and Life Satisfaction by Arland, William Thomas, Edd from University of Maine, 1989, 78 pages http://wwwlib.umi.com/dissertations/fullcit/9023842

•

A Linguistic Analysis of Cognitions in Depression by Rockwood, Gary F., Phd from Indiana University, 1991, 140 pages http://wwwlib.umi.com/dissertations/fullcit/9212304

•

A Local Church Depression Ministry. by Hutchison, Ashmead Scott, Dmin from The Eastern Baptist Theological Seminary, 1975, 153 pages http://wwwlib.umi.com/dissertations/fullcit/7526115

•

A Longitudinal Study of Anxiety: Noted Relationships between Anxiety, Depression, Parenting Style, and Academic Achievement by Rector, Cherie Lynn, Phd from University of Southern California, 1994 http://wwwlib.umi.com/dissertations/fullcit/f1557411

•

A Longitudinal Study of Childhood Risk Factors for Hospitalization under a Depression-related Diagnosis by Heringa, Marcia Sue; Phd from University of Georgia, 2002 http://wwwlib.umi.com/dissertations/fullcit/f410417

•

A Longitudinal Study of Preparation for Childbirth, Pain in Labour and Postnatal Depression by Leachman, Jennifer, Phd from University of Bath (united Kingdom), 1988, 327 pages http://wwwlib.umi.com/dissertations/fullcit/DX84607

•

A Meta-analysis of the Efficacy of Cognitive Therapy, Pharmacotherapy, and the Combination of Cognitive Therapy and Pharmacotherapy in the Treatment of Depression by Davis, Andrew Spencer, Edd from Idaho State University, 1991, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9129319

•

A Multivariate Regression Examination of Stressful Life Events, Social Support, and the Postpartum Depression Syndrome by Cohen, David A., Phd from University of Southern California, 1983 http://wwwlib.umi.com/dissertations/fullcit/f3032981

•

A Multivariate Study of Depression in Elderly Caucasian Women by Sigurdson, Marion Kay, Phd from Indiana State University, 1979, 154 pages http://wwwlib.umi.com/dissertations/fullcit/8101029

•

A New Treatment Modality for Social Work Practice: Integrating Cognitive Behavioral Theory and Interpersonal Theory in the Treatment of Major Depression by Jensen, Carla C., Phd from University of Denver, 1990, 259 pages http://wwwlib.umi.com/dissertations/fullcit/9026958

•

A Preventive Intervention for Postpartum Depression in Primiparous Women by Meeker, Cynthia Ann Houtman, Phd from University of Kansas, 1984, 169 pages http://wwwlib.umi.com/dissertations/fullcit/8424337

•

A Program Design to Screen and Treat Parents Suffering from Postpartum Depression by Ganesh, Jan Allison; Psyd from Carlos Albizu University, 2002, 90 pages http://wwwlib.umi.com/dissertations/fullcit/3067814

374 Depression

•

A Prospective Study of Postpartum Depression a Test of the Cognitive Vulnerability Model by Acton, Robert Gordon; Phd from The University of Saskatchewan (canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL45027

•

A Role-learning Model for the Study of Historical Change in Parent Behavior; with a Test of the Model on the Behavior of American Parents in the Great Depression by Mechling, Jay Edmund, Phd from University of Pennsylvania, 1971, 275 pages http://wwwlib.umi.com/dissertations/fullcit/7126060

•

'a Second Severance from the Body of Our Mother': Manic-depression and the Search for Identity in Selected Novels of Virginia Woolf by Caramagno, Thomas Carmelo, Phd from University of California, Los Angeles, 1984, 339 pages http://wwwlib.umi.com/dissertations/fullcit/8411849

•

A Social and Economic History of Columbia, South Carolina, during the Great Depression, 1929-1940. by Lofton, Paul Stroman, Jr., Phd from The University of Texas at Austin, 1977, 346 pages http://wwwlib.umi.com/dissertations/fullcit/7729061

•

A Society Unto Themselves: a Theoretical and Empirical Examination of Women's Proclivity for Depressive Disorders by Schwartz, Sharon, Phd from Columbia University, 1985, 402 pages http://wwwlib.umi.com/dissertations/fullcit/8523237

•

A Structural Analysis of Depression and Its Relationship to Perfectionism, Selfesteem and Racial Identity in African American College Students by Crow, Germayne Monteil; Phd from Auburn University, 2002, 82 pages http://wwwlib.umi.com/dissertations/fullcit/3043994

•

A Structural Analysis of Relationships among Stress, Social Support, Dysfunctional Attitudes, and Depression in Older Adults by Hyers, Darryl Ann, Phd from The University of North Carolina at Greensboro, 1995, 149 pages http://wwwlib.umi.com/dissertations/fullcit/9531843

•

A Structural Equation Model of the Relationship between Dependency, Burden Selfimage, and Depression among Chronically Ill Elders by Dyeson, Timothy Bruce, Phd from The University of Texas at Arlington, 1997, 120 pages http://wwwlib.umi.com/dissertations/fullcit/9804662

•

A Study of Adolescent Depression, Suicide, Self-esteem and Family Strengths in Special Education Female Students Compared with Regular Education Female Students by Harper, Diane Joan Provencher, Phd from Walden University, 1996, 130 pages http://wwwlib.umi.com/dissertations/fullcit/9840083

•

A Study of Bereavement and the (reactive) Depression That May Result from It: with Specific Reference to the Function of Faith by Mbogori, Elijah K., Phd from University of Aberdeen (united Kingdom), 1991, 390 pages http://wwwlib.umi.com/dissertations/fullcit/DX97621

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A Study of Black Politics and Protest in Depression-decade Chicago: 1930-1939 by Reed, Christopher Robert, Phd from Kent State University, 1982, 474 pages http://wwwlib.umi.com/dissertations/fullcit/8216951

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A Study of Childhood Depression with Special Emphasis on Classroom Behaviour by Morris, Mary L; Phd from University of Toronto (canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK38788

Dissertations 375

•

A Study of Depression and Self-esteem in Moderately Gifted and Nongifted Children by Davis, Susan Dolores, Edd from United States International University, 1995, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9604726

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A Study of Depression in Learning Disabled Adolescents by Bonner, Mary Elaine, Phd from The University of Mississippi, 1986, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8703466

•

A Study of Hwa-byung in Korean Society: Narcissistic/masochistic Self-disorder and Christian Conversion (psychosomatic Illness, Depression, Anxiety Disorder) by Hwang, Yong Hoon, Phd from Princeton Theological Seminary, 1995, 225 pages http://wwwlib.umi.com/dissertations/fullcit/9530825

•

A Study of the Effect of a Six-week Counseling Group on Well-being and Depression Scores and Ratings of Self-perceived Health of Elderly African-american Participants by Baker, Barbara Elaine, Edd from Peabody College for Teachers of Vanderbilt University, 1990, 80 pages http://wwwlib.umi.com/dissertations/fullcit/9027441

•

A Study of the Effects of Group Assertion Training on Anxiety, Depression, Selfconcept and Assertiveness in Heroin Addicts by Herdey, Janice Joy, Phd from University of Southern California, 1982 http://wwwlib.umi.com/dissertations/fullcit/f91062

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A Study of the Impact of Managed Health Care in the Treatment of Adult Patients Identified with Depression by Troast, Thomas Paul, Phd from The University of Wisconsin - Milwaukee, 1997, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9822100

•

A Study of the Life Events-illness Relationship in Women: the Roles of Perception of Life Events, Personality, and Life-style in the Prediction of Physical Illness and Depression by Zone, Joan Bricks, Phd from The University of Utah, 1986, 115 pages http://wwwlib.umi.com/dissertations/fullcit/8610412

•

A Study of the Relationship between Depression and Factors in the Rehabilitation Process of the Hospitalized Spinal-cord Injured Patient by Klas, Leroy Dean, Phd from The University of Utah, 1970, 163 pages http://wwwlib.umi.com/dissertations/fullcit/7022249

•

A Study of the Relationship between Family Structure and Depression. by Panides, Wallace Constantine, Phd from The Florida State University, 1975, 128 pages http://wwwlib.umi.com/dissertations/fullcit/7526805

•

A Study of the Relationship of Negative Affectivity and Learning Problems in Children (depression, Anxiety) by Leavitt, Bryce James, Phd from Indiana University, 1996, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9627371

•

A Study of the Social Origins of Clinical Depression in Black Women by Ricard, John H., Dsw from The Catholic University of America, 1985, 206 pages http://wwwlib.umi.com/dissertations/fullcit/8515072

•

A Study of the Use of Music Therapy Techniques in a Group for the Treatment of Adolescent Depression by Hendricks, C. Bret; Edd from Texas Tech University, 2001, 156 pages http://wwwlib.umi.com/dissertations/fullcit/3005267

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A Study to Determine the Effect of a Life-skills Related Suicide Prevention Curriculum on the Depression Levels of Adolescents (life Skills-related) by Taylor, Charlotte Murrow, Edd from Memphis State University, 1992, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9224290

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A Study to Determine the Effect of Exercise on Depression in Middle-aged Women by Weaver, Dolores Custer, Da from Middle Tennessee State University, 1984, 180 pages http://wwwlib.umi.com/dissertations/fullcit/8422552

•

A Systematic Investigation of Two Psychological Treatments of Depression by Shaw, Brian Frank; Phd from The University of Western Ontario (canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK24664

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A Test of the Cognitive Model of Depression by Carlomagno, Alfred, Dsw from Adelphi University, School of Social Work, 1989, 167 pages http://wwwlib.umi.com/dissertations/fullcit/8909436

•

A Test of the Cognitive Triad in Beck's Cognitive Theory of Depression by Giles, Donna; Phd from The University of Western Ontario (canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK54096

•

A Theory-driven, Multiple-case Study Program Evaluation of a School-based Depression Prevention Intervention by Moothart, Mary Minnehan; Phd from The University of Iowa, 1999, 227 pages http://wwwlib.umi.com/dissertations/fullcit/9945433

•

A Time of Crisis: Japan, the Great Depression, and Relief Policy by Smith, Kerry Douglas, Phd from Harvard University, 1994, 501 pages http://wwwlib.umi.com/dissertations/fullcit/9500202

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Academic Grades, Delinquency, and Depression among Ethnically Diverse Youth: the Influences of Parental Connection, Regulation, and Psychological Control by Bean, Roy A., Phd from Brigham Young University, 1997, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9806351

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Acculturation and Depression among Puerto Ricans and Puerto Rican Veterans in the Continental United States by Ramos, Blanca Magdalena, Phd from State University of New York at Albany, 1997, 260 pages http://wwwlib.umi.com/dissertations/fullcit/9816263

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Acculturation of Immigrants from Spain: Implications for Symptoms of Depression and Anxiety by Lozano Mulone, Jacqueline; Psyd from Hofstra University, 2002, 119 pages http://wwwlib.umi.com/dissertations/fullcit/3072176

•

Acculturation, Psychological Adjustment (stress, Depression, Self-esteem), and the Academic Achievement of Jamaican Immigrant College Students by Buddington, Steve Apalong; Phd from Tulane University, 2000, 172 pages http://wwwlib.umi.com/dissertations/fullcit/9971278

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Acculturative Stress and Depression among Homeless Hispanic Males (men) by Danaher-nash, Zelda, Phd from California School of Professional Psychology - Los Angeles, 1994, 98 pages http://wwwlib.umi.com/dissertations/fullcit/9429321

Dissertations 377

•

Adaptive Coping Strategies of Othermothers: an Examination of Social Support, Spirituality, Stress and Depression by Smith, Pamela L. Phd from University of Maryland, Baltimore, 2003, 156 pages http://wwwlib.umi.com/dissertations/fullcit/3083297

•

Adhd: Social Skills Effects on Impulsivity and Depression (attention Deficit Hyperactivity Disorder) by Harper, Karen Ann, Phd from The Fielding Institute, 1996, 223 pages http://wwwlib.umi.com/dissertations/fullcit/9621989

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Adlerian Life Style and Clinical Depression in Mothers of Disturbed Children by Earles, Thomas Drew, Phd from Georgia State University, 1982, 140 pages http://wwwlib.umi.com/dissertations/fullcit/8226145

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Adlerian Life Style, Social Interest, and Depression in Parents by Highlander, Don Hugh, Jr., Phd from Georgia State University, 1984, 114 pages http://wwwlib.umi.com/dissertations/fullcit/8412516

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Adolescent Depression by Richards, John Dean, Phd from The University of Utah, 1983, 85 pages http://wwwlib.umi.com/dissertations/fullcit/8325640

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Adolescent Depression and Family Cohesion (depression) by Bougere, Alan Achille, Dsw from Tulane University, School of Social Work, 1992, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9302856

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Adolescent Depression in Public Schools by Johnson, Bruce B., Phd from Marquette University, 1990, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9101416

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Adolescent Depression: the Impact of Parental Divorce during Childhood As It Manifests Itself in Adolescence (depression, Divorce) by Pool, Elsa-rae, Dsw from Tulane University, School of Social Work, 1993, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9403436

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Adult Education As a Welfare Measure during the Great Depression: a Historical Case Study of the Educational Program of the Civilian Conservation Corps, 1933-1942 by Ralston, Charles Frederick; Ded from The Pennsylvania State University, 2000, 443 pages http://wwwlib.umi.com/dissertations/fullcit/9998416

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Affect and Cognitions in Obese Binge Eaters: the Association between Depression, Anxiety, and Bulimic Cognitions by Lazarus, Shulamit, Phd from The University of North Carolina at Chapel Hill, 1991, 108 pages http://wwwlib.umi.com/dissertations/fullcit/9216744

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African-american Adolescent Girls and Fathers: Paternal Contribution to Depression, Self-efficacy, and Religiosity by Jackson, Jennifer Lee; Phd from Columbia University, 2003, 106 pages http://wwwlib.umi.com/dissertations/fullcit/3077192

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American Money and the German Economy: Economics and Politics on the Eve of the Great Depression by Mcneil, William Charles, Phd from University of California, Berkeley, 1981, 498 pages http://wwwlib.umi.com/dissertations/fullcit/8200203

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America's Depression Culture: Social Art and Literature of the 1930s by Peeler, David P., Phd from The University of Wisconsin - Madison, 1980, 440 pages http://wwwlib.umi.com/dissertations/fullcit/8020579

•

An Analysis of Anxiety and Depression Levels in Out-of-treatment Drug Abusers: Implications for Counseling by Ataabadi, Ali Nateghi, Edd from Texas Southern University, 1997, 139 pages http://wwwlib.umi.com/dissertations/fullcit/9809905

•

An Analysis of Depression and Social Support among Blacks in the United States by Dumas, Tracey Chante; Phd from University of Oregon, 2002, 120 pages http://wwwlib.umi.com/dissertations/fullcit/3072579

•

An Analysis of Learning Disabilities and Childhood Depression in Pre-adolescent Students by Bonomo, Janice Abrams, Edd from Indiana University of Pennsylvania, 1990, 132 pages http://wwwlib.umi.com/dissertations/fullcit/9024303

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An Analysis of the Mood Depression, As Perceived by Treatment Counselors, in Alcohol Dependent Patients in a Twenty-eight Day Hospital Based Treatment Program (addiction, Chemical-dependence) by Vrechek, Nancy Marie, Phd from University of Georgia, 1984, 92 pages http://wwwlib.umi.com/dissertations/fullcit/8421165

•

An Analysis of the Proposed Subtype: Hopelessness Depression by Stockum, Robert Weston, Phd from Ohio University, 1999, 241 pages http://wwwlib.umi.com/dissertations/fullcit/9923675

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An Analysis of the Relationships between Problems, Anxiety, Depression, and Hostility of Suburban Teachers by Johnson, Weston Rayfield, Edd from University of Northern Colorado, 1982, 164 pages http://wwwlib.umi.com/dissertations/fullcit/8305235

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An Analysis of Unemployment Solutions Proposed in Selected American Journals of Opinion during the Great Depression by Fuchs, David William, Phd from New York University, 1968, 968 pages http://wwwlib.umi.com/dissertations/fullcit/6811815

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An Assessment of Life Satisfaction and Depression in Community Elderly and Their Relationship to Other Demographic and Social Variables (geriatrics) by Skoglund, Pennelope A., Phd from University of Colorado at Boulder, 1986, 178 pages http://wwwlib.umi.com/dissertations/fullcit/8618999

•

An Assessment of Support Group Participation on Depression and Adherence in Veterans with Hepatitis C by Chun, Doris Sohyun; Phd from New York University, 2002, 154 pages http://wwwlib.umi.com/dissertations/fullcit/3045705

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An Assessment of the Effects of the Psychoeducational Workshop on Minor Depression for Enrollees in a Hospital-based 55plus(rtm) Program by Mullen, Robert P., Edd from University of Arkansas, 1998, 116 pages http://wwwlib.umi.com/dissertations/fullcit/9838317

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An Efficacy Study of Group and Individual Cognitive-behavioral Therapy Combined with Pharmacotherapy in the Treatment of Major Depression by Johnson, Susan Claire, Phd from The University of Wisconsin - Madison, 1989, 261 pages http://wwwlib.umi.com/dissertations/fullcit/9013351

Dissertations 379

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An Empirical Analysis of Uncertainty and Investment during the Great Depression (business Cycles) by Zalewski, David Alan, Phd from Clark University, 1993, 219 pages http://wwwlib.umi.com/dissertations/fullcit/9323648

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An Empirical Examination of the Roles That Consumption, Investment and Money Played during the Great Depression by Agee, Steven Craig, Phd from University of Kansas, 1982, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8301707

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An Empirical Exploration of Predictions Arising from a Cognitive-behavioral Model of Depression among Persons with Spinal Cord Injury by Tirch, Dennis D. Phd from Fairleigh Dickinson University, 2002, 132 pages http://wwwlib.umi.com/dissertations/fullcit/3032986

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An Empirical Study of the Relationship between Vital Longevity, Retirement and Depression (older Adults) by Watson, Marian L., Edd from Northern Illinois University, 1993, 346 pages http://wwwlib.umi.com/dissertations/fullcit/9414842

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An Evaluation of Depression, Self-efficacy, Satisfaction with Life and Perceived Access to Medical Care across Stages of Hiv Infection (immune Deficiency) by Didona, Toni Marie, Phd from Florida International University, 1994, 224 pages http://wwwlib.umi.com/dissertations/fullcit/9420379

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An Evaluation of Two Methods of Diagnosing Depression in Clinic Outpatients by Ellis, Lynn Fred, Phd from The University of Michigan, 1984, 77 pages http://wwwlib.umi.com/dissertations/fullcit/8502803

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An Examination of Adolescent Life Event Stressors and Their Relationship with Depression, Anxiety, and Irritability by Esman, Flora B., Phd from The University of Toledo, 1992, 242 pages http://wwwlib.umi.com/dissertations/fullcit/9229638

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An Examination of Beck's Theory Within the Context of Post-partum Depression by Olioff, Mark; Phd from Mcgill University (canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK64532

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An Examination of Certain Psychosocial Factors Involved in the Prediction of Depression by Sherman, Daniel Philip, Phd from Southern Illinois University at Carbondale, 1982, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8321466

•

An Examination of Change in Anger and Depression during Early Stages of Therapy (treatment Efficacy) by Tatera, David Michael, Phd from University of Southern California, 1995, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9617145

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An Examination of Depression in Adolescence: Its Relationship to Egocentrism and Interpersonal Relationships by Caravias, Mary, Phd from University of Toronto (canada), 1991, 132 pages http://wwwlib.umi.com/dissertations/fullcit/NN73845

•

An Examination of Effectiveness of a Sleep Induction Audiotape in Conjunction with a Standardized Behavioral Treatment Protocol on Anxiety, Depression, Psychosocial Functioning, and Sleep among a Clinical Population with Insomnia by Dunn, Jeffrey Allan; Phd from The Florida State University, 2001, 304 pages http://wwwlib.umi.com/dissertations/fullcit/3021555

380 Depression

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An Examination of Environmental Stressors, Social Mediators, Depression and Suicidal Ideation in Academically Gifted and Non-gifted Adolescents (gifted) by Baker, Jean A., Phd from The University of Wisconsin - Madison, 1992, 255 pages http://wwwlib.umi.com/dissertations/fullcit/9221898

•

An Examination of Models of Efficacy and Esteem Pathways to Depression in Young Adulthood by Smith, Heather Marie; Phd from The Ohio State University, 2002, 115 pages http://wwwlib.umi.com/dissertations/fullcit/3059326

•

An Examination of Social Skills and Family Environment and Their Relationship to Childhood Depression (depression) by Crook, Kimberly Frances, Phd from The University of Texas at Austin, 1994, 237 pages http://wwwlib.umi.com/dissertations/fullcit/9428492

•

An Examination of the Monetary Hypothesis of the Depression and Interest Rates (price Expectation, Fisher Effect, Macroeconomics, Finance) by True, Bruce Norris, Phd from University of California, Los Angeles, 1985, 115 pages http://wwwlib.umi.com/dissertations/fullcit/8525885

•

An Examination of the Post-stroke and Vascular Depression Hypotheses among Geriatric Rehabilitation Patients by Mast, Benjamin Todd; Phd from Wayne State University, 2002, 106 pages http://wwwlib.umi.com/dissertations/fullcit/3038203

•

An Examination of the Reinforcement Process in Mild and Clinical Depression by Morelli, Rosa M; Phd from Queen's University at Kingston (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK65917

•

An Experimental Analysis of Training the Anticipation and Performance of Reinforcing Activities in the Treatment of Depression. by Anton, Jane Lee, Phd from Stanford University, 1974, 147 pages http://wwwlib.umi.com/dissertations/fullcit/7506802

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An Exploration of the Relationship between Amish Identity and Depression among the Old Order Amish by Reiling, Denise Mae; Phd from Michigan State University, 2000, 426 pages http://wwwlib.umi.com/dissertations/fullcit/9985454

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An Exploratory and Confirmatory Factor-analytic Investigation of the Tripartite Model of Anxiety and Depression in Older Adults by Burdenski, Thomas Kevin, Jr. Phd from Texas A&m University, 2002, 267 pages http://wwwlib.umi.com/dissertations/fullcit/3072414

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An Exploratory Study Examining the Interactions between Depression, Health Status, Memory-efficacy, and Selected Demographic Variables with the Metamemory of Older Adults by Mcdougall, Graham Joseph, Jr., Phd from The University of Texas at Austin, 1991, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9128304

•

An Exploratory Study of Student-teacher Morale with Reference to the Determination of the Existence of a Depression Period during Student-teaching. by Arneson, David Michael, Edd from University of Northern Colorado, 1976, 273 pages http://wwwlib.umi.com/dissertations/fullcit/7711045

Dissertations 381

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An Exploratory Study of the Effects of Humor on Depression and Hopelessness of Incarcerated Males (men Inmates) by Silverman, Stanley Ronald, Phd from University of Maryland College Park, 1994, 141 pages http://wwwlib.umi.com/dissertations/fullcit/9508054

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An Intervention Program for Children of Recently Hospitalized, Depressed Mothers (maternal Depression) by Bennett, Robert Bruce, Dsw from The University of Utah, 1991, 97 pages http://wwwlib.umi.com/dissertations/fullcit/9129289

•

An Intraindividual Study of the Relationship between Pain and Depression by Tarbell, Sally Elizabeth; Phd from York University (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK61526

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An Investigation into Neglected (untreated) Late Life Depression among Lonely, Community-dwelling Elderly by Merkel, Katherine Lee; Phd from Walden University, 2001, 172 pages http://wwwlib.umi.com/dissertations/fullcit/3000385

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An Investigation into the Construct of Global Self-esteem Using Selected Measures of Self-esteem, Depression, and Directiveness (construct Validity) by Chen, Steven John, Phd from Brigham Young University, 1991, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9131146

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An Investigation into the Effects of Aerobic Exercise on Anxiety and Depression by Eby, John M; Edd from University of Toronto (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NL23527

•

An Investigation of Antidepressant Mechanisms in an Animal Model of Depression by Jesberger, James A; Phd from The University of Saskatchewan (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK65355

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An Investigation of Anxiety, Depression and Family Role Involvement of Adolescent Males Whose Fathers Have Cardiovascular Disability by Chiampi, John David, Phd from University of Pittsburgh, 1982, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8218150

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An Investigation of Holism in Student Personnel Work, with Special Emphasis on the Depression Year 1931-1932 by Dewey, Mary Evelyn, Phd from Syracuse University, 1967, 339 pages http://wwwlib.umi.com/dissertations/fullcit/6807054

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An Investigation of Some Neuropsychological, Cognitive and Behavioral Aspects of Depression by Johnson, Olive Skene; Phd from The University of British Columbia (canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK51710

•

An Investigation of the Perceptions of Bullying and Victimization among Students in Grades 7 and 8: Prevalence; Relationship to Gender, Grade Level, Ethnicity; and Selfesteem and Depression by Seals, Dorothy L. Edd from Delta State University, 2002, 90 pages http://wwwlib.umi.com/dissertations/fullcit/3059493

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An Investigation of the Relation between Depression and Hostility of Adolescent Girls Suffering Father Loss. by Diamond, Charles, Edd from Boston University School of Education, 1973, 92 pages http://wwwlib.umi.com/dissertations/fullcit/7323546

382 Depression

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An Investigation of the Relationship between Depression and Assertiveness in Egyptian Depressed Subjects by Ghareeb, Ghareeb Abdel-fattah, Phd from University of Pittsburgh, 1983, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8411698

•

An Investigation of the Relationship between Levels of Physical Activity and Levels of Depression by Lipira, Patsy Kay, Edd from University of Arkansas, 1993, 100 pages http://wwwlib.umi.com/dissertations/fullcit/9434911

•

An Investigation of the Relationship between Perceived Social Support, Support Satisfaction and Depression among Working Female Caregivers by Mitchell, Margaret Lucretia, Dsw from Fordham University, 1991, 184 pages http://wwwlib.umi.com/dissertations/fullcit/9203420

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An Investigation of the Relationship of Perceived Family Dynamics to Depression and Anxiety Experienced by Hospitalized Coronary Patients by Fussell, Juanita, Edd from Peabody College for Teachers of Vanderbilt University, 1985, 77 pages http://wwwlib.umi.com/dissertations/fullcit/8517412

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An Investigation of the Relationships among Attributional Style, Hardiness, Gender, and Depression As Predictors of Coping with Real Life Events by Chemically Dependent Inpatients by Voyce, Jo Ann, Phd from University of Missouri - Kansas City, 1996, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9701858

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An Investigation of the Relationships among Depression, Locus-of-control, and Assertive Behavior in Freshman College Women. by Borovay, Rena Frajtag, Phd from University of Miami, 1977, 164 pages http://wwwlib.umi.com/dissertations/fullcit/7721909

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An Investigation of the Relationships among Personal Resources, Coping Styles, and Depression in College Students by Pooput, Kanda, Phd from University of Missouri Columbia, 1992, 129 pages http://wwwlib.umi.com/dissertations/fullcit/9400052

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An Outline of Clergy Depression with Suggested Procedures and Strategies for Healing by Haynes, Ralph Douglas, Dmin from Fuller Theological Seminary, Doctor of Ministry Program, 1986, 259 pages http://wwwlib.umi.com/dissertations/fullcit/8720764

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Anaclitic and Introjective Dimensions and Depression in Borderline Personality Disorder by Trifiletti, Robert James; Phd from University of Calgary (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL54340

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Analysis of State Markers for Alcohol Consumption and Trait Markers for Alcohol Dependence and Depression by Martinez, Larry Dean; Phd from University of Colorado Health Sciences Center, 2002, 186 pages http://wwwlib.umi.com/dissertations/fullcit/3056500

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Analysis of the Genetic Basis of Inbreeding Depression in the Pacific Oyster Crassostrea Gigas by Bucklin, Katherine Adelaide; Phd from University of California, Davis, 2002, 139 pages http://wwwlib.umi.com/dissertations/fullcit/3062193

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And Still They Rise: an Examination of Risk and Protective Factors for Depression and Antisocial Behavior in African American Adolescents by House, Laura Elizabeth; Phd from Howard University, 2001, 159 pages http://wwwlib.umi.com/dissertations/fullcit/3040807

Dissertations 383

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Anger and Depression among Incarcerated Juvenile Delinquents: a Pilot Intervention by Tellier, Jen Emily, Psyd from The Wright Institute, 1998, 93 pages http://wwwlib.umi.com/dissertations/fullcit/9912972

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Antecedents of the 1929 Recession (commercial Banking, Finance, Depression, Stock Market, Business Cycles) by Hanson, Richard X., Phd from University of California, Los Angeles, 1986, 93 pages http://wwwlib.umi.com/dissertations/fullcit/8621072

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Anti-depression Public Works: Federal-aid Roadbuilding, 1920--1922 by Davis, John Oscar; Phd from Iowa State University, 2002, 401 pages http://wwwlib.umi.com/dissertations/fullcit/3061823

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Anxiety and the Benzodiazepine/gaba-chloride Ionophore Receptor Complex: Implications for Learned Helplessness, Coping and Behavioral Depression (librium, Escape Deficit, B-carboline) by Drugan, Robert Charles, Phd from University of Colorado at Boulder, 1984, 114 pages http://wwwlib.umi.com/dissertations/fullcit/8428645

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Anxiety, Depression, and Posttraumatic Stress Disorder: Health Conditions of Women Who Cope with Conjugal Violence by Tyson, Sheryl; Phd from University of California, Los Angeles, 2002, 404 pages http://wwwlib.umi.com/dissertations/fullcit/3059554

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Apocalyptic Metaphors in John Ford's 'the Hurricane' and Other American Films of the 1930s (great Depression) by Fitzsimmons, Lorna, Phd from The University of Texas at Dallas, 1994, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9424282

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Arkansas during the Great Depression. by Rison, David Ellery, Phd from University of California, Los Angeles, 1974, 178 pages http://wwwlib.umi.com/dissertations/fullcit/7429274

•

Art for the People: Art in Michigan Sponsored by the Treasury Section of Fine Arts, 1934 to 1943. (volumes I and Ii) (murals, Depression) by Ruby, Christine Muriel Nelson, Phd from The University of Michigan, 1986, 474 pages http://wwwlib.umi.com/dissertations/fullcit/8702821

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Artists Respond to the Great Depression and the Threat of Fascism: the New York Artists' Union and Its Magazine 'art Front' (1934-1937) by Tyler, Francine, Phd from New York University, 1991, 427 pages http://wwwlib.umi.com/dissertations/fullcit/9124769

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Aspects of Emotional Expression in Flat Affect Schizophrenia and Depression by Novack, Danielle Lee; Phd from New York University, 2002, 213 pages http://wwwlib.umi.com/dissertations/fullcit/3048851

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Assertiveness, Social Support, and Susceptibility to Depression: an Analysis Using Induced Mood by Croner, Christopher James; Phd from Southern Illinois University at Carbondale, 2002, 175 pages http://wwwlib.umi.com/dissertations/fullcit/3065347

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Assessing Change in Psychosocial Treatment for Depression from Multiple Perspectives: the Client, the Significant Other, and the Mental Health Professional by Park, Sun-young; Phd from The University of Chicago, 2002, 231 pages http://wwwlib.umi.com/dissertations/fullcit/3060251

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Assessing Depressive Symptoms Using the Child Depression Scale and the Children's Depression Inventory: a Cross Cultural Comparison of Children in Puerto

384 Depression

Rico and the United States by Lopez, Nancy, Phd from The University of Wisconsin Madison, 1985, 121 pages http://wwwlib.umi.com/dissertations/fullcit/8513465 •

Assessing Distress in Couples with Cancer: a Life Cycle View (caregiver Burden, Depression) by Dwyer, Timothy Francis, Phd from Purdue University, 1995, 202 pages http://wwwlib.umi.com/dissertations/fullcit/9601490

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Assessing Grief, Depression, and Coping Behaviors of Women Participating in in Vitro Fertilization Embryo Transfer by Lukse, Michelle Prince, Phd from The University of North Carolina at Greensboro, 1991, 119 pages http://wwwlib.umi.com/dissertations/fullcit/9204450

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Assessing Level of Outness among Gay, Lesbian, and Bisexual Individuals and Its Relation to Depression, Anxiety, and Self-esteem by Bosker, Mary Jane; Phd from Southern Illinois University at Carbondale, 2002, 145 pages http://wwwlib.umi.com/dissertations/fullcit/3083228

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Assessing the Usefulness of the Informant in Identifying Late Life Depressive Disorders by Mcavay, Gail; Phd from Columbia University, 2002, 220 pages http://wwwlib.umi.com/dissertations/fullcit/3048188

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Assessment of Clinical Depression in Public School Teachers Experiencing Career Burnout by Fisher, Ronald Paul, Phd from University of Georgia, 1995, 120 pages http://wwwlib.umi.com/dissertations/fullcit/9604041

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Assessment of Depression among Bilingual Adolescent Hispanics (reynolds Adolescent Depression Scale) by Davis, Kerry Ann, Phd from The University of Utah, 1991, 122 pages http://wwwlib.umi.com/dissertations/fullcit/9135359

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Assessment of Depression in School-age Children: a Cross-cultural Comparison of Mexican American and Caucasian Students by Rybolt, Yvette Dawson, Phd from The University of Arizona, 1994, 222 pages http://wwwlib.umi.com/dissertations/fullcit/9517585

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Assessment of Family Environment and Marital Functioning in Couples with Bipolar Affective Disorder and Major Depression by Jabalpurwala, Sheila Kaizer, Phd from Hofstra University, 1994, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9425242

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Associations among Subclinical Attention Deficit Hyperactivity Disorder, Substance Abuse, and Depression in Young Adults by Nunes, Michael Anthony; Ms from California State University, Fresno, 2002, 48 pages http://wwwlib.umi.com/dissertations/fullcit/1412220

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Atlanta, the Depression, and the New Deal (south, Urban, Georgia) by Fleming, Douglas Lee, Phd from Emory University, 1984, 388 pages http://wwwlib.umi.com/dissertations/fullcit/8504952

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Attachment Behaviors, Depression, and Anxiety in Nonoffending Mothers of Child Sexual Abuse Victims by Lewin, Linda Carol; Phd from The University of Toledo, 2000, 86 pages http://wwwlib.umi.com/dissertations/fullcit/9969434

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Attention Mechanisms in Bipolar Depression by Burdick, Katherine Elizabeth; Phd from City University of New York, 2002, 119 pages http://wwwlib.umi.com/dissertations/fullcit/3063809

Dissertations 385

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Attribution Theory and Ecclesiogenic Depression (depression) by Homan, Kenneth Bruce, Phd from The University of Iowa, 1990, 314 pages http://wwwlib.umi.com/dissertations/fullcit/9112433

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Attributional Style and Depression in Adolescents with Asperger Syndrome by Barnhill, Eugena Patricia; Phd from University of Kansas, 2000, 167 pages http://wwwlib.umi.com/dissertations/fullcit/9985099

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Attributional Style and Depression in Chronic Pain Patients Receiving Worker's Compensation Benefits (pain Management) by Mcguigan, Jane Boyer, Phd from University of Maryland College Park, 1992, 182 pages http://wwwlib.umi.com/dissertations/fullcit/9234621

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Attributional Style in Three Outpatient Groups: Relationship to Negative Life Events and Depression by Wilson, James Clinton, Phd from The University of Arizona, 1985, 142 pages http://wwwlib.umi.com/dissertations/fullcit/8517506

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Autobiographical Memory Analysis and Micro-narrative Coherence in Brief Experiential Psychotherapy for Depression: an Exploratory Analysis by Rotonditrevisan, Debra L. Ma from York University (canada), 2002, 341 pages http://wwwlib.umi.com/dissertations/fullcit/MQ71620

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Baltimore: the Depression Years by Argersinger, Jo Ann Eady, Phd from The George Washington University, 1980, 362 pages http://wwwlib.umi.com/dissertations/fullcit/8014054

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Battered Women: the Relationship between Depression, Coping Skills, and Assertiveness (women) by Margan, Halina Ring, Dsw from Tulane University, School of Social Work, 1990, 276 pages http://wwwlib.umi.com/dissertations/fullcit/9119999

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Behavioral and Cognitive Factors in the Co-occurrence of Depression and Marital Dissatisfaction by Assh, Sharon Donna; Phd from The University of New Brunswick (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL55792

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Beneath the Poverty Line during the Great Depression: the Measurement and Demographic Composition of Poverty in 1939 by Barrington, Linda, Phd from University of Illinois at Urbana-champaign, 1991, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9210737

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Between the Scylla and Charybdis of Anarchy and Despotism: the State, Capital, and the Working Class in the Great Depression, Toronto, 1929-1940 (ontario) by Klee, Marcus Aurelius, Phd from Queen's University at Kingston (canada), 1999, 531 pages http://wwwlib.umi.com/dissertations/fullcit/NQ35966

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Biofeedback-assisted, Client-centered Counseling in the Treatment of Anxiety and Depression in Mastectomy Patients by Lazar, Janice Claire Morgan, Phd from Michigan State University, 1981, 121 pages http://wwwlib.umi.com/dissertations/fullcit/8212419

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Black Adolescent Alcohol Abusers: Severity of Alcohol Use, History of Child Abuse and Current Level of Depression by London, Dyanne Patricia, Phd from Boston University, 1990, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9001154

386 Depression

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Black Female Domestics during the Great Depression in New York City 1930-1940 by Clegg, Brenda Faye, Phd from The University of Michigan, 1983, 222 pages http://wwwlib.umi.com/dissertations/fullcit/8324157

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Black Playwrights of the Federal Theatre Project during the Great Depression: a Critical Analysis of Select Works, 1935-1939 by Caple, Horace B., Phd from The Union Institute, 1991, 312 pages http://wwwlib.umi.com/dissertations/fullcit/9204657

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Blame, Depression and Coping in Battered Women by Porter, Carol Anne; Phd from The University of British Columbia (canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK65006

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Boston during the Great Depression: 1929-1940. by Trout, Charles Hathaway, Phd from Columbia University, 1972, 692 pages http://wwwlib.umi.com/dissertations/fullcit/7309051

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Brain Imaging Studies of Medial Temporal Structures and the Pituitary Gland in Early Onset Depression by Macmaster, Frank P. Msc from Dalhousie University (canada), 2002, 121 pages http://wwwlib.umi.com/dissertations/fullcit/MQ75513

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Brain Reward System Dysfunction in Major Depressive Disorder: Differential Behavioural Response to D-amphetamine and Corresponding Neuroanatomical Substrates by Tremblay, Lescia Kryworuchko; Phd from University of Toronto (canada), 2002, 167 pages http://wwwlib.umi.com/dissertations/fullcit/NQ74757

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Bringing Religion Back In: the Life Stress Process and the Study of Depression by Ellison, Christopher Gaillard, Phd from Duke University, 1991, 309 pages http://wwwlib.umi.com/dissertations/fullcit/9424617

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Burden and Depression in Caregivers of Senile Dementia Patients in Korea by Shin, Seung Yeun, Phd from Columbia University, 1995, 191 pages http://wwwlib.umi.com/dissertations/fullcit/9606953

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Business Responses to Crisis: the Depression 1929-1932. by Trommald, Elliott Corbett, Phd from State University of New York at Buffalo, 1977, 474 pages http://wwwlib.umi.com/dissertations/fullcit/7719485

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Calling All Cars: Radio Crime Dramas and the Construction of Policing during the Depression Era by Battles, Kathleen Marie; Phd from The University of Iowa, 2002, 279 pages http://wwwlib.umi.com/dissertations/fullcit/3073349

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Calling the Soul Back to the Heart: Soul Loss, Depression and Healing among Indigenous Mexicans (zapotec) by Taub, Bonnie, Phd from University of California, Los Angeles, 1992, 215 pages http://wwwlib.umi.com/dissertations/fullcit/9310870

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Catholicism and the Industrial Worker during the Great Depression by Betten, Neil Bernard, Phd from University of Minnesota, 1968, 269 pages http://wwwlib.umi.com/dissertations/fullcit/6901489

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Change in Locus of Control, Anxiety, Depression and Social Behavior As a Function of Time in Methadone Maintenance Therapy by Hanbury, Raymond Francis Jr., Phd from New York University, 1980, 198 pages http://wwwlib.umi.com/dissertations/fullcit/8017503

Dissertations 387

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Change Versus Stability in Depression and Social Support among Caregivers of Impaired Elders by Coon, David Wayne, Phd from Stanford University, 1996, 206 pages http://wwwlib.umi.com/dissertations/fullcit/9702882

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Changes in Depression and Self-esteem of Spouses of Stroke Patients with Aphasia As a Result of Group Counseling by Emerson, Roger Walter, Phd from Oregon State University, 1980, 100 pages http://wwwlib.umi.com/dissertations/fullcit/8005612

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Charles L. Mcnary and the Republican Party during Prosperity and Depression by Johnson, Roger Taylor, Phd from The University of Wisconsin - Madison, 1967, 418 pages http://wwwlib.umi.com/dissertations/fullcit/6712435

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Child Adjustment and Maternal Depression As Predictors of Partner Dissatisfaction by Sonnenklar, Jill Weinstein; Phd from St. John's University (new York), 2002, 107 pages http://wwwlib.umi.com/dissertations/fullcit/3054363

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Childhood and Maternal Depression in a Clinical Population by Lasko, Carol Ann, Phd from The University of Akron, 1990, 304 pages http://wwwlib.umi.com/dissertations/fullcit/9110810

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Childhood Depression and Social Skill Deficits (depression) by Linn, James Lee, Phd from The University of Texas at Austin, 1989, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9016928

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Childhood Depression: Relationships between Parent, Child, and Clinician Reports by Fegurgur, Mary Katherine; Psyd from Alliant International University, San Diego, 2002, 86 pages http://wwwlib.umi.com/dissertations/fullcit/3061077

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Childhood Depression: Educational Implications and Criteria for Screening Children (depression Screening) by Hecht, Janet L., Phd from Stanford University, 1992, 125 pages http://wwwlib.umi.com/dissertations/fullcit/9221621

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Childhood Parental Loss and Adult Depression: an Evaluation of Psychoanalytic, Attachment, and Sociological Theories by Mcleod, Jane Donnell, Phd from The University of Michigan, 1987, 265 pages http://wwwlib.umi.com/dissertations/fullcit/8801372

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Childrearing, Social Contact, and Depression: a Structural Analysis of the Transition to Parenthood by Munch-rotolo, Allison Christi; Phd from The University of Arizona, 2000, 308 pages http://wwwlib.umi.com/dissertations/fullcit/9972088

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Children's Interests / Mothers' Rights: Women, Professionals, and the American Family, 1920-1945 (day Care, Mental Hygiene, Great Depression, World War Ii) by Michel, Sonya Alice, Phd from Brown University, 1986, 475 pages http://wwwlib.umi.com/dissertations/fullcit/8617598

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China under the Depression: the Regional Economy of the Lower Yangzi Delta, 19311937 by Shiroyama, Tomoko, Phd from Harvard University, 1999, 392 pages http://wwwlib.umi.com/dissertations/fullcit/9935900

388 Depression

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Chinese Causal Beliefs and Help Seeking Preferences Concerning Depression by Sinclair, David Byron; Phd from University of Alberta (canada), 2000, 222 pages http://wwwlib.umi.com/dissertations/fullcit/NQ60025

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Chronic Illness and Depression among Women: the Role of Social Support by Fuller, Taleria Renee; Phd from Wayne State University, 2000, 163 pages http://wwwlib.umi.com/dissertations/fullcit/9966140

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Citizen Savers: the Family Economy, Financial Institutions, and Social Policy in the Northeastern United States from the Market Revolution to the Great Depression by Wadhwani, Rohit Daniel; Phd from University of Pennsylvania, 2002, 451 pages http://wwwlib.umi.com/dissertations/fullcit/3055007

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Clinical Depression: a Sociological Inquiry by Brissett, Dennis D., Phd from University of Minnesota, 1966, 281 pages http://wwwlib.umi.com/dissertations/fullcit/6801596

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Clinical Treatments of Depression by Orth, Deborah Kay, Edd from West Virginia University, 1979, 369 pages http://wwwlib.umi.com/dissertations/fullcit/8012905

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Cognitive and Behavioral Approaches to the Modification of Depression by Taylor, Frederick George; Phd from Queen's University at Kingston (canada), 1974 http://wwwlib.umi.com/dissertations/fullcit/NK21168

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Cognitive Correlates of Depression in Regular Education and Emotionally Disturbed Children by Little, Vija Karlija Ziemelis, Phd from Texas A&m University, 1989, 213 pages http://wwwlib.umi.com/dissertations/fullcit/9015538

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Cognitive Factors Associated with Depression in Presbyterian (usa) Clergy: a Comparison Study with Mental Health Counselors by Griffin, Wayne David, Phd from University of Florida, 1993, 230 pages http://wwwlib.umi.com/dissertations/fullcit/9505765

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Cognitive Markers in Adolescent Major Depression by Haley, Glenn Michael Thompson; Phd from Simon Fraser University (canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL48748

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Cognitive Patterns in Symptomatic Depression between Unipolar and Bipolar Depressives (mood Disorder, Clinical, Abnormal Psychology, Affective Disorders) by Brown, Paul Wendell, Phd from The University of Mississippi, 1984, 75 pages http://wwwlib.umi.com/dissertations/fullcit/8502608

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Cognitive Therapy and Michel Foucault As Resources for a Feminist Theological Approach to the Pastoral Care and Counseling of Depression in Women As Construed by a Biopsychosocial Model of Depression by Dunlap, Susan Jane, Phd from Princeton Theological Seminary, 1994, 273 pages http://wwwlib.umi.com/dissertations/fullcit/9509081

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Cognitive Therapy: Intervention with the Depressed Elderly (depression) by Dehope, Eileen Kathryn, Dsw from University of Pennsylvania, 1990, 302 pages http://wwwlib.umi.com/dissertations/fullcit/9113875

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Cognitive Versus Instrumental Views of the Negative Bias in Depression by Nussbaum, Karen Lee, Phd from University of Washington, 1980, 130 pages http://wwwlib.umi.com/dissertations/fullcit/8026284

Dissertations 389

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Cognitive Vulnerability to Depression: Attention and Memory Biases in Neverdepressed Daughters of Depressed Mothers by Traill, Saskia Katherine; Phd from Stanford University, 2002, 110 pages http://wwwlib.umi.com/dissertations/fullcit/3067965

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College Athletics and Physical Education in Ohio during the Depression by Barnett, Clarence Robert, Phd from The Ohio State University, 1972, 312 pages http://wwwlib.umi.com/dissertations/fullcit/7301932

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College Mental Health Provider's Ability to Identify Dating Violence As the Etiology of Depression in a Battered College Female by Ellis, Gayle Marie; Phd from The University of Wisconsin - Madison, 2001, 127 pages http://wwwlib.umi.com/dissertations/fullcit/3012564

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College Student Expectations about Counseling by a Peer or Professional Counselor for Two Types of Problems (counseling Expectations, Peer Counselor, Depression, Alcoholism) by Weathington, Faith Myer, Edd from Auburn University, 1991, 83 pages http://wwwlib.umi.com/dissertations/fullcit/9217914

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Colorado and the Great Depression: Business Thought in a Time of Crisis by Sims, Robert Carl, Phd from University of Colorado at Boulder, 1970, 159 pages http://wwwlib.umi.com/dissertations/fullcit/7121626

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Commonality of Factors in the Personal Histories of Severely Disabled Schizophrenia and Bipolar Disorder/major Depression Clients by Monschke, Alice Allen, Phd from Kansas State University, 1997, 239 pages http://wwwlib.umi.com/dissertations/fullcit/9817170

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Communication in Marital Dyads Implications for Interactional Approaches to Depression by Kowalik, Debra Lynn; Phd from The University of Western Ontario (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL49316

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Communication Processes of Depression: an Analysis of Verbal Interactions of Depressed College Students with Their Nondepressed Peers by Ziomek, Madelyn Marie, Phd from University of California, Berkeley, 1989, 221 pages http://wwwlib.umi.com/dissertations/fullcit/9006583

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Communism and the Canadian Working Class during the Great Depression the Workers' Unity League, 1930-1936 by Manley, John; Phd from Dalhousie University (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK66123

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Community and Crisis: Black Harlem in the Great Depression (harlem, New York) by Greenberg, Cheryl Lynn, Phd from Columbia University, 1988, 461 pages http://wwwlib.umi.com/dissertations/fullcit/9102420

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Comorbidity between Conduct Disorder and Major Depression: Phenomenology, Correlates, Course, and Familial Aggregation by Seeley, John Robert; Phd from University of Oregon, 2001, 84 pages http://wwwlib.umi.com/dissertations/fullcit/3035576

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Comparison of Adolescent Pic-r and Mmpi Depression Scores to Dsm-iii Criteria by Lavenau, David B., Psyd from Rosemead School of Psychology, Biola University, 1988, 87 pages http://wwwlib.umi.com/dissertations/fullcit/8725083

390 Depression

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Competition and Productivity in the Depression-era Steel Industry by Bertin, Amy Lynn, Phd from Harvard University, 1994, 148 pages http://wwwlib.umi.com/dissertations/fullcit/9514760

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Components of Stress: Anxiety, Depression, and Alienation (workplace, Coping Mechanism) by Tucker, Brian, Phd from Cornell University, 1986, 261 pages http://wwwlib.umi.com/dissertations/fullcit/8623208

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Concurrent Validity of the Suicide Probability Scale (depression) by Lee, W. Vernon, Phd from Temple University, 1992, 74 pages http://wwwlib.umi.com/dissertations/fullcit/9227492

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Cone: a Personal-computer Program Simulating Aquifer Tests for Teaching Groundwater Concepts (depression Cone, Hydrology, Geology) by Brooks, Thomas David, Phd from University of Idaho, 1995, 80 pages http://wwwlib.umi.com/dissertations/fullcit/9606358

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Congruence between Child Self-reports and Those of Their Parents and Teachers on Anxiety and Depression: a Preliminary Investigation of Parameters of Agreement by Brook, William Samuel, Phd from The University of Texas at Austin, 1995, 197 pages http://wwwlib.umi.com/dissertations/fullcit/9617180

•

Connecticut in the Great Depression, 1929-1933. by Lombardo, Peter Joseph, Jr., Phd from University of Notre Dame, 1979, 257 pages http://wwwlib.umi.com/dissertations/fullcit/7919951

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Consumption and Income Distribution: the Revised Standard Income Theory with Application to the Great Depression. by Nagle, Reid, Phd from The Johns Hopkins University, 1979, 196 pages http://wwwlib.umi.com/dissertations/fullcit/7914297

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Contemporary American Poets, Poetry Writing, and Depression by Staltaro, Shirley Oribio; Psyd from Alliant International University, Fresno, 2002, 60 pages http://wwwlib.umi.com/dissertations/fullcit/3062692

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Contracts, Collapse, and Coercion: a Katallactic Reappraisal of the Great Depression by Cochran, Jay, Iii; Phd from George Mason University, 1999, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9949089

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Coping As a Mediator or Moderator of Temperament Risk for Depression and Alcohol Involvement by Mckernon, Wendy L. Phd from Loyola University of Chicago, 2002, 97 pages http://wwwlib.umi.com/dissertations/fullcit/3077495

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Coping Factors That Affect Depression in African American Female Survivors of Child Sexual Abuse: Family Cohesion, Involvement at Church or Temple And, Mother's Perception of Daughter's Depression by Kelley, Robin T. Phd from University of Maryland College Park, 2002, 224 pages http://wwwlib.umi.com/dissertations/fullcit/3055583

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Coping in Adolescent-mother Conflictual Interactions As a Predictor of Adolescent Depression by Bonica, Cheryl A. Phd from University of Massachusetts Amherst, 2002, 87 pages http://wwwlib.umi.com/dissertations/fullcit/3056200

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Coping Strategies, Life Perceptions and Depression in Adolescents by Kay, Lori Ann, Phd from University of Toronto (canada), 1995, 150 pages http://wwwlib.umi.com/dissertations/fullcit/NN07319

Dissertations 391

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Correlates of Demoralization/depression and Related Conditions in Primary Support Persons Caring for Dependent Elderly Relatives (burden, Family) by Brieff, Robert Lewis, Edd from Columbia University Teachers College, 1986, 384 pages http://wwwlib.umi.com/dissertations/fullcit/8620339

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Correlates of Depression Following Romantic Breakups in Adolescence by Peresie, Cheryl Ann; Phd from Ball State University, 2002, 81 pages http://wwwlib.umi.com/dissertations/fullcit/3057050

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Correlates of Depression in Fifth and Sixth-grade School Children by Berenson, Naomi Janet, Phd from Hofstra University, 1987, 246 pages http://wwwlib.umi.com/dissertations/fullcit/8800451

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Correlates of Self-concept and Depression among Left Hemiplegic Male Patients Disabled by Stroke (stroke Patients) by Galura-siasoco, Gloria Samia, Phd from New York University, 1991, 162 pages http://wwwlib.umi.com/dissertations/fullcit/9136313

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Correlation of Marital Satisfaction and Depression among Couples Where One Spouse Has Become Involuntarily Unemployed by Kessler, Esther, Phd from Seton Hall University, College of Education and Human Services, 1995, 204 pages http://wwwlib.umi.com/dissertations/fullcit/9619188

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Cortisol Release, Memory Dysfunction and Depression by Walder, Deborah Joy; Phd from Emory University, 2002, 87 pages http://wwwlib.umi.com/dissertations/fullcit/3059029

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Couples Coping with Cancer: a Combined Interactional and Problem-solving Approach to Depression by Mcclure, Kelly Sprague; Phd from Mcp Hahnemann University, 2002, 131 pages http://wwwlib.umi.com/dissertations/fullcit/3041287

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Creating the American Paper Boy: Circulation Managers and Middle-class Route Service in Depression-era America by Postol, Todd Alexander, Phd from The University of Chicago, 1997, 305 pages http://wwwlib.umi.com/dissertations/fullcit/9811921

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Critical Life Events, Irrational Beliefs and Locus of Control As Components of Steady State Depression by Pellegrini, Wayne L; Phd from University of Ottawa (canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK44123

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Cultivating the Terrain: Public Image and Politics of California Farming from the Depression to the Postwar Years by Bradley, Karen Jane, Phd from University of California, Berkeley, 1995, 341 pages http://wwwlib.umi.com/dissertations/fullcit/9621060

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Cultural Values, Depression, and Social Anxiety in Asian American Adolescents by Zheng, Shufeng; Phd from The University of Utah, 2001, 123 pages http://wwwlib.umi.com/dissertations/fullcit/3031632

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Culture and the Self: Implications for Koreans' Mental Health (depression, Immigrants) by Hyun, Kyoung Ja, Phd from The University of Michigan, 1995, 195 pages http://wwwlib.umi.com/dissertations/fullcit/9610147

392 Depression

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Dancing on Our Graves: Addressing Issues of Depression in Church-going Christian Women of African Descent. Developing Models of Care for Women of Color by Balamani, Michele Deleaver, Dmin from United Theological Seminary, 1997, 135 pages http://wwwlib.umi.com/dissertations/fullcit/9819536

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Darkening Mirrors: Imperial Representation, Otherness and Subjectivity in African American Performance during the Depression Era by Batiste, Stephanie Leigh; Phd from The George Washington University, 2003, 408 pages http://wwwlib.umi.com/dissertations/fullcit/3075177

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Death of a Parent When Children Are Young and Development of Depression in Childhood (bereavement, Mother Loss, Father Loss) by Barile, Bernard Joseph, Phd from University of Pittsburgh, 1984, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8500152

•

Dementia and Depression: a Study of Prevalence in an Elderly Residential Setting by Marrocco, Geraldine Fahy, Edd from Columbia University Teachers College, 1996, 134 pages http://wwwlib.umi.com/dissertations/fullcit/9620160

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Dependence upon Unsustaining Environments As an Antecedent Variable of Depression. by Wetzel, Janice Wood, Phd from Washington University, 1976, 152 pages http://wwwlib.umi.com/dissertations/fullcit/7704060

•

Depression across Cultures: the Construction of Depressive Disturbances in Greater Sao Paulo, Brazil by Pereira De Miranda, Damiana; Phd from The University of Arizona, 1999, 358 pages http://wwwlib.umi.com/dissertations/fullcit/9946866

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Depression America and Its Movies by Bergman, Andrew Lawrence, Phd from The University of Wisconsin - Madison, 1970, 285 pages http://wwwlib.umi.com/dissertations/fullcit/7024684

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Depression among a National Probability Sample of Post-hospitalized Patients and Matched Controls by Ricks, Paul Grant, Drph from University of California, Berkeley, 1985, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8524865

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Depression among African Patients: Three Diagnostic Approaches by Fisha, Senathi; Dphil from University of Pretoria (south Africa), 2002 http://wwwlib.umi.com/dissertations/fullcit/f779521

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Depression among Married Female Applicants for Mental Health Service in Southwest Missouri by Fillinger, John W., Edd from University of Northern Colorado, 1983, 98 pages http://wwwlib.umi.com/dissertations/fullcit/8408146

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Depression and Adjustment in Marriage by Olin, George V., Edd from East Texas State University, 1984, 175 pages http://wwwlib.umi.com/dissertations/fullcit/8425049

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Depression and Alcohol Problems in Women by Turnbull, Joanne Emily, Phd from The University of Michigan, 1986, 310 pages http://wwwlib.umi.com/dissertations/fullcit/8612643

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Depression and Anxiety in Cancer Patients Seeking Psychosocial Therapy by Nicholl, Sheldon William; Ma from Lakehead University (canada), 2002, 69 pages http://wwwlib.umi.com/dissertations/fullcit/MQ70798

Dissertations 393

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Depression and Anxiety in Postmenopausal Women: a Study of Black, White, and Hispanic Women by Groessl, Patricia Ann, Edd from Western Michigan University, 1987, 87 pages http://wwwlib.umi.com/dissertations/fullcit/8714651

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Depression and Conduct Disorders As Co-morbid Conditions in Students Who Have Been Suspended from Regular High School Units and Are Attending an Alternative School by Thomas, Gale Denise, Phd from Georgia State University, 1992, 131 pages http://wwwlib.umi.com/dissertations/fullcit/9220336

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Depression and Decline: Newark, New Jersey: 1929-1941 by Stellhorn, Paul Anthony, Phd from Rutgers the State University of New Jersey - New Brunswick, 1982, 416 pages http://wwwlib.umi.com/dissertations/fullcit/8214711

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Depression and Fatigue in Cancer Patients: Implications for Mental Health Practitioners by Van Duursen, Theresa Renee Tiedemann; Phd from University of Northern Colorado, 2002, 113 pages http://wwwlib.umi.com/dissertations/fullcit/3071871

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Depression and Learning Disabilities by Freeman, Emily; Phd from Dalhousie University (canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL33154

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Depression and Life Satisfaction in Black, White and Latina Grandmothers Parenting Their Grandchildren by Melton, Carolyn Elaine; Msw from California State University, Long Beach, 2002, 74 pages http://wwwlib.umi.com/dissertations/fullcit/1410815

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Depression and Locus-of-control in College Students with Learning Disabilities by Stephens, Martha Craig, Phd from University of Georgia, 1989, 290 pages http://wwwlib.umi.com/dissertations/fullcit/9003465

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Depression and Loneliness in the Early Adolescent, Learning-disabled Population by Finkelstein, Robert J., Phd from Hofstra University, 1995, 92 pages http://wwwlib.umi.com/dissertations/fullcit/9610412

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Depression and Marital Interaction: an Analysis of Systemic Patterns of Marital Communication by Jabs, Carol Ann; Phd from The University of Chicago, 2000, 146 pages http://wwwlib.umi.com/dissertations/fullcit/9959095

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Depression and Marital Satisfaction, among Married Women Ages 25 to 44, As a Function of Intimacy, Control, and Interpersonal Dependency by Adams, Sheryl Lee, Phd from The Florida State University, 1989, 250 pages http://wwwlib.umi.com/dissertations/fullcit/8915734

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Depression and New Deal in Pendleton: a History of a West Virginia County from the Great Crash to Pearl Harbor, 1929-1941 by Taylor, John Craft, Phd from The Pennsylvania State University, 1980, 890 pages http://wwwlib.umi.com/dissertations/fullcit/8024498

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Depression and New Deal in Virginia by Heinemann, Ronald Lynton, Edd from University of Virginia, 1968, 329 pages http://wwwlib.umi.com/dissertations/fullcit/6903979

394 Depression

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Depression and Perception of Maternal Rejection in Latency-age, African American Children of Alcoholic Mothers by Marse, Karen; Phd from Seton Hall University, College of Education and Human Services, 2002, 121 pages http://wwwlib.umi.com/dissertations/fullcit/3041328

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Depression and Physical Illness: a Longitudinal Analysis of the National Health and Nutrition Examination Survey Data by Skarupski, Kimberly Ann, Phd from Case Western Reserve University, 1996, 227 pages http://wwwlib.umi.com/dissertations/fullcit/9720448

•

Depression and Preattributions for Life Problems and Pleasures a Test of Kelley's Model by Flett, Gordon L; Phd from University of Toronto (canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL46376

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Depression and Reinforcement : a Test of Three Hypotheses by Rowney, J. I. A; Phd from University of Calgary (canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK25058

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Depression and Right Hemisphere Dysfunction in Children with Learning Disabilities by Chaskelson, Marsha Ina, Phd from Boston College, 1985, 148 pages http://wwwlib.umi.com/dissertations/fullcit/8601576

•

Depression and Self-silencing in Lesbian and Heterosexual Women by Kirk, Samantha Ann; Phd from West Virginia University, 2002, 146 pages http://wwwlib.umi.com/dissertations/fullcit/3055924

•

Depression and Smoking Relapse: an Evaluation of Nicotine Mechanisms by Balabanis, Mark Homer; Phd from University of Pittsburgh, 2002, 113 pages http://wwwlib.umi.com/dissertations/fullcit/3066932

•

Depression and Social Anxiety among Asian and European Americans: the Roles of Self-discrepancy, Optimism, and Pessimism by Hardin, Erin Elizabeth; Phd from The Ohio State University, 2002, 190 pages http://wwwlib.umi.com/dissertations/fullcit/3049032

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Depression and the Disablement Process in Older People by Jordan, Anne K. Phd from The Pennsylvania State University, 1999, 163 pages http://wwwlib.umi.com/dissertations/fullcit/9960614

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Depression and the Magnet School Adolescent: Identification, Prevelance, Related Characteristics, and Directions for Treatment by Manning, Bradley Jack; Phd from The Ohio State University, 2002, 136 pages http://wwwlib.umi.com/dissertations/fullcit/3062648

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Depression and Underachievement in the Gifted Male Adolescent by Thomsen, Alice K., Phd from Seton Hall University, School of Education, 1985, 120 pages http://wwwlib.umi.com/dissertations/fullcit/8617877

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Depression and War: Three Essays on the Canadian Economy, 1930--1945 by Rogers, Sean Harris; Phd from Mcgill University (canada), 2000, 245 pages http://wwwlib.umi.com/dissertations/fullcit/NQ70191

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Depression As a Predictor of Ischemic Heart Disease by Rowan, Paul John; Phd from The University of Alabama, 2002, 173 pages http://wwwlib.umi.com/dissertations/fullcit/3067307

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Depression As Loneliness in Post-generative Women: a Crisis of Faith Development by Mader, Shirley Titcomb, Phd from Boston University, 1986, 424 pages http://wwwlib.umi.com/dissertations/fullcit/8624466

Dissertations 395

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Depression As Related to Family Abuse and Family Structure in an Urban Community by Traylor, Lawrence Henry, Edd from Texas Southern University, 1996, 128 pages http://wwwlib.umi.com/dissertations/fullcit/9810252

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Depression Era Extremists: a Study of Three Demagogues and Their Tactics. by Bouton, Michael Wickham, Da from Illinois State University, 1978, 212 pages http://wwwlib.umi.com/dissertations/fullcit/7913036

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Depression Identification among Nursing Home Residents: the Gds Vs. the Mds by Heiser, Deborah Sue; Phd from Fordham University, 2003, 140 pages http://wwwlib.umi.com/dissertations/fullcit/3077254

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Depression in a Preventive Group Intervention for Couples: Individual and Group Level Effects by Brooks, Heidi Stultz; Phd from University of California, Berkeley, 2002, 73 pages http://wwwlib.umi.com/dissertations/fullcit/3063303

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Depression in Adolescence by Marziali, Elsa A., Dsw from Smith College School for Social Work, 1971, 221 pages http://wwwlib.umi.com/dissertations/fullcit/7208403

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Depression in Adolescents by Chow, Hau Lin, Phd from University of Alberta (canada), 1990, 317 pages http://wwwlib.umi.com/dissertations/fullcit/NN64992

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Depression in Adolescents with Attention Deficit Hyperactivity Disorder: Using Conditional Probabilities Based on Teacher Ratings from the Behavior Assessment System for Children by Barton, Nancy Faye; Phd from Oklahoma State University, 1999, 107 pages http://wwwlib.umi.com/dissertations/fullcit/9942420

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Depression in Adolescents: Some Cognitive Developmental Considerations by Griffin, Mary Elizabeth, Phd from University of Pittsburgh, 1988, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8815227

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Depression in Alabama Women with Hiv (immune Deficiency) by Rehner, Timothy Alan, Phd from The University of Alabama, 1994, 165 pages http://wwwlib.umi.com/dissertations/fullcit/9508506

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Depression in Assisted Living Facilities by Wagenaar, Deborah Banazak; Ms from Michigan State University, 2002, 79 pages http://wwwlib.umi.com/dissertations/fullcit/1411991

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Depression in Early Adolescence: Life Events, Ongoing Stressors, and Causal Attribution Linkages in Urban Black Youth (low Socioeconomic, Success, Failure, Interpersonal, Relationships) by Hargrow, Mary Elizabeth, Phd from University of California, Los Angeles, 1985, 189 pages http://wwwlib.umi.com/dissertations/fullcit/8601898

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Depression in Mormon Women by Spendlove, David Craig, Phd from The University of Utah, 1982, 133 pages http://wwwlib.umi.com/dissertations/fullcit/8305425

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Depression in Nonfamilial Caregivers of Young Children: Prevalence and Associations with Caregiver Behavior in Child Care Settings by Hamre, Bridget Kathleen; Phd from University of Virginia, 2002, 177 pages http://wwwlib.umi.com/dissertations/fullcit/3057475

396 Depression

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Depression in Normal Subjects : Predisposing Cognitive Factors and Precipitating Situations by Wright, Phillip Grant; Phd from Mcgill University (canada), 1977 http://wwwlib.umi.com/dissertations/fullcit/NK35818

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Depression in Older Adults: an Examination of Expressive Features by Metz, Helen Emily, Phd from Columbia University, 1987, 114 pages http://wwwlib.umi.com/dissertations/fullcit/8724067

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Depression in Parents of Clinic-referred Children: Links with the Marital, Parentchild, and Child Behavior Domains by Hawkins, Heidi Noell; Phd from Bowling Green State University, 2002, 135 pages http://wwwlib.umi.com/dissertations/fullcit/3066552

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Depression in Pregnancy As It Relates to Feminine Identification Conflict and Perceived Environmental Support by Rothstein, Arnold, Dsw from Smith College School for Social Work, 1971, 146 pages http://wwwlib.umi.com/dissertations/fullcit/7208405

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Depression in Students with Learning Disabilities As Examined by a Developmental Model and Influenced by Hemispheric Differences by Wright-strawderman, Carol, Phd from The University of New Mexico, 1988, 149 pages http://wwwlib.umi.com/dissertations/fullcit/8905771

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Depression in the Caregiving Mothers of Adult Schizophrenics: a Test of the Resource Deterioration Model by Hobbs, Tom Ray, Phd from The University of Alabama, 1994, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9522425

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Depression in Underachieving Gifted High School Students and Effects of a Brief Intervention Strategy (counseling, Reframing, One-session) by Gill, Fredda Herndon, Edd from Virginia Polytechnic Institute and State University, 1984, 125 pages http://wwwlib.umi.com/dissertations/fullcit/8507187

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Depression in Young and Old Adults: the Relative Efficacy of Cognitive Versus Behavioral Group Therapy Interventions by Grossman-morris, Cheryl Fern, Phd from State University of New York at Buffalo, 1986, 239 pages http://wwwlib.umi.com/dissertations/fullcit/8629069

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Depression of Intrinsically Motivated Performance by Rewards the Role of Frustration-mediated Contrast Effects by Dimitroff, George; Phd from University of Toronto (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK62116

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Depression of Intrinsically Motivated Performance by Rewards: the Role of Frustration-mediated Contrast Effects by Dimitroff, George Peter, Phd from University of Toronto (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/f2126917

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Depression of Murine Hepatic Mixed Function Oxidase during Infection with Listeria Monocytogenes by Azri, Shana; Phd from Dalhousie University (canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL49802

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Depression Pioneers: the Conclusion of an American Odyssey. Oklahoma to California, 1930-1950, a Reinterpretation by Manes, Sheila Goldring, Phd from University of California, Los Angeles, 1982, 469 pages http://wwwlib.umi.com/dissertations/fullcit/8219731

Dissertations 397

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Depression Politics in Michigan, 1929-1933 by Ortquist, Richard Theodore, Jr., Phd from The University of Michigan, 1968, 281 pages http://wwwlib.umi.com/dissertations/fullcit/6912198

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Depression, Anxiety, and Locus of Control in a Terminal Versus Nonterminal Population by Burns, Kathleen Marie, Edd from The University of Utah, 1984, 61 pages http://wwwlib.umi.com/dissertations/fullcit/8424970

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Depression, Cognitive Distortion and Self-efficacy in Chronic-pain Patients by Sprague, Ann M; Phd from University of Windsor (canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL29293

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Depression, Exercise Schemas, and Physical Self-efficacy by Clark, Camillia Grace; Phd from Fielding Graduate Institute, 2002, 144 pages http://wwwlib.umi.com/dissertations/fullcit/3037965

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Depression, Hopelessness, and Problem-solving in Three Latino Groups by Alberti, Roxana Dearing, Phd from University of Southern California, 1996, 72 pages http://wwwlib.umi.com/dissertations/fullcit/9720174

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Depression, Learning Disabilities, and Social Competence in Prepubertal Children (childhood Depression) by Acker, Haskell Brewington, Phd from Georgia State University, 1990, 158 pages http://wwwlib.umi.com/dissertations/fullcit/9102990

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Depression, Life Satisfaction, and the Will to Live in College-educated 67-72 Year Old Men (employment, Retirement, Aged) by Boy, Stephen Francis, Phd from Boston College, 1986, 153 pages http://wwwlib.umi.com/dissertations/fullcit/8616090

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Depression, Prosperity, and Economic Policy in Japan: Crisis and Stabilization in a Long-run Perspective by Metzler, Mark David, Phd from University of California, Berkeley, 1998, 552 pages http://wwwlib.umi.com/dissertations/fullcit/9922968

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Depression, Self-esteem and Attributional Style As Predictors of Students' Satisfaction with College Life by Abdullatif, Hassan I., Edd from Indiana University, 1992, 163 pages http://wwwlib.umi.com/dissertations/fullcit/9306146

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Depression, Self-focused Attention, and Causal Analysis by Musson, Robert F., Phd from Northwestern University, 1988, 240 pages http://wwwlib.umi.com/dissertations/fullcit/8823012

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Depression, Strain, and Health Outcomes in Caregivers of Cognitively Impaired, Hospitalized Patients: Do Ace Units Help? by Fritsch, Thomas; Phd from Miami University, 2000, 121 pages http://wwwlib.umi.com/dissertations/fullcit/9964487

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Depression, Stress, and Social Supports among Single Mothers of Young Children Exhibiting Severe Behavior Problems by Stanley-bryson, Kaye Lynne, Phd from Kent State University, 1995, 107 pages http://wwwlib.umi.com/dissertations/fullcit/9631221

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Depression--a Theological Disorder (counseling Psychology) by Probst, Theodor, Dmin from Westminster Theological Seminary, 1984, 231 pages http://wwwlib.umi.com/dissertations/fullcit/8425223

398 Depression

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Depressive Cognitions in University Students an Investigation of Two Theories of Depression by Breiter, Hans Juergen; Phd from The University of Western Ontario (canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NK66057

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Depressive Disorders in Primary School Children: Development of a Screening Instrument and Refinement of Dsm-iv Criteria to Account for Developmental Stage by Van Der Westhuizen, Deborah; Md from University of Pretoria (south Africa), 2002 http://wwwlib.umi.com/dissertations/fullcit/f779505

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Depressive Symptoms, Depletion or Developmental Change? Multidimensionality in the Geriatric Depression Scale According to Contemporary Interpretations of the Disengagement Theory of Aging by Adams, Kathryn Betts; Phd from University of Maryland, Baltimore, 2000, 150 pages http://wwwlib.umi.com/dissertations/fullcit/9998795

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Depressotypic Cognitive Patterns in Conjugal Bereavement and Major Depression by Robinson, Paul J; Phd from York University (canada), 1987 http://wwwlib.umi.com/dissertations/fullcit/NL35793

•

Desert Myth: the Great Plains Environment and Depression America by Lookingbill, Brad Darren, Phd from The University of Toledo, 1995, 320 pages http://wwwlib.umi.com/dissertations/fullcit/9601627

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Despair and Depression on Dissolution of an Intimate Relationship and the Healing Process: a Cultural Perspective (divorce, Separation, Cohabitation) by Scalice, Marybeth, Edd from Boston University, 1986, 780 pages http://wwwlib.umi.com/dissertations/fullcit/8615335

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Determining the Structure of Client Participation in Interpersonal Psychotherapy for Depression: Is It Different for Male and Female Clients? by Jones, Marylouise Evans; Phd from Loyola University of Chicago, 2002, 381 pages http://wwwlib.umi.com/dissertations/fullcit/3039286

•

Development and Test of a Model That Explains Depression among Korean Older Immigrants in the United States by Sung, Hyunsook, Phd from Indiana University, 1998, 141 pages http://wwwlib.umi.com/dissertations/fullcit/9932709

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Dieting Behaviors in a Community Sample: Associations with Depression, Drug Use, Health and Personality Revealed Through Latent Variable Methods by Zimmer-schur, Lori Ann, Phd from University of Southern California, 1993 http://wwwlib.umi.com/dissertations/fullcit/f2402547

•

Differences between Undergraduate and Graduate Students in Self-concept and Depression by Woolley, Ann Lynette; Phd from Andrews University, 2002, 246 pages http://wwwlib.umi.com/dissertations/fullcit/3058318

•

Differences in Family Functioning between Hospitalized Children with Depression and Behavior Problems by Kline, Paul Michael, Dsw from Boston College, 1990, 205 pages http://wwwlib.umi.com/dissertations/fullcit/9119367

•

Differences in Self-esteem and Depression among Parents of Individuals with Mental Retardation by Graham, Edward William, Dsw from Boston College, 1992, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9232380

Dissertations 399

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Differential Coping Strategies, Anxiety, Depression, and Symptomatology among African-american Women with Hiv/aids by Arrindell, Janis Marie; Phd from Howard University, 2003, 188 pages http://wwwlib.umi.com/dissertations/fullcit/3085404

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Differentiating Attentional Functions in Children with Adhd, Anxiety, and Depression (attention Deficit Hyperactivity Disorder) by Michaels, Katherine Louise, Phd from University of Georgia, 1996, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9624072

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Diffusion during Depression: the Adoption of the Tractor by Illinois Farmers by Graham, Robert Charles, Phd from University of Illinois at Urbana-champaign, 1985, 188 pages http://wwwlib.umi.com/dissertations/fullcit/8521772

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Digging for Dollars: the Impact of the New Deal on the Professionalization of American Archaeology (depression, Relief, Wpa, Paradigm) by Fagette, Paul Harvey, Jr., Phd from University of California, Riverside, 1985, 421 pages http://wwwlib.umi.com/dissertations/fullcit/8524482

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Dirtied Faces: Crisis and the Representation of Childhood and Youth on the Broadway Stage during the Great Depression by Turner, Julius Jeffrey; Phd from University of Colorado at Boulder, 2000, 239 pages http://wwwlib.umi.com/dissertations/fullcit/9969415

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Dissenting Science: Psychologists' Democratic Critique during the Depression Era by Pandora, Katherine Ann, Phd from University of California, San Diego, 1993, 537 pages http://wwwlib.umi.com/dissertations/fullcit/9405457

•

Distress in Major Adult Roles and Depression among White Men and Women by Schaeffer, Nora Cate, Phd from The University of Chicago, 1984 http://wwwlib.umi.com/dissertations/fullcit/T-28957

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Does Maternal Psychopathology Affect Child Clinical Assessment? a Test of the Generality and Specificity of the Depression→distortion Theory by Chi, Terry Chih-hsiang; Phd from University of California, Berkeley, 2002, 108 pages http://wwwlib.umi.com/dissertations/fullcit/3082141

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Doing Things and Talking It Out: Themes of Resistance in Young Adults' Accounts of Parental Depression by Dufraimont, Daniel Gordon; Msc from University of Guelph (canada), 2002, 99 pages http://wwwlib.umi.com/dissertations/fullcit/MQ71779

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'don't Buy from Where You Can't Work': Black Urban Boycott Movements during the Depression, 1929-1941. by Hunter, Gary Jerome, Phd from The University of Michigan, 1977, 329 pages http://wwwlib.umi.com/dissertations/fullcit/7726272

•

Double Depression in Male Veterans: a Descriptive and Comparative Study in a Rural Department of Veterans Affairs Medical Center by Dixon, Danny Roy, Phd from University of Georgia, 1997, 78 pages http://wwwlib.umi.com/dissertations/fullcit/9817792

•

Down in the Dumps: Place, Modernity, and the American Depression by Scandura, Janette M., Phd from University of Michigan, 1997, 271 pages http://wwwlib.umi.com/dissertations/fullcit/9811182

400 Depression

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Dysfunctional Attitudes and the Cognitive Treatment of Depression by Keller, Kevin Edward, Phd from University of Missouri - Columbia, 1980, 190 pages http://wwwlib.umi.com/dissertations/fullcit/8117447

•

Dysfunctional Attitudes and Vulnerability to Depression Implications for Stress Appraisals and Coping by Cane, Douglas B; Phd from The University of Western Ontario (canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL43283

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Dysfunctional Attitudes, Performance Deficits and Vulnerability to Depression by Olinger, Linda Joan; Phd from The University of Western Ontario (canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK60089

•

Early Intervention and Major Depressive Disorder by Quiring, Jason Matthew; Phd from University of Oregon, 2002, 123 pages http://wwwlib.umi.com/dissertations/fullcit/3055704

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Early Manifestations of Depression: Temperamental and Parental Influences by Bateman, Alison Elizabeth; Phd from Pacific Graduate School of Psychology, 2003, 119 pages http://wwwlib.umi.com/dissertations/fullcit/3055182

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Easing the Burden: the Era of Depression and New Deal in Mississippi. by Tate, Roger D., Jr., Phd from The University of Tennessee, 1978, 230 pages http://wwwlib.umi.com/dissertations/fullcit/7823356

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Economic Depression in Higher Education; Emory University, the University of Georgia and Georgia Tech, 1930-1940 (1930s, New Deal, Great Depression) by Reeves, Mary Garwood, Phd from Georgia State University, 1985, 366 pages http://wwwlib.umi.com/dissertations/fullcit/8604320

•

Economic Depression in Maryland and Virginia, 1783-1787 by Maganzin, Louis, Phd from Georgetown University, 1967, 294 pages http://wwwlib.umi.com/dissertations/fullcit/6801893

•

Economic Policy and Political Leadership in the German Depression 1930-1936 by Heyl, John David, Phd from Washington University, 1971, 396 pages http://wwwlib.umi.com/dissertations/fullcit/7119817

•

Education and the Great Depression: an Inquiry into the Social Ideas and Activities of Radical American Educators during the Economic Crisis of the 1930's by Baskin, Alex, Edd from Wayne State University, 1966, 478 pages http://wwwlib.umi.com/dissertations/fullcit/6710472

•

Effect of Religious Coping on Post-stroke Depression by Garvin, Kathy Campbell; Psyd from Regent University, 2003, 57 pages http://wwwlib.umi.com/dissertations/fullcit/3085842

•

Effectiveness of a Clinical Intervention Program for Reduction of Pain, and Concomitant Symptoms of Anxiety, Depression, and Hostility in Individuals Experiencing Chronic Pain (rehabilitation) by Linzer, Marc Rubin, Phd from The University of Arizona, 1986, 109 pages http://wwwlib.umi.com/dissertations/fullcit/8704778

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Effectiveness of Teaching Postpartum Depression Screening Methods Using Lecture and Group Discussion for Undergraduate Nursing Students by Thomas, Usha; Ms from D'youville College, 2002, 86 pages http://wwwlib.umi.com/dissertations/fullcit/1408480

Dissertations 401

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Effects of Depression and Substance Use on Head and Neck Cancer Mortality by Ehlers, Shawna Lee; Phd from The University of Iowa, 2002, 109 pages http://wwwlib.umi.com/dissertations/fullcit/3058400

•

Effects of Depression on Learned Resourcefulness and Prenatal Self-care Practices in Pregnant Women with and without Hiv Seropositivity in Thailand by Sae-han, Chayanin; Phd from Case Western Reserve University (health Sciences), 2002, 229 pages http://wwwlib.umi.com/dissertations/fullcit/3058842

•

Effects of Disputation Strategies in Rational Emotive Behavior Therapy (rebt) on the Treatment of Depression by Moriarty, Dana Lieber; Phd from Hofstra University, 2002, 207 pages http://wwwlib.umi.com/dissertations/fullcit/3041340

•

Effects of Four-day and Five-day Academic Weeks on Stress and Depression Levels in Gifted Secondary Students by Howe, Isabelle Hamilton, Edd from Texas Tech University, 1986, 140 pages http://wwwlib.umi.com/dissertations/fullcit/8707914

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Effects of Individual Leisure Counseling on Perceived Freedom in Leisure, Perceived Self-efficacy, Depression, and Abstinence of Adults in a Residential Program for Substance Dependence by Collins, G. Colleen, Edd from Temple University, 1997, 192 pages http://wwwlib.umi.com/dissertations/fullcit/9813485

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Effects of Relaxation among Sixth-graders on Achievement, Self-esteem, Anxiety and Depression (sixth Graders, Relaxation Training) by Campo, Peter Angelo, Phd from Temple University, 1993, 109 pages http://wwwlib.umi.com/dissertations/fullcit/9316461

•

Effects of Scientific Weight Training and Muscle Building Nutrition on Self-reports of Mild to Moderate Depression by Pendola, David P., Edd from United States International University, 1995, 373 pages http://wwwlib.umi.com/dissertations/fullcit/9543294

•

Effects of Separation on Vietnamese Unaccompanied Minors: Assessment Through the Use of the Kinetic Family Drawing Test, Hopkins Symptom Checklist-25, and the Vietnamese Depression Scale (refugee Children, Art Therapy) by Mcclementshammond, Ronna Beth, Edd from Rutgers the State University of New Jersey - New Brunswick, 1993, 191 pages http://wwwlib.umi.com/dissertations/fullcit/9328921

•

Effects of Survival Skills Workshops on Depression and Attributional Style of Urban Women in Poverty by Mckeehan, Janice Carol, Phd from Kansas State University, 1992, 170 pages http://wwwlib.umi.com/dissertations/fullcit/9235640

•

Effects of the Great Depression on Private Higher Education: Impact on Private College and University Planning by Hostetler, James Michael, Edd from Western Michigan University, 1989, 207 pages http://wwwlib.umi.com/dissertations/fullcit/9015612

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Effects of the New Beginnings Program at Polk Community College on Depression, Anxiety, and Self-esteem by Pimpinelli, Angelo Richard, Phd from The Union for Experimenting Colleges and Universities, 1989, 123 pages http://wwwlib.umi.com/dissertations/fullcit/9010766

402 Depression

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Effects of the Type a Behavior Pattern, Depression and the Duration of Noncontrol on the Illusion of Control by Dresel, K. Michael; Phd from The University of Manitoba (canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NK57764

•

Efficacy of an Aerobic Exercise Program As Treatment for Depression and Anxiety in Alcohol and Chemically Dependent Adults by Deivert, Richard Galen, Phd from The Pennsylvania State University, 1990, 135 pages http://wwwlib.umi.com/dissertations/fullcit/9032269

•

Efficacy of Cognitive Therapy for Adolescent Depression and the Relationship of Empathy to Outcome (psychotherapy) by Brent, Richard P., Edd from The University of Rochester, 1987, 166 pages http://wwwlib.umi.com/dissertations/fullcit/8705919

•

Elation-depression and Skill As Determinants of Desire for Excitement by Ludwig, Lawrence Donald, Phd from The University of Wisconsin - Madison, 1971, 215 pages http://wwwlib.umi.com/dissertations/fullcit/7209137

•

Eleanor Roosevelt and Federal Responsibility and Responsiveness to Youth, the Negro, and Others in Time of Depression by Abramowitz, Mildred Winer, Phd from New York University, 1970, 265 pages http://wwwlib.umi.com/dissertations/fullcit/7113628

•

Eliminating Self-defeating Behavior: a Method of Treating Depression by Perkins, Steven Eugene, Phd from Brigham Young University, 1981, 113 pages http://wwwlib.umi.com/dissertations/fullcit/8208399

•

Emotional Availability and Depression in Mothers of Preschool Children by Terry, Gale Janette, Phd from Smith College School for Social Work, 1990, 118 pages http://wwwlib.umi.com/dissertations/fullcit/9017238

•

Empathy Levels and Depression in Physically-abusive Adolescent Mothers and Nonphysically-abusive Adolescent Mothers (child Abuse) by Marino, Marie Ann, Edd from Columbia University Teachers College, 1992, 175 pages http://wwwlib.umi.com/dissertations/fullcit/9228504

•

Emphatically Middling : a Critical Examination of Canadian Poetry in the Great Depression by Thompson, Joyce Lesley; Phd from Queen's University at Kingston (canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK24892

•

Empirical Evaluation of a Three Stage Screening Model for Adolescent Depression by Evert, Thomas Frank, Phd from The University of Wisconsin - Madison, 1987, 452 pages http://wwwlib.umi.com/dissertations/fullcit/8723327

•

Employees' Knowledge and Fears about Depression at the Workplace by Orvis, Barbara Jean Bridgford; Phd from University of Minnesota, 2001, 217 pages http://wwwlib.umi.com/dissertations/fullcit/3020605

•

En Defensa De La Raza: the Los Angeles Mexican Consulate and Colonia Mexicana during the Great Depression. by Balderrama, Francisco Enrique, Phd from University of California, Los Angeles, 1978, 244 pages http://wwwlib.umi.com/dissertations/fullcit/7901331

Dissertations 403

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Endocrine Dysfunction in Primary Depressive Disorders in the Mentally Retarded and Its Behavioral Correlates by Pawlarczyk, Douglas Joseph, Phd from The University of North Dakota, 1984, 174 pages http://wwwlib.umi.com/dissertations/fullcit/8507632

•

'enter the Dream House': the British Film Industry and the Working Classes in Depression England, 1929 - 1939 by Shafer, Stephen Craig, Phd from University of Illinois at Urbana-champaign, 1982, 424 pages http://wwwlib.umi.com/dissertations/fullcit/8218560

•

Environmental Implications of Zooarchaeological Measures of Resource Depression by Wolverton, Steven John; Phd from University of Missouri - Columbia, 2001, 181 pages http://wwwlib.umi.com/dissertations/fullcit/3013044

•

Essays in Empirical Macroeconomics: Interpreting the Productivity Resurgence since 1980, and Nominal Wage Stickiness in the Great Depression by Carey, Kevin Joseph, Phd from Princeton University, 1994, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9519127

•

Ethnic Community in Economic Crisis: New York Jews and the Great Depression (new York City) by Wenger, Beth S., Phd from Yale University, 1992, 370 pages http://wwwlib.umi.com/dissertations/fullcit/9315272

•

Ethnic Variations in Women's Report of Depression: a Question of Women's Adaptation to Changing Gender Roles (black, Asian, Stress/support) by Oakley, Linda Denise, Phd from University of Washington, 1985, 163 pages http://wwwlib.umi.com/dissertations/fullcit/8521643

•

Evaluating an Interpersonal Model of Depression with Adults with Down Syndrome by Ailey, Sarah Herrink; Phd from University of Illinois at Chicago, Health Sciences Center, 2002, 152 pages http://wwwlib.umi.com/dissertations/fullcit/3058228

•

Evaluation Du Radar a Ouverture Synthetique En Bande C (5.26 Ghz), Selon Deux Angles De Depression (37a Et 60a), Pour Le Domaine Agricole by Poirier, Sylvain; Phd from Universite Laval (canada), 1987 http://wwwlib.umi.com/dissertations/fullcit/NL39092

•

Evolution of Mating System and Inbreeding Depression in the Mimulus Moschatus (scrophulariaceae) Alliance by Carlson, Matthew Lawrence; Phd from University of Alaska Fairbanks, 2002, 221 pages http://wwwlib.umi.com/dissertations/fullcit/3059719

•

Exercise and Clinical Depression: Examining Psychological Mechanisms by Craft, Lynette Leigh; Phd from Michigan State University, 2002, 108 pages http://wwwlib.umi.com/dissertations/fullcit/3064213

•

Exercise and Its Effect on Hopelessness and Depression in an Aging Female Population in Eastern Oklahoma by Hembree, Lynna Diane; Phd from University of Arkansas, 2000, 109 pages http://wwwlib.umi.com/dissertations/fullcit/9987255

•

Exercise As a Treatment for Depression Within a National Health Service (antidepressant, Aerobic Exercise, General Practioner) by Mutrie, Nanette, Phd from The Pennsylvania State University, 1986, 188 pages http://wwwlib.umi.com/dissertations/fullcit/8615227

404 Depression

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Exercise As It Relates to Depression and Locus-of-control by Brawner, Patricia Sparks, Phd from University of Georgia, 1989, 106 pages http://wwwlib.umi.com/dissertations/fullcit/9003371

•

Exercise Vs. Imipramine in the Treatment of Clomipramine-induced Depression in Male Rats by Yoo, Ho Sang, Phd from University of Georgia, 1995, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9604090

•

Exiled America: Sherwood Anderson, Thomas Hart Benton, Benjamin A. Botkin, Constance Rourke, Arthur Raper and the Great Depression (anderson Sherwood, Benton Thomas Hart, Botkin Benjamin A. , Rourke Constance, Raper Arthur) by Moore, David Ryan, Phd from Brown University, 1992, 297 pages http://wwwlib.umi.com/dissertations/fullcit/9308857

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Expectations, Outcome, and Patient Satisfaction with Mental Health Treatment (depression, Treatment Satisfaction) by Harrington, Janice, Phd from The University of Michigan, 1993, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9319534

•

Exploration Des Caracteristiques Graphiques Du Temps Vecu Dans La Depression Majeure a Travers Le Dessin D'une Ligne De Vie (french Text) by Dasseville, Violaine Nathalie; Ma from Concordia University (canada), 2002, 63 pages http://wwwlib.umi.com/dissertations/fullcit/MQ72963

•

Exploring Symptoms of Depression in School Children by Berg, Derek Heath; Med from Queen's University at Kingston (canada), 2002, 153 pages http://wwwlib.umi.com/dissertations/fullcit/MQ65601

•

Factors Associated with Depression and Low Life Satisfaction in the Low-income, Frail Elderly by Rogers, Anissa Taun, Phd from The University of Utah, 1997, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9724461

•

Factors Contributing to Depression in Mexicans and Central Americans by Arias, Luz Cristina; Msw from California State University, Long Beach, 2002, 63 pages http://wwwlib.umi.com/dissertations/fullcit/1410278

•

Factors Involved in Depression and Facilitation of Transmission at Crayfish Opener Neuromuscular Synapses by Acosta-urquidi, Juan; Phd from University of Toronto (canada), 1981 http://wwwlib.umi.com/dissertations/fullcit/NK46990

•

Factors Related to the Ability of Certain Small, Private, Liberal Arts Colleges to Cope with the New Depression in Higher Education. by Wormley, Wayne Marvin, Phd from Stanford University, 1978, 244 pages http://wwwlib.umi.com/dissertations/fullcit/7822593

•

'faking Good' and 'faking Bad' on the Beck Depression Inventory and Variables Which Might Contribute to 'faking' by Adult Clients of a Community Mental Health Center. by Davis, Thomas Whitmell, Phd from Duke University, 1978, 99 pages http://wwwlib.umi.com/dissertations/fullcit/7912786

•

Family Adaptability, Cohesion and Conflict in Families with Rheumatoid Arthritis, Chronic Pain and Depression by Caldwell, Karen Leigh, Phd from Virginia Polytechnic Institute and State University, 1988, 106 pages http://wwwlib.umi.com/dissertations/fullcit/8910943

Dissertations 405

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Family Caregivers of the Elderly: the Relationship between Dementia Caregiver Burden, Caregiver Depression and Beliefs about Caregiving by Mantell, Robert Alan; Phd from University of Minnesota, 2000, 180 pages http://wwwlib.umi.com/dissertations/fullcit/9966249

•

Family Resilience and Parental Competence: Contributors to Variation on Child Depression Scores in Divorced and Intact Families by Wolfe, Lesa; Phd from University of Calgary (canada), 2001, 223 pages http://wwwlib.umi.com/dissertations/fullcit/NQ64847

•

Family Structure and Depression: a Study of Puerto Rican Women in New York by Rodriguez-gomez, Jose Raul, Phd from Fordham University, 1993, 116 pages http://wwwlib.umi.com/dissertations/fullcit/9324625

•

Family Therapy with Multigenerational Households: Factors Related to Changes in Depression for Dependent and Non-dependent Elderly (dependent Elderly) by Mitchell, Tim, Phd from Brigham Young University, 1993, 70 pages http://wwwlib.umi.com/dissertations/fullcit/9316737

•

Faulkner and the Great Depression: Aesthetics, Ideology, and the Politics of Art (william Faulkner) by Atkinson, Theodore B., Iii; Phd from Louisiana State University and Agricultural & Mechanical College, 2001, 257 pages http://wwwlib.umi.com/dissertations/fullcit/3016525

•

Fear, Anger and Depression in Organizations: a Study of the Emotional Consequences of Power. by Myers, Robert J., Phd from St. John's University (new York), 1977, 271 pages http://wwwlib.umi.com/dissertations/fullcit/7900274

•

Female Adolescents Identified and Not Identified As Victims of Sexual Abuse: Selfesteem, Depression, Gender-related Personality Traits, and Social Desirability (adolescents) by Brown, Madonna Houltram, Phd from University of Southern California, 1991 http://wwwlib.umi.com/dissertations/fullcit/f1378084

•

Feminist Consciousness Raising, Self-concept and Depression. by Weitz, Rose, Phd from Yale University, 1978, 236 pages http://wwwlib.umi.com/dissertations/fullcit/7819491

•

Fetal Attachment: Measurement Matters. Relationships among Depression, Marital Satisfaction and Emotional Intelligence by Kunkel, Gail F. Ma from York University (canada), 2002, 162 pages http://wwwlib.umi.com/dissertations/fullcit/MQ75398

•

Fighting the Fascist Option in the Great Depression: Raymond Swing, Dale Carnegie and the Cultural History of the Specter of Fascism in the 1930s' United States by Krueckeberg, John Christian, Phd from The University of Arizona, 1997, 589 pages http://wwwlib.umi.com/dissertations/fullcit/9738942

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Forgiveness and Survivors of Sexual Abuse: Relationships among Forgiveness of the Perpetrator, Spiritual Well-being, Depression and Anxiety by Wilson, Heather Patricia, Phd from Boston University, 1994, 239 pages http://wwwlib.umi.com/dissertations/fullcit/9422514

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'forward to a Farm': the Back-to-the-land Movement As a Relief Initiative in Saskatchewan during the Great Depression by Bowen, Dawn Suzanne, Phd from Queen's University at Kingston (canada), 1998, 279 pages http://wwwlib.umi.com/dissertations/fullcit/NQ27817

406 Depression

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Frank Capra Malgre Lui: a Filmmaker and the Contradictions of American Society, 1928-1934 (depression) by Zagarrio, Vito, Phd from New York University, 1995, 303 pages http://wwwlib.umi.com/dissertations/fullcit/9528546

•

Free Gold As a Constraint on Monetary Policy during the Early Stages of the Great Depression by Mcelhone, Josephine Matilda, Phd from Iowa State University, 1970, 119 pages http://wwwlib.umi.com/dissertations/fullcit/7107307

•

From Depression to Defense: the Reconstruction Finance Corporation: 1932-1940 by Olson, James S., Phd from State University of New York at Stony Brook, 1972, 350 pages http://wwwlib.umi.com/dissertations/fullcit/7229359

•

Gender and Crisis: Women's Employment Patterns during the Great Depression (women Workers, Ohio, New York) by Mutari, Ellen Macdonald, Phd from The American University, 1995, 122 pages http://wwwlib.umi.com/dissertations/fullcit/9603510

•

Gender and Depression: an Evaluation of Social Role Explanations by Michello, Janet Anne, Phd from The University of Akron, 1989, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8922326

•

Gender Differences in Adolescent Depression: a Consequence of Exposure to Adverse Life Circumstances and the Loss of Parent Support by Rudolph, Barbara Ann, Phd from The University of Wisconsin - Madison, 1996, 267 pages http://wwwlib.umi.com/dissertations/fullcit/9708696

•

Gender Differences in Depression an Examination of Chronic Life Conditions, Personal Mastery, and Coping by Miles, Jaye; Phd from The University of Manitoba (canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL47951

•

Gender Differences in the Relationship between Attributions, Consequences and Depression by Coben, Robert Alan, Phd from University of Kansas, 1991, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9238627

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Gender Differences in the Relationship between Depression, Internalizing/externalizing Problems, and Personality Styles in Adolescents by Mabery, Deborah Lynn; Psyd from Pace University, 2002, 106 pages http://wwwlib.umi.com/dissertations/fullcit/3056050

•

Gender Identity and Risk for Depression by Martin, Penny Louise; Phd from University of Miami, 2002, 127 pages http://wwwlib.umi.com/dissertations/fullcit/3050742

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Gender Roles, Self-esteem, Depression and Perceived Parental Practices: Trajectories among Culturally Diverse Urban Adolescent Girls by Younes, Maha M. Phd from New York University, 2002, 170 pages http://wwwlib.umi.com/dissertations/fullcit/3062857

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Gender, Sex Typing, and Vulnerability to Depression: Extending Self-discrepancy Theory by Mendelson, Tamar; Phd from Duke University, 2002, 140 pages http://wwwlib.umi.com/dissertations/fullcit/3063196

Dissertations 407

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Gendering Work and Welfare: Women's Relationship to Wage-work and Social Policy in Canada during the Great Depression by Hobbs, Margaret Helen, Phd from University of Toronto (canada), 1995, 361 pages http://wwwlib.umi.com/dissertations/fullcit/NN02769

•

Genetic and Environmental Influences on Associations between Marital Relationships and Depression in Women by Spotts, Erica Lynn; Phd from The George Washington University, 2002, 117 pages http://wwwlib.umi.com/dissertations/fullcit/3032770

•

Genetic Factors Involved in Depressive Behavior and Stress Reactivity in an Amimal Model of Depression by Solberg, Leah Catherine; Phd from Northwestern University, 2002, 312 pages http://wwwlib.umi.com/dissertations/fullcit/3071713

•

George Mcgill of Kansas: Depression Senator (agriculture, New Deal) by Shockley, Dennis Monleauh, Phd from Kansas State University, 1986, 255 pages http://wwwlib.umi.com/dissertations/fullcit/8705861

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Gis-based Parameterization for Hydraulic Modeling of Watersheds with Depression Storage by Sebti, Saleh; Msc from University of Guelph (canada), 2002, 215 pages http://wwwlib.umi.com/dissertations/fullcit/MQ67376

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Giving Voice to Hope in the Despair of Aging Women: an Approach to Despair, Depression and Anxiety by Ungerstedt-savage, Lena Therese, Edd from Boston University, 1987, 248 pages http://wwwlib.umi.com/dissertations/fullcit/8704819

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Giving Voice to Women's Experience of Depression by Reilly, Mary Louise, Phd from University of Victoria (canada), 1993, 281 pages http://wwwlib.umi.com/dissertations/fullcit/NN90166

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Good Neighbours in Depression : the United States and Colombia, 1928-1938 by Randall, Stephen J; Phd from University of Toronto (canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK31316

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Good Neighbours in Depression: the United States and Colombia, 1928-1938. by Randall, Stephen James, Phd from University of Toronto (canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/f1224055

•

Government Policy, Working Women and Feminism in the Great Depression: Section 213 of the 1932 Economy Act by Scime, Joy Anne, Phd from State University of New York at Buffalo, 1987, 290 pages http://wwwlib.umi.com/dissertations/fullcit/8727743

•

Group Counseling As an Intervention in Anger Expression and Depression in Older Adults by Johnson, Wanda Yates, Phd from University of North Texas, 1988, 105 pages http://wwwlib.umi.com/dissertations/fullcit/8908922

•

Harlem in the Great Depression: 1928-1936 by Greene, Larry Alfonso, Phd from Columbia University, 1979, 584 pages http://wwwlib.umi.com/dissertations/fullcit/8222397

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Harry L. Hopkins: Spokesman for Franklin D. Roosevelt in Depression and War by Cotham, Perry Coleman, Phd from Wayne State University, 1970, 369 pages http://wwwlib.umi.com/dissertations/fullcit/7117253

408 Depression

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Health of the State: British and American Public Health Policies in the Depression and World War Ii by Adams, Paul Langford, Dsw from University of California, Berkeley, 1979, 501 pages http://wwwlib.umi.com/dissertations/fullcit/8014585

•

Helplessness and Self-blame Attributions in Depression: Investigation of One Possible Resolution of This Paradox among College Students in Taiwan (china) by Wu, Li-chuan, Phd from University of Oregon, 1994, 247 pages http://wwwlib.umi.com/dissertations/fullcit/9434804

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Helplessness, Depression, and Mood in End-stage Renal Disease by Devins, Gerald Michael; Phd from Mcgill University (canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK54777

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Helplessness, Sex Roles and Depression by Billingsley, Ralph; Phd from University of Windsor (canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL29282

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Herbert Hoover and the Farm Crisis of the Twenties: a Study of the Commerce Department's Efforts to Solve the Agricultural Depression, 1921-1928 by Koerselman, Gary Harlan, Phd from Northern Illinois University, 1971, 417 pages http://wwwlib.umi.com/dissertations/fullcit/7129820

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Herbert Hoover's Economic Foreign Policies for Dealing with the Great Depression: 1929-1933. by Vlaun, Joan Gloria, Phd from New York University, 1977, 265 pages http://wwwlib.umi.com/dissertations/fullcit/7721328

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Hollywood and Political Issues: Three Films of the Depression Era. by Mcconnell, Robert Lee, Phd from The University of Iowa, 1977, 286 pages http://wwwlib.umi.com/dissertations/fullcit/7728487

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Homeless Single Female Heads-of-households: Assessment of Crisis-related Levels of Depression, Self-esteem, and Anxiety As Well As Factors Associated with Homelessness (single Women, Women Heads of Households) by England, Diane Lynn, Phd from The University of Texas at Arlington, 1992, 142 pages http://wwwlib.umi.com/dissertations/fullcit/9301606

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Hoover, the Banks, the Depression: the Iowa Experience, 1930-1933 by Coquillette, Calvin Whitney, Phd from The University of Iowa, 1997, 343 pages http://wwwlib.umi.com/dissertations/fullcit/9819927

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Hoovervilles: Homelessness and Squatting in California during the Great Depression by Gold, Christina Anne Sheehan, Phd from University of California, Los Angeles, 1998, 373 pages http://wwwlib.umi.com/dissertations/fullcit/9823494

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Hopelessness Depression in Women: the Role of Parental Rejection, Attributional Style, and Daily Stress by Gordon, Rebecca Elaine, Edd from Northern Illinois University, 1990, 141 pages http://wwwlib.umi.com/dissertations/fullcit/9118756

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Hopelessness, Depression, and Adolescent Suicidal Behaviors in a Rural Population by Grothus-magee, Marion Donna, Phd from Purdue University, 1992, 92 pages http://wwwlib.umi.com/dissertations/fullcit/9301305

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Hours Vs. Employment: the Determinants of Labor Market Adjustment since the Great Depression by Golden, Lonnie Mark, Phd from University of Illinois at Urbanachampaign, 1985, 225 pages http://wwwlib.umi.com/dissertations/fullcit/8600194

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How Board Certified Family Practice Physicians in Rural Kansas Diagnose and Treat Depression by Kelly, Steven Glenn; Dha from Medical University of South Carolina College of Health Professions, 2002, 80 pages http://wwwlib.umi.com/dissertations/fullcit/3066106

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Hurricane High. Part I: Tropical Depression (original Writing, Novel Section) by Fontenot, Kenneth John; Ma from University of Houston-clear Lake, 2002, 166 pages http://wwwlib.umi.com/dissertations/fullcit/1410039

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Hypnosis for Major Depression: Complementary Strategy or Contraindication? a Survey of Members of Asch, Sceh, and Division 30 by Hensel, Carolyn S. Phd from The University of Wisconsin - Milwaukee, 2001, 216 pages http://wwwlib.umi.com/dissertations/fullcit/3033211

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Identification of a Visual or Auditory Modality Profile Preference of Child and Parent: a Comparative Study of Latency Age Children Diagnosed As Conduct Disorder or Depressive Disorder (sensory Modality Profile, Maternal Depression) by Friedman, Dianne De Lys, Phd from Smith College School for Social Work, 1994, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9502462

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Idled Outside, Overworked Inside: the Political Economy of Prison Labor during Depressions in Chicago, 1871-1897 (illinois, Economic Depression, Unemployment) by Phelps, Margaret Dorsey, Phd from The University of Iowa, 1992, 425 pages http://wwwlib.umi.com/dissertations/fullcit/9308106

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Illinois State Bank Failures in the Great Depression by Guglielmo, Mark Anthony, Phd from The University of Chicago, 1998, 107 pages http://wwwlib.umi.com/dissertations/fullcit/9841523

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Images of Order: American Comic Strips during the Depression, 1929-1938 by Young, William Henry, Phd from Emory University, 1969, 259 pages http://wwwlib.umi.com/dissertations/fullcit/6919621

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Images of Women during the Great Depression and the Golden Age of American Film by Medeiros, Patricia, Phd from University of California, San Diego, 1988, 544 pages http://wwwlib.umi.com/dissertations/fullcit/8817171

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Immigrants and the 1930's: Ethnicity and Alienage in Depression and On-coming War. by Thatcher, Mary Anne, Phd from University of California, Los Angeles, 1973, 342 pages http://wwwlib.umi.com/dissertations/fullcit/7411579

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Incidence and Characteristics of Depression in Late Childhood an Exploratory Study by Paananen, Noreen Ruth; Phd from University of Alberta (canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK67534

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Indicators of Adolescent Depression Within the Millon Adolescent Personality Inventory (depression) by Clinton, Marian Marie Haddock, Phd from Texas Woman's University, 1990, 206 pages http://wwwlib.umi.com/dissertations/fullcit/9119206

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Indonesia in the Great Depression: a Study of East Sumatra and Jogjakarta in the 1930's. by O'malley, William Joseph, Phd from Cornell University, 1977, 411 pages http://wwwlib.umi.com/dissertations/fullcit/7728400

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Infertility and Marital Adjustment: the Influence of Perception of Social Support, Privacy Preference and Level of Depression by Maillet, Margaret Haviland; Phd from Louisiana State University and Agricultural & Mechanical College, 2002, 118 pages http://wwwlib.umi.com/dissertations/fullcit/3069721

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Inflationary Measures: Consumption and Depression in Gertrude Stein, Louis Zukofsky and Ezra Pound (stein Gertrude, Zukofsky Louis, Pound Ezra) by Carson, Luke Brendan, Phd from University of California, Los Angeles, 1993, 470 pages http://wwwlib.umi.com/dissertations/fullcit/9408226

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Institutional Revisions: Modernism and American Public Schools from the Depression Through the Second World War by Weisser, Amy Suzanne, Phd from Yale University, 1995, 529 pages http://wwwlib.umi.com/dissertations/fullcit/9538697

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Intellectual and Memory Abilities of Elderly Psychiatric Outpatients with Coexisting Dementia and Depression by Breen, Alan Richard, Phd from University of Washington, 1982, 135 pages http://wwwlib.umi.com/dissertations/fullcit/8218206

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Intensity and Mastery in Physical Activity As Related to Depression and Mood by Monk, Susan V., Phd from The Pennsylvania State University, 1990, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9032345

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Interdisciplinary Training in the Treatment of Depression by Silverstone, Naomi, Dsw from The University of Utah, 1991, 279 pages http://wwwlib.umi.com/dissertations/fullcit/9208455

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Interferon Linked Depression of Hepatic Cytochrome P-450 by Singh, Gurmit; Phd from Dalhousie University (canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK53783

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Inter-informant Agreement and Childhood Depression by Crocker, Alison Denise, Phd from University of Windsor (canada), 1994, 234 pages http://wwwlib.umi.com/dissertations/fullcit/NN93261

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Interpersonal Schemas in Major Depression and Axis Ii Disorders by Cohen, Eliana; Phd from York University (canada), 2002, 198 pages http://wwwlib.umi.com/dissertations/fullcit/NQ71968

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND DEPRESSION Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning depression.

Recent Trials on Depression The following is a list of recent trials dedicated to depression.8 Further information on a trial is available at the Web site indicated. •

Adult Outpatients with Major Depressive Disorder Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): Wyeth-Ayerst Research Purpose - Excerpt: To compare the antidepressant efficacy and safety of subjects receiving DVS-233 SR versus subjects receiving placebo. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00063206

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Bone Mineral Density in Patients with Major Depression Condition(s): Healthy; Involutional Depression; Osteoporosis Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Researchers have observed significant decreases in the levels of bone density in 24 pre-menopausal women diagnosed with depression, as compared to 24 matched pre-menopausal women without depression. Bone density levels were noted to

8

These are listed at www.ClinicalTrials.gov.

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be significantly lower than normal at several sites (femoral neck decreased by 13.6%, Ward's triangle decreased by 13.6%, and trochanter decreased by 10.8%). Previous studies suggest that levels as low as those observed in these 24 women are associated with increased chances of fracture by 50%. Exactly what causes the decrease in bone density is unknown, but researchers have made note that these women have increased levels of cortisol in their urine. Cortisol is a hormone produced by the adrenal gland and is elevated in patients with Cushing's syndrome. The high levels of cortisol in patients with Cushing's syndrome, works against the cells normally responsible for bone formation (osteoblasts). Like patients with Cushing's syndrome, depressed patients produce high levels of cortisol. However, researchers think that it is unlikely that cortisol alone could be responsible for the very low densities in bone. It is likely that depressed patients have additional hormonal and biochemical abnormalities that can contribute to low bone mineral densities. Researchers believe that patients diagnosed with depression may have impaired calcium absorption. It is unknown if the abnormal calcium absorption is a result of the condition of depression or a side effect of the drugs used to treat depression. Researchers hope to determine an estimate of the true fractional calcium absorption (TFCA) by using non-radioactive calcium isotopes. Patients will be given 46Ca or 44Ca, a non-radioactive calcium isotope that can be taken by mouth and 42Ca a non-radioactive calcium isotope that must be injected directly into the vein. Researcher will then check levels of isotopes in the patient's urine after 24 hours in order to estimate the true fractional calcium absorption (TFCA). Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001413 •

Brain Chemical Receptor Effects in Patients with Panic Disorder and Post-Traumatic Stress Disorder Condition(s): Panic Disorder; Posttraumatic Stress Disorder; Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to examine how certain brain chemicals work in patients with Panic Disorder (PD) and Post-Traumatic Stress Disorder (PTSD) with and without major depressive disorder (MDD). Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00025974

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Brain Regulation of Emotions in People with Depression and Anhedonia Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: This study will use magnetic resonance imaging (MRI) to examine how the brain regulates emotions in healthy people and in patients who have major depression and anhedonia (loss of feeling of pleasure in things that normally give pleasure). Healthy normal volunteers and patients between 18 and 50 years of age with major depression, with or without significant anhedonia, are eligible for this study.

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Candidates will be screened with a psychiatric interview, a physical examination that will include blood and urine samples, and an electrocardiogram, and a questionnaire about their emotions. Participants will perform a monetary reward task while lying in an MRI scanner. The task is similar to playing a computer video game with the possibility of winning cash. The amount of cash is largely dependent on the subject's performance. The accumulated amount of cash earned in a session will fluctuate depending on the subject's continuing performance level. That is, during a single session, a subject could lose money earned early in the session if his or her performance later in the session is not as good as earlier. MRI pictures will be taken during performance of the task. MRI uses a magnetic field and radio waves to produce images of body tissues and organs. The patient lies on a table that is moved into the scanner (a narrow cylinder) and wears earplugs to muffle loud knocking and thumping sounds that occur during the scanning process. The procedure will last about 1 to 1-1/2 hours. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00059579 •

Clinical Trial of Estrogen for Postpartum Depression Condition(s): Postpartum Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to evaluate the effectiveness of 17 betaestradiol, a form of estrogen, in treating women with postpartum depression (PPD). Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00059228

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Clinical trials of three non-drug treatments for winter depression (SAD). Condition(s): Seasonal Affective Disorder; Mood Disorders; Depressive Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: We are offering non-pharmacologic therapy for alleviation of symptoms associated with depressed mood that recurs annually in fall or winter. The treatments are self-administered at home by the patient, with close clinical supervision. Our trials use specially designed devices that replenish two different environmental elements, naturally occurring light and negative ions in the air. Both factors may be reduced in winter, bringing on depression. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006517

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Clinical trials of two non-drug treatments for chronic depression Condition(s): Mood Disorders; Depressive Disorders; Depression; Chronic depression; Nonseasonal depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: This study investigates the potential efficacy of two nonpharmacologic treatments for nonseasonal depression, bright light exposure or highdensity negative air ion exposure. Treatments are self-administered at home by the patient under close clinical supervision. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006172

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Combination Therapy for the Treatment of Chronic Depression Condition(s): Depression; Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to determine whether psychotherapy is an effective treatment for patients with chronic depression who have not completely responded to antidepressant medication. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057551

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Continuation Electroconvulsive Therapy vs Medication to Prevent Relapses in Patients with Major Depressive Disorder Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to compare the safety and effectiveness of two treatments to prevent relapses in seriously ill patients with major depressive disorder (MDD) who have responded to electroconvulsive therapy (ECT). Patients will either continue to receive ECT (continuation electroconvulsive therapy [C-ECT]), or they will be treated with antidepressant medications. ECT is a highly effective treatment for MDD; however, relapses are a major concern. To prevent relapse in patients who have responded to ECT, the common treatment is antidepressants as continuation therapy (following the initial therapy in order to continue treating the disorder). Relapses, however, can still occur even after antidepressant continuation therapy. This study will evaluate a potent antidepressant combination in order to prevent relapse. C-ECT is another option that needs to be tested. If the patient responds to the first round of ECT, he/she will be assigned randomly (like tossing a coin) to either continue receiving ECT or to receive an antidepressant combination of nortriptyline plus lithium (NOR-Li) for 6 months. The patient will have psychological tests before, shortly after, and 3 months after the first round of ECT, and at the end of the 6-month continuation trial. Patients will be monitored for symptoms and side effects. All patients will have urine tests to test

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for drug abuse. An individual may be eligible for this study if he/she: Has major depressive disorder and responds positively to ECT treatment and is 18 to 80 years old. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000375 •

Depression Study In Adults Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A Placebo Controlled Study Evaluating Efficacy, Safety and Tolerability of Medication in Patients with Major Depressive Disorder (MDD) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057239

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Depression Study In Elderly Patients Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: Major Depressive Disorder (MDD) Study in Elderly Outpatients Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00067444

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Drug Treatment for Depressed Alcoholics (naltrexone/fluoxetine) Condition(s): Alcoholism; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will examine the effects of combing naltrexone and fluoxetine (Prozac) versus fluoxetine and placebo in alcoholics with co-occurring major depression. Both groups will actively participate in the 6-month study, which includes weekly individual Dual Disorders Recovery Counseling during the first month and every two weeks during the second through sixth months, plus the naltrexone and fluoxetine or fluoxetine and placebo. Subjects will complete follow-up assessments at 9 and 12 months. Phase(s): Phase IV Study Type: Interventional

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006204 •

Heart Disease Risk Factors in Major Depression Condition(s): Adrenal Gland Hyperfunction; Cardiovascular Disease; Involutional Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Patients with major depression have an increased risk for coronary artery disease, independent of smoking and traditional cardiac risk factors. Several hormonal changes that occur with depression may be associated with this increased risk. Our hypothesis is that one of these is probably related to the decreased response to insulin (insulin resistance). This study will examine insulin resistance in patients with major depression and, how severe it is and why it occurs. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001969

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Interactions of Depressed Mothers with Their Infants Condition(s): Healthy; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD) Purpose - Excerpt: This study will examine 1) differences among mothers' behaviors and how these behaviors influence their infants' reactions, and 2) how mother-child interactions relate to children's temperament, and cognitive (thought processing) abilities, and other areas of development. Depressed and non-depressed Englishspeaking mothers between 20 and 45 years of age, with an infant 4 months or younger, may be eligible for this study. Candidates will be screened with a mailed survey regarding their moods and feelings. Participants will undergo the following procedures: - Psychiatric Interview: Subjects will participate in a 30-90 minute interview consisting of a series of standardized questions about the their behaviors and feelings. Participants whose interviews suggest a condition that may impact their mental health will be referred to the study clinician for follow-up to confirm or clarify the preliminary findings. Continued participation in the study will be determined following this. Home Visit: A study investigator will visit the home for 1 hour to film the mother and baby during the mother's typical daily activities. This visit will take place when the baby is about 5 months old. At the end of the visit, the mother will be given a variety of surveys to fill out at home and return at the next visit (see Lab Visit below). The survey questions deal with the mother's relationship with her partner, support from people in her life, typical behaviors of her infant, and how often she feels certain emotions. A packet of surveys will also be left for the participant's partner to complete and mail back to the investigator. The partner may or may not be the child's biological father and may or may not choose to participate in the study. - Lab Visit: Within 1 week of the home visit, the mother and child will come to the NICHD clinic for about 2 hours. During this time, the mother will return the previous surveys and fill out another one regarding her current mood. She will then interact with her child, who will be seated in front of her. The 20-minute session will be videotaped. (There will be breaks during the session.) The

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mother will be instructed about how she should act (happy or sad). She and her baby will then participate in a variety of filmed situations that will induce certain emotions in the baby, such as happiness, fear, activity, frustration, and interest, in order to learn how different children react to different situations. Participants will be contacted to continue the study when their babies are 12 months old and again when the children are 24 months old. The above procedures will be repeated and some new measures will be added for toddlers that involve activities investigating aspects of early language and social reasoning.. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044174 •

Lethargic Depression Study Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: Major Depressive Disorder (MDD) study in patients with decreased energy, pleasure and interests Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064467

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Major Depressive Disorder Study In Adults Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A study to obtain safety and tolerability data Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00049972

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MRI Study of Brain Activity and Risk for Depression in Adolescents Condition(s): Involutional Depression; Anxiety Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: This study will use magnetic resonance imaging (MRI) to investigate brain changes in adolescents at risk for Major Depressive Disorder. It also calls for healthy volunteers to compare to children at risk for major depression. Study Type: Observational Contact(s): see Web site below

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Web Site: http://clinicaltrials.gov/ct/show/NCT00047944 •

Optimizing Electroconvulsive Therapy for Depression Condition(s): Depression; Depressive Disorder; Bipolar Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to evaluate electroconvulsive therapy (ECT) administered concurrently with antidepressant medication. This study will also compare two different types of ECT. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00045916

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Serotonin Function During Depression Condition(s): Depression, Involutional; Healthy Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Serotonin is a chemical involved in regulation of emotions, anxiety, sleep, stress hormones, and other body functions. The purpose of this study is to use a procedure called tryptophan depletion to study the function of serotonin in people with depression and in healthy volunteers. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033787

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Study Of Adults With Depression Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A Placebo Controlled Study Evaluating Efficacy, Safety and Tolerability of Medication in Patients with Major Depressive Disorder (MDD) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057226

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Study Of Depression In Adults Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending)

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Purpose - Excerpt: A Placebo Controlled Study Evaluating Efficacy, Safety and Tolerability of Medication in Patients with Major Depressive Disorder (MDD) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057213 •

The Effects of Hormones in Postpartum Mood Disorders Condition(s): Depressive Disorder; Mood Disorder; Postpartum Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to determine how women who have experienced a postpartum mood disorder respond to estrogen and progesterone in comparison to women who have had an episode of major depression not related to PPD, and in comparison with women who have not experienced mood disorders. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001481

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The Study of Olanzapine Plus Fluoxetine in Combination for Treatment-Resistant Depression Without Psychotic Features Condition(s): Depressive Disorders Study Status: This study is currently recruiting patients. Sponsor(s): Eli Lilly and Company Purpose - Excerpt: The purposes of this study are to determine: * Whether olanzapine plus fluoxetine in combination will help patients with treatment-resistant major depression. * The safety of olanzapine plus fluoxetine in combination, plus and any side effects that might be associated with the combination. * The effectiveness of olanzapine plus fluoxetine compared to olanzapine and fluoxetine alone. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00035321

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Therapy for Depression with Co-occurring Panic or Anxiety Symptoms Condition(s): Depression; Mood Disorder; Anxiety Disorder; Panic Disorder; Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to develop and test a new therapy designed to treat depressed patients with co-occurring symptoms of panic or anxiety. Phase(s): Phase I; Phase II

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Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00051207 •

Treatment for Adolescents With Depression Study (TADS) Condition(s): Major Depressive Disorder; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: TADS is designed to compare the effectiveness of established treatments for teenagers suffering from major depressive disorder (MDD). The treatments are: psychotherapy ("talking therapy"); medication; and the combination of psychotherapy and medication. Altogether, 432 teenagers (both males and females) ages 12 to 17, will take part in this study at 12 sites in the United States. The TADS design will provide answers to the following questions: What is the long-term effectiveness of medication treatment of teenagers who have major depression? What is the long-term effectiveness of a specific psychotherapy ("talking therapy) in the treatment of teenagers who have major depression? How does medication treatment compare with psychotherapy in terms of effectiveness, tolerability and teenager and family acceptance? And, What is the cost-effectiveness of medication, psychotherapy and combined treatments? The medication being used in this study is called fluoxetine. Fluoxetine is also known as Prozac. Research has shown that medications like Prozac help depression in young persons. Fluoxetine has been approved by the FDA for use in the treatment of adult depression and is under study for children and teenagers. The psychotherapy or "talking therapy" being used in this study is called Cognitive Behavioral Therapy (CBT). CBT is a talking therapy that will teach both the teenager and his or her family member (e.g., parent) new skills to cope better with depression. Specific topics include education about depression and the causes of depression, setting goals, monitoring mood, increasing pleasant activities, social problem-solving, correcting negative thinking, negotiation, compromise and assertiveness. CBT sessions may also help with resolving disagreements as they affect families. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006286

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Treatment Of Resistant Depression In Adolescents (TORDIA) Condition(s): Major Depressive Disorder; Dysthymic Disorder; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: This is a study of depression in adolescents, ages 12 to 18, who are currently taking a prescribed selective serotonin reuptake inhibitor (SSRI) antidepressant medication but are still experiencing depression. The purpose of the study is to determine how best to treat adolescents with depression that is "resistant" to the first SSRI they have tried. In addition to receiving a complete psychiatric evaluation, participants will be randomly assigned to receive one of three other antidepressant medications, either alone or in combination with cognitive behavioral therapy.

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Participants will be monitored for 24 weeks and will receive follow-up psychiatric evaluations for one year. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00018902 •

Treatment of Vascular Depression Condition(s): Depressive Disorder; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to determine the effectiveness of the antidepressant sertraline (Zoloft) in treating people with vascular depression. A second goal is to determine how well a Magnetic Resonance Imaging (MRI) scan and tests of concentration, thought, and memory can predict response to antidepressant medications. This study will also test the effects of frontal lobe dysfunction on treatment response. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00045773

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Treatments for Depression: Drug vs. Psychotherapy Condition(s): Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to compare supportive expressive psychodynamic therapy to antidepressant medication plus Clinical Management for the treatment of patients with Major Depressive Disorder (MDD). A second goal is to evaluate the long-term effects of these 2 treatments on the recurrence of depression. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00043550

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Vascular Depression and Magnetic Stimulation Therapy Condition(s): Depressive Disorder; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to examine the effectiveness of rapidtranscranial magnetic stimulation (rTMS) in the treatment of vascular depression. Phase(s): Phase III

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Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044798 •

Acupuncture in the Treatment of Depression Condition(s): Depressive Disorders; Depression Study Status: This study is no longer recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The current large randomized placebo-controlled trial is testing the ability of acupuncture to treat major depression. The study is unique in that treatment effects will be from the perspective of both Western psychiatry and Chinese medicine. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00010517

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Depression Study Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A Placebo Controlled Study Evaluating Efficacy And Safety of Medication In Patients With Major Depressive Disorder (MDD) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00048204

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Dose Escalation, Double-Blind Treatment with Duloxetine Hydrochloride Once Daily Dosing for Evaluation of Safety in Major Depression Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): Eli Lilly and Company Purpose - Excerpt: The Purposes of this Study are to determine: The safety of duloxetine and any side effects that might be associated with it. Whether duloxetine can help patients with major depression. It is possible that information collected during this study will be analyzed by the sponsor in the future to evaluate duloxetine for other possible uses or for other medical or scientific purposes other than those currently proposed. Duloxetine might not have any good effects for you. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00042575

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Long Term Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression. Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00048594

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression. Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034944

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034983

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Treatment of patients with Major Depressive disorder with an investigational compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00035009

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression. Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00035048

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression. Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00035282

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression. Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00035295

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression. Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00042029

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Treatment of Patients with Major Depressive Disorder with an Investigational Compound Condition(s): Major Depressive Disorder Study Status: This study is no longer recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: A clinical study to determine the efficacy and safety of an investigational medication in the treatment of depression Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00048607

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Acute Effectiveness of Additional Drugs to the Standard Treatment of Depression Condition(s): Bipolar Disorder; Depressive Disorder Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: This study will compare the effectiveness of relatively new antidepressants which have different mechanisms of action. Buproprion (Wellbutrin) works on dopamine and the dopaminergic pathway. Sertraline (Zoloft) works as a selective serotonin reuptake inhibitor (SSRI). Venlafaxine (Effexor) works as a mixed serotonin, norepinephrine, and dopamine reuptake inhibitor. Subjects enrolled in this study will be patients diagnosed with a bipolar disorder who are presently taking medication to prevent the symptoms of the disease (prophylactic treatment), but have had breakthrough episodes of depression despite taking their medication. Patients will receive any one of the three antidepressant medications as noted above plus a placebo inactive sugar pill, in order to mask which antidepressant is being prescribed) in addition to their regular medication for bipolar disorder. All of the doses will be calculated as effective for the treatment of a unipolar major depressive disorder. The patient will continue receiving the medication for ten weeks. The effectiveness of the drug treatment will be measured by using three different scales; 1. Inventory for Depressive Symptoms - Clinicians form (IDS-C) 2. Clinical Global Impression scale(CGIBP) 3. Life Charting Methodology (LCM) Patients who do not respond to their medication within ten weeks from the beginning of the study will be considered as nonresponders and be offered the opportunity to start the study again, taking one of the two remaining medications. For example, if a patient was assigned to take Wellbutrin but it was ineffective, he/she could re-enter the study and be given either Zoloft or Effexor. Patients that do respond in the first ten weeks of the study will be eligible to continue taking the medication for one year to assess the long term effectiveness of the drug on preventing episodes of depression and to assess for any possible differential induction of mania. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001483

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Consequences of Conjugal Bereavement in Adults Condition(s): Bereavement; Depressive Disorder; Immunologic Disease; Mental Disorder; Sleep Disorder

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Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Bereavement refers to the expected reactions and sadness associated with the loss of a loved one. It has been reported that the loss of a spouse is rated as the major life stressor among survivors of varying ages and diverse cultural backgrounds. Statistics have shown that in the United States over 800,000 men and women lose a spouse each year. A wide range of symptoms has been associated with bereavement including; depressed mood, tearfulness, sleep disturbances, and irrational behavior. Previous studies have shown that up to 50% of bereaved individuals can develop major depression. Bereavement has also been associated with dysfunction of the immune system. As a result, bereaved adults are more vulnerable to infection. However, the exact relationship between bereavement and immunity is uncertain. Researchers firmly believe that a relationship does exist between stress, more specifically bereavement, immunity, and the increased chance of dying following the loss of a long-term spouse. The objective of this study is to find possible links between bereavement, depression, and the immune system. This study will follow a group of elderly bereaved spouses and a group of elderly people who have not lost a long-term spouse. The group of bereaved individuals will be followed for approximately 13 months after the loss of their spouse and the group of controls will be followed for 13 months after entering the study. Researchers will make note of any clinical, biological, and immunological changes in any participants of the study. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001659 •

Duloxetine Versus Placebo in the Prevention of Relapse of Major Depressive Disorder Condition(s): Depressive Disorder Study Status: This study is completed. Sponsor(s): Eli Lilly and Company Purpose - Excerpt: The purpose of this study is to determine if duloxetine is effective when compared to placebo in preventing recurrence of major depressive disorder in patients who have responded to open-label duloxetine treatment. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00036309

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Open-Label Treatment with Duloxetine Hydrochloride Once-Daily Dosing for Evaluation of Stabilization Dose in Patients with Major Depression Condition(s): Major Depressive Disorder Study Status: This study is not yet open for patient recruitment. Sponsor(s): Eli Lilly and Company Purpose - Excerpt: The purposes of this study are to determine: The safety of duloxetine and any side effects that might be associated with it. Whether duloxetine can help

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patients with major depression. The safety associated with switching from a medication you may be taking for depression to taking duloxetine. It is possible that information collected during this study will be analyzed by the sponsor in the future to evaluate duloxetine for other possible uses or for other medical or scientific purposes other than those currently proposed. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00042562 •

Progestin (progesterone-like hormones) induced dysphoria (depressed mood, irritability, anxiety) Condition(s): Depressive Disorder; Mood Disorder; Psychomotor Agitation Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Often women are prescribed hormone replacement therapy (HRT) during the perimenopause or menopause. Hormone replacement therapy includes both estrogen and progesterone. The estrogen component of HRT helps to relieve the symptoms and has a beneficial effect on the heart and bones, but estrogen also increases the risk of uterine cancer. The progesterone component of the HRT (progestin) works to prevent the increased risk of uterine cancer. There is evidence that some women experience unpleasant mood symptoms (such as irritability, depressed mood and anxiety) while receiving hormone replacement therapy (HRT) while taking the progestin / progesterone component of the HRT. This study is designed to evaluate the ability of progestins to produce negative mood symptoms in women. Researchers intend on doing this by comparing the effects of medroxyprogesterone acetate (Provera) and a placebo inactive sugar pill. Patient's moods will be monitered based on their response to questionnaires answered in the outpatient clinic and at home. This research will attempt to answer the following questions: 1. Are progestins associated with changes in mood during hormone replacement therapy? 2. If progestins are associated with mood disturbance, is it because they are blocking the beneficial effects of estrogen? Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001770

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Treatment Effects on Platelet Calcium in Hypertensive and Depressed Patients Condition(s): Depression; Hypertension Study Status: This study is not yet open for patient recruitment. Sponsor(s): Department of Veterans Affairs Medical Research Service; SmithKline Beecham Purpose - Excerpt: This study aims to determine if treatment with an SSRI antidepressant medication, paroxetine, is associated with cellular calcium response to serotonin, platelet serotonin receptors, and improvement in mood in depressed patients with or without hypertension. It is hypothesized that platelets of hypertensive patients with depressive symptomatology with be hyper-responsive to serotonin. Additionally, treatment with an SSRI antidepressant is expected to produce a down-regulation of the

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serotonin receptor with an associated reduction in platelet cytosolic calcium response as well as improved mood. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00018759 •

Treatment of Major Depression with St. John's Wort (Hypericum) Condition(s): Major Depression Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH); National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this trial is to study the acute efficacy and safety of a standardized extract of the herb Hypericum perforatum (St. John's Wort), called hypericum for purposes of this trial, in the treatment of patients with major depression. Clinical depression is a serious medical disorder that can be debilitating and can lead to suicide. There is growing public interest in claims that hypericum may be an effective treatment for depression. Although it is widely prescribed in Europe, no studies of its long-term use have been conducted, and published studies have treated different types of patients and have used several different doses. The toxicity and side effects of hypericum appear to be substantially less than those of standard tricyclic antidepressant medications, and thus hypericum may be more acceptable to patients. In addition, the cost is significantly less than standard antidepressant medications. Published studies assessed acute efficacy and lasted between 4 and 12 weeks (most being 4-6 weeks). The longer-term effects of hypericum have not been evaluated. There is a need for a largescale, controlled clinical trial to assess whether Hypericum has a significant therapeutic effect in patients with clinical depression. Patients are assigned randomly (like tossing a coin) to receive St. John's wort, Sertraline (Zoloft), or a placebo (sugar pill) for 8 weeks. This is a double-blind study, meaning neither the patient nor the doctor will know which treatment is being assigned. Patients who respond well to the treatment will continue on the assigned treatment for an additional 4 months. Patients will have regular follow-up visits to monitor their symptoms and any side effects they experience. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005013

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Treatment Resistant Depression Study Condition(s): Depression; Major Depressive Disorder Study Status: This study is completed. Sponsor(s): Johnson & Johnson Pharmaceutical Research and Development, L.L.C. Janssen Pharmaceutica Purpose - Excerpt: A Study to evaluate the efficacy and safety of risperidone in patients with treatment-resistant depression. Phase(s): Phase III Study Type: Interventional

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044681 •

Use of Bone Biopsy to Better Understand the Causes of Decreased Bone Mineral Density in Depression Condition(s): Bone Diseases, Metabolic; Depression, Involutional; Osteoporosis Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: In this study researchers would like to learn more about the low levels of bone mineral density seen in approximately half of women in their forties diagnosed as currently having or previously had depression. Bones are always undergoing a process of building (formation) and breakdown (resorption). This process is referred to as bone remodeling. When more bone is formed than resorbed, the density (level of calcium) in bone increases and the bones become stronger. However, if more bone is resorbed than formed the density of bone decreases and the bones become weak. This condition is called osteoporosis. It is unknown if women with depression have decreased bone mineral density as a result of too much breakdown of bone or not enough building. It is important to know the cause of low bone mineral density because it will influence the way a patient is treated. Medications like bisphosphonates are used when there is too much bone breakdown. Growth hormone replacement can be given in cases where there is not enough bone production. Presently, bone biopsy and a procedure known as histomorphometry can determine what processes are going on in bones. Researchers have decided to use a sample of bone (biopsy) from part of the hip bone (iliac crest). In addition, researchers will collect a sample of bone marrow (the soft tissue found in the center of bones) to tell them more about the biochemical, cellular, and molecular processes that may be contributing to the problem of decreased bone density in depressed premenopausal women. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001916

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “depression” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials:

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For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 6. PATENTS ON DEPRESSION Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “depression” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on depression, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Depression By performing a patent search focusing on depression, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on depression: •

.beta..sub.3 -Adrenoceptor agonists and antagonists for the treatment of intestinal motility disorders, depression, prostate disease and dyslipidemia Inventor(s): Kreutter; David K. (Madison, CT), Dow; Robert L. (Waterford, CT) Assignee(s): Pfizer Inc (New York, NY) Patent Number: 5,627,200 Date filed: September 26, 1994 Abstract: This invention relates to methods for treating intestinal motility disorders, intestinal ulcerations, including inflammatory bowel disease, ulcerative colitis, Crohn's disease and proctitis, and gastrointestinal ulcerations, depression, prostate disease and dyslipidemia by administering a.beta..sub.3 -adrenoceptor antagonist or agonist. Excerpt(s): This invention relates to methods for treating or preventing intestinal motility disorders, depression, prostate disease and dyslipidemia by administering a.beta..sub.3 -adrenoceptor antagonist or agonist. This invention also relates to pharmaceutical compositions for treating or preventing intestinal motility disorders, depression, prostate disease and dyslipidemia comprising a.beta..sub.3 -adrenoceptor antagonist or agonist.....beta.-Adrenergic receptors have been categorized into.beta..sub.1,.beta..sub.2 and.beta..sub.3 -subtypes. Agonists of.beta.-receptors promote the activation of adenylyl cyclase. Activation of.beta..sub.1 -receptors invokes increases in heart rate while activation of.beta..sub.2 -receptors induces relaxation of skeletal muscle tissue which produces a drop in blood pressure and the onset of smooth muscle tremors. Activation of.beta..sub.3 -receptors is known to stimulate lipolysis (the breakdown of adipose tissue triglycerides to glycerol and free fatty acids), and thereby promote the loss of fat mass. Compounds that stimulate.beta..sub.3 -receptors are therefore useful as anti-obesity agents. In addition, compounds which are.beta..sub.3 adrenoceptor agonists have hypoglycemic or anti-diabetic activity, but the mechanism of this effect is unknown.... Until recently.beta..sub.3 -adrenoceptors were thought to be found predominately in adipose tissue..beta..sub.3 -receptors are now known to be located in such diverse tissues as the intestine and the brain. J. Clin. Invest., 91, 344 (1993). Stimulation of the.beta..sub.3 -receptor has been demonstrated to cause relaxation of smooth muscle in colon and trachea. Life Sciences, 44, 19, 1411 (1989); Br. J. Pharm., 112, 55 (1994). For example, stimulation of.beta..sub.3 -receptors has been found to induce relaxation of histamine-contracted guinea pig ileum, J. Pharm. Exp. Ther., 260, 1, 192 (1992). Web site: http://www.delphion.com/details?pn=US05627200__

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1-Oxo-1H-naphtho [2,1-b] pyran derivatives for treating depression Inventor(s): Passerini; Norina (Milan, IT), Ermili; Aldo (Genoa, IT), Roma; Giorgio (Genoa, IT), Balbi; Alessandro (Genoa, IT), Mazzei; Mauro (Genoa, IT) Assignee(s): Carlo Erba S.p.A. (IT) Patent Number: 4,001,424 Date filed: March 12, 1976

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Abstract: 1-Oxo-1H-naphtho [ 2,1-b] pyran derivatives, such as, for instance, 1-oxo-3-(Nmethyl-N-ethyl) amino-1H-naphtho [2,1-b] pyran, are disclosed, as well as pharmaceutical compositions containing same and the method of treating depression by administering such compositions.These compounds are active on the central nervous system, and therefore function as antidepressive agents. Excerpt(s): Each of the R.sub.1 and R.sub.2 groups, being the same or different, may be hydrogen, C.sub.1 -C.sub.6 alkyl, C.sub.2 -C.sub.6 alkenyl, or R.sub.1 and R.sub.2, taken together with the nitrogen atom, may form a monocyclic ring which may contain one or more other heteroatoms, under the condition that, when both R and R.sub.3, R.sub.4, R.sub.5 are hydrogen, R.sub.1 and R.sub.2 cannot be both methyl or both ethyl or both propyl, and not even can they be, taken together with the nitrogen atom, the Npyrrolidinyl or the N-piperidyl radical; as well as pharmaceutically acceptable salts of the compounds of formula (I).... When R.sub.1 and R.sub.2, taken together with the nitrogen atom, form a heteromonocyclic ring, said ring is preferably azacycloheptyl or, when at least one of R, R.sub.3, R.sub.4, R.sub.5, is different from hydrogen, said heteromonocyclic ring may also be the N-pyrrolidinyl or the N-piperidyl radical.... Another object of the present invention is represented by pharmaceutical compositions containing a suitable carrier and, as an active principle, a compound of formula (I) of a salt thereof, wherein R, R.sub.3, R.sub.4 and R.sub.5 are as hereabove defined, and wherein R.sub.1 and R.sub.2 may be not only defined as hereabove indicated, but also, even when both R and R.sub.3, R.sub.4, R.sub.5 are hydrogen, they may be both methyl or both ethyl or both propyl or, taken together with the nitrogen atom, they may be the N-pyrrolidinyl or the N-piperidyl radical. Web site: http://www.delphion.com/details?pn=US04001424__ •

Aminoalkyloximes for treating depression and affective disorders Inventor(s): Shutske; Gregory M. (Pittstown, NJ), Freed; Brian S. (Phillipsburg, NJ), Tomer, IV; John D. (Perkasie, PA), Hamer; R. Richard L. (Lebanon, NJ) Assignee(s): Hoechst Marion Roussel, Inc. (Cinncinnati, OH) Patent Number: 5,686,447 Date filed: June 1, 1995 Abstract: Novel aminoalkyloximes, precursors and processes for the preparation thereof, and methods of treating depression and obsessive compulsive disorders are described. Excerpt(s): As used throughout the specification and appended claims, the term "alkyl" refers to a straight or branched chain hydrocarbon radical containing no unsaturation and having 1 to 8 carbon atoms. Examples of alkyl groups are methyl, ethyl, 1-propyl, 2propyl, 1-butyl, 1-hexyl, 3-hexyl, 4-heptyl, 2-octyl and the like. The term "alkoxy" refers to a monovalent substituent which consists of an alkyl group linked through an ether oxygen having its free valence bond from the ether oxygen. Examples of alkoxy groups are methoxy, ethoxy, propoxy, 1-butoxy, 1-pentoxy, 3-hexoxy, 4-heptoxy, 2-octoxy and the like. The term "alkanol" refers to a compound formed by a combination of an alkyl group and hydroxy radical. Examples of alkanols are methanol, ethanol, 1- and 2propanol, 2,2-dimethylethanol, hexanol, octanol and the like. The term "halogen" refers to a member of the family fluorine, chlorine, bromine, or iodine. The term "lower" as applied to any of the aforementioned groups refers to a group having a carbon skeleton containing up to and including 6 carbon atoms.... The compounds of the present

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invention which lack an element of symmetry exist as optical antipodes and as the racemic forms thereof. The optical antipodes may be prepared from the corresponding racemic forms by standard optical resolution techniques, involving, for example, the separation of diastereomeric salts of those instant compounds characterized by the presence of a basic amino group and an optically active acid, or by synthesis from optically active precursors.... In the Z-isomer, the aminoalkyloxy group of the oxime function and the phenyl moiety, the group of greater priority, are cis to each other and in the E-isomer, the aminoalkyloxy group of the oxime function and the phenyl moiety, are trans to each other. The wiggly (.about.) line in the formulas of the aminoalkyloximes of formula 1 indicate that the compound may be the E- or Z-isomer. See B. Unterhalt, Methodicum Chimicum 6, 403 (1975), for a discussion of the E-Z nomenclature. Web site: http://www.delphion.com/details?pn=US05686447__ •

Antidepressant polycyclic imides to treat depression Inventor(s): Moyer; John A. (New Hope, PA), Stack; Gary P. (Ambler, PA) Assignee(s): American Home Products Corporation (New York, NY) Patent Number: 5,134,141 Date filed: September 6, 1991 Abstract: A method for relieving depression with decahydro-3-[4-[4-(2-pyrimidinyl)-1piperazinyl]butyl]-1,5-methano-6,7,9-m etheno-2H-pentaleno[1,2-d]azepine-2,4(3H)dione, or a pharmaceutically acceptable salt thereof. Excerpt(s): U.S. Pat. No. 4,957,913 discloses a method of treatment of rhypertension which involves administration of one of a series of serotoninergic polycyclic imides. One of these imides is decahydro-3-[4-[4-(2-pyrimidinyl)-1-piperazinyl]butyl]-1,5-methano6,7,9-m etheno-2H-pentaleno[1,2-d]azepine-2,4(3H)-dione (I).... In accordance with this invention there is provided a method for treating depression which comprises administering, orally or parenterally, to a patient suffering from depression, an antidepressant amount of compound I, or a pharmaceutically acceptable salt thereof.... The pharmaceutically acceptable salts are those derived from such organic and inorganic acids as: acetic, lactic, citric, tartaric, succinic, maleic, fumaric, malonic, gluconic, hydrochloric, hydrobromic, phosphoric, nitric, sulfuric, methane sulfonic, and similarly known acceptable acids. Web site: http://www.delphion.com/details?pn=US05134141__

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Apparatus And Method For Adjunct (Add-On) Therapy For Depression, Migraine, Neuropsychiatric Disorders, Partial Complex Epilepsy, Generalized Epilepsy And Involuntary Movement Disorders Utilizing An External Stimulator Inventor(s): Boveja; Birinder Bob (8879 S. Chestnut Hill Way, Highlands Ranch, CO 80130) Assignee(s): none reported Patent Number: 6,356,788 Date filed: November 30, 2000

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Abstract: An apparatus and method for adjunct (add-on) therapy of depression, migraine, neuropsychiatric disorders, partial complex epilepsy, generalized epilepsy and involuntary movement disorders comprises an implantable lead-receiver, and an external stimulator having controlling circuitry, a power source, and a coil to inductively couple the stimulator to the lead-receiver. The external stimulator emits electrical pulses to stimulate a cranial nerve such as the left vagus nerve according to a predetermined program. In a second mode of operation, an operator may manually override the predetermined sequence of stimulation. Excerpt(s): This invention relates generally to electrical stimulation therapy for neurologic and neuropsychiatric disorders, more specifically to neuromodulation therapy for depression, migraine, and neuropsychiatric disorders, as well as adjunct treatment for partial complex, generalized epilepsy and involuntary movement disorders utilizing an implanted lead-receiver and an external stimulator.... It has been observed clinically that electrical stimulation therapy for seizures produced mood improvement independent of the anti-seizure effects. This discovery led to medical research into the therapeutic effects of electrical stimulation for depression. Medical research has shown beneficial medical effects of vagus nerve stimulation (VNS) for severely depressed patients.... Vagus nerve stimulation, and the profound effects of electrical stimulation of the vagus nerve on central nervous system (CNS) activity, extends back to the 1930's. Medical studies in clinical neurobiology have advanced our understanding of anatomic and physiologic basis of the anti-depressive effects of vagus nerve stimulation. Web site: http://www.delphion.com/details?pn=US06356788__ •

Apparatus and method for transcranial magnetic brain stimulation, including the treatment of depression and the localization and characterization of speech arrest Inventor(s): Epstein; Charles M. (Atlanta, GA), Davey; Kent R. (New Smyrna Beach, FL) Assignee(s): Emory University (Atlanta, GA) Patent Number: 6,425,852 Date filed: January 18, 2000 Abstract: An apparatus and method for transcranial magnetic brain stimulation. The apparatus allows transcranial stimulation at higher power efficiency and lower heat generation than prior available magnetic stimulator coils without an iron core. Use of the apparatus allows an improved method for active localization of language function. The device can also be used in rapid rate transcranial magnetic stimulation for the treatment of depression. Excerpt(s): The present invention relates to an apparatus for transcranial magnetic brain stimulation. The invention also relates to methods for localizing and characterizing speech arrest, and for treatment of depression using transcranial magnetic stimulation.... Magnetic stimulation of neurons has been heavily investigated over the last decade. Almost all magnetic stimulation work has been done in vivo. The bulk of the magnetic stimulation work has been in the area of brain stimulation.... Cohen has been a rather large contributor to this field of research (See e.g., T. Kujirai, M. Sato, J. Rothwell, and L. G. Cohen, "The Effects of Transcranial Magnetic Stimulation on Median Nerve Somatosensory Evoked Potentials", Journal of Clinical Neurophysiology and Electro Encephalography, Vol. 89, No. 4, 1993, pps. 227-234, the disclosure of which is fully incorporated herein by reference.) This work has been accompanied by various other

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research efforts including that of Davey, et al. and that of Epstein (See, K. R. Davey, C. H. Cheng, C. M. Epstein "An Alloy--Core Electromagnet for Transcranial Brain Stimulation", Journal of Clinical Neurophysiology, Volume 6, Number 4, 1989; and, Charles Epstein, Daniel Schwartzberg, Kent Davey, and David Sudderth, "Localizing the Site of Magnetic Brain Stimulation in Humans", Neurology, Volume 40, April 1990, pps. 666-670, the disclosures of which are fully incorporated herein by reference). Web site: http://www.delphion.com/details?pn=US06425852__ •

Cholecystokinin antagonists useful for treating depression Inventor(s): Woodruff; Geoffrey N. (Braughing, GB) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,217,957 Date filed: August 20, 1991 Abstract: The invention concerns cholecystokinin (CCK) antagonists useful in the treatment major and minor forms of depression. CCK-B, -A, and mixed -A and -B antagonists are useful. Especially useful are CCK.sub.B antagonists such as CI-988. Excerpt(s): Cholecystokinin (CCK) is a neuropeptide with a widespread distribution in brain. CCK receptors are classified into two types; CCK.sub.A and CCK.sub.B, both of which are present in brain (Woodruff, G. N. and Hughes, J., 1991, Ann. Rev. Pharmacol. 31, 469-501).... Mixed CCK.sub.A and CCK.sub.B antagonists include but are not limited to (1S-trans)-N-[.alpha.-methyl-N-[[(2-methylcyclohexyl)oxy]carbonyl]-D-trypt ophyl]L-3-(phenylmethyl)-.beta.-alanine.... The above CCK antagonists have been described in EPA 0405537. These antagonists are also described in U.S. application Ser. No. 07/629,809, filed Dec. 19, 1990, the disclosure of which is hereby incorporated by reference. Web site: http://www.delphion.com/details?pn=US05217957__

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Combination treatment for depression Inventor(s): Howard, Jr. Harry Ralph (Bristol, CT) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 6,436,938 Date filed: October 9, 2001 Abstract: The present invention relates to a method of treating depression, especially refractory depression, in a mammal, including a human, by administering to the mammal a sigma receptor ligand in combination with an antidepressant agent. It also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a sigma receptor ligand and a serotonin reuptake inhibitor. Excerpt(s): The present invention relates to a method of treating depression, especially refractory depression, in a mammal, including a human, by administering to the mammal a sigma receptor ligand in combination with a Serotonin Reuptake Inhibitor (SRI). It also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a sigma receptor ligand and a Serotonin Reuptake Inhibitor (SRI).... Major depression is characterized by feelings of intense sadness and despair, mental

Patents 437

slowing and loss of concentration, pessimistic worry, agitation, and self-deprecation. Physical changes also occur, especially in severe or "melancholic" depression. These include insomnia or hypersomnia, anorexia and weight loss (or sometimes overeating), decreased energy and libido, and disruption of normal circadian rhythms of activity, body temperature, and many endocrine functions.... Serotonin Selective Reuptake Inhibitors (SSRIs) currently provide efficacy in the treatment of major depressive disorder (MDD) and are generally perceived by psychiatrists and primary care physicians as effective, well-tolerated and easily administered. However, they are associated with undesirable features, such as high incidence of sexual dysfunction, delayed onset of action and a level of non-responsiveness estimated to be as high as 30% (see M. J. Gitlin, Journal of Clinical Psychiatry, 1994, 55, 406-413 and R. T. Segraves, Journal of Clinical Psychiatry, 1992, 10(2), 4-10). Preclinical and clinical evidence has indicated that the sexual dysfunction associated with SSRI therapy can be reduced through the use of monoamine reuptake inhibitors (SRI) and dopamine reuptake inhibitors (DRIs), such as bupropion (see A. K. Ashton, Journal of Clinical Psychiatry, 1998, 59(3), 112-115). Furthermore, the combination of SRI and DRI may hasten the onset of action as well as offering relief to refractory patients, possibly through a synergistic mechanism (see R. D. Marshall et al, Journal of Psychopharmacology, 1995, 9(3), 284286) and prove beneficial in the treatment of substance abuse and attention deficit hyperactivity disorder (ADHD) according to Barrickman et al, Journal of the American Academy of Child and Adolescent Psychology, 1995, 34(5), 649 and Shekim et al, Journal of Nervous and Mental Disease, 1989, 177(5), 296. Web site: http://www.delphion.com/details?pn=US06436938__ •

Combined use of pramipexole and sertraline for the treatment of depression Inventor(s): Maj; Jerzy (Kracau, PL) Assignee(s): Boehringer Ingelheim Pharma KG (Ingelheim, DE) Patent Number: 6,255,329 Date filed: July 6, 1999 Abstract: The present invention relates to the use of 2-amino-4,5,6,7-tetrahydro-6-npropylamino-benzothiazole (pramipexole), the (+)- or (-)- enantiomer thereof, or one of the pharmacologically acceptable salts thereof, in conjunction with sertraline for the improved treatment of depression and depressive states. Excerpt(s): The present invention relates to an agent with an antidepressant activity containing 2-amino-4,5,6,7-tetrahydro-6-n-propylamino-benzothiazole, the (+) or (-) enantiomer thereof, the pharmacologically acceptable acid addition salts thereof and a conventional antidepressant. The combination of pramipexole and sertraline is of particular interest.... Pramipexole--(-)-2-amino-6-n-propylamino-4,5,6,7tetrahydrobenzo-thiazole-- is a dopamine-D.sub.3 /D.sub.2 agonist, the synthesis of which is described in European Patent 186 087 and U.S. Pat. No. 4,886,812. Pramipexole is known primarily for treating schizophrenia and particularly for the treatment of Parkinson's disease. German Patent Application DE 38 43 227 discloses that pramipexole lowers the prolactin serum level, and it is also known from German Patent Application DE 39 33 738 to use pramipexole to lower high TSH levels. Its transdermal administration is disclosed in U.S. Pat. No. 5,112,842, and WO Patent Application PCT/EP93/03389 describes the use of pramipexole as an antidepressant.... Details of the preparation of the title compound can be found in EP-A 85 116 016, and reference is hereby made specifically to the literature cited therein.

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Web site: http://www.delphion.com/details?pn=US06255329__ •

Composition and method of treating depression using a pentacyclic nucleus opioid antagonist in combination with a tricyclic antidepressant Inventor(s): Dante; Lee G. (Merion Station, PA) Assignee(s): Nagle, Esq. John S. (Thousand Oaks, CA) Patent Number: 5,856,332 Date filed: August 28, 1996 Abstract: A new composition and method for treating depression is claimed comprising administering to a patient exhibiting said illness or illnesses a pharmacologically effective dose of an opioid antagonist having a pentacyclic nucleus, and a pharmacologically effective dose of a tricyclic antidepressant. Excerpt(s): The present invention relates to the use of an opioid antagonist such as naltrexone in combination with one or more serotonin (5-hydroxytryptamine or 5-HT) or norepinephrine reuptake inhibitor(s) and/or lithium to treat mental or emotional disorders characterized by depression, obsessiveness, depression with anxiety, mania, manic depression, depression with manic episodes, and depression concomitant with an illness causing seizures which are inhibited by carbamazepine, or a combination of any of these mental or emotional illnesses, or mental or emotional illnesses with seizures. The inventor has discovered that naltrexone is useful in combination with lithium and/or one or more serotonin (5-HT) uptake inhibitor and/or norepinephrine (N.E.) uptake inhibitor drug compounds in treating patients whose depression and/or associated mental illnesses or conditions were refractory to drug treatment using one or more known antidepressant agents or agents for manic and manic depressive disorders such as lithium, and tricyclic and a-typical antidepressants including, but not limited to clomipramine, amitriptyline, imipramine, sertraline and nortriptyline that inhibit 5-HT and/or N.E. reuptake.... The inventor has further discovered that such treatment using naltrexone in combination with lithium and/or 5-HT or N.E. reuptake inhibitors is effective even where benzodiazepines are concurrently administered to treat anxiety. Additionally, the inventor has discovered that lithium in combination with naltrexone in some cases reduces manic and manic depressive bipolar symptoms.... A general discussion of the effectiveness of tricyclic antidepressants and non-tricyclic a-typical antidepressants in inhibiting 5-HT and/or N.E. neuronal synaptic reuptake and in treating depression, along with the pharmacology of these compounds is found in Goodman and Gillman, The Pharmacological Basis of Therapeutics, 7th and 8th Eds. (MacMillan Publ. Co.) Chapt. 19, Section 11 "Drugs Used in the Treatment of Disorders of Mood", incorporated by reference herein. According to the present invention, tricyclic antidepressants include, but are not limited to, imipramine, amitriptyline, trimipramine, doxepin, desipramine, nortriptyline, protriptyline, amoxapine, clomipramine, maprotriline, and carbamazepine, and their pharmaceutically effective salts and esters, such as, but not limited to their hydrochlorides, maleates, tartrates and lactates. Although carbamazepine is approved in the U.S. as antiepileptic, it is chemically related to tricyclic antidepressants, its actions on human brain neurons are not completely known, and for the present invention it is classified as a tricyclic antidepressant. See, Goodman and Gillman, The Pharmacological Basis of Therapeutics, referenced above, 7th Ed., page 457 et seq. Web site: http://www.delphion.com/details?pn=US05856332__

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Composition and method of treating depression using naloxone or naltrexone in combination with a serotonin reuptake inhibitor Inventor(s): Dante; Lee G. (Merion Station, PA) Assignee(s): Nagle; John S. (Thousand Oaks, CA) Patent Number: 5,817,665 Date filed: November 20, 1995 Abstract: This invention relates to a composition and method for treating depression by administering to a patient a pharmacologically effective dose of an opioid antagonist having a pentacyclic nucleus structurally analogous to naltrexone, and a pharmacologically effective dose of a nontricyclic antidepressant Excerpt(s): The present invention relates to the use of an opioid antagonist such as naltrexone in combination with one or more serotonin (5-hydroxytryptamine or 5-HT) or norepinephrine reuptake inhibitor(s) and/or lithium to treat mental or emotional disorders characterized by depression, obsessiveness, depression with anxiety, mania, manic depression, depression with manic episodes, and depression concomitant with an illness causing seizures which are inhibited by carbamazepine, or a combination of any of these mental or emotional illnesses, or mental or emotional illnesses with seizures. The inventor has discovered that naltrexone is useful in combination with lithium and/or one or more serotonin (5-HT) uptake inhibitor and/or norepinephrine (N.E.) uptake inhibitor drug compounds in treating patients whose depression and/or associated mental illnesses or conditions were refractory to drug treatment using one or more known antidepressant agents or agents for manic and manic depressive disorders such as lithium, and tricyclic and a-typical antidepressants including, but not limited to clomipramine, amitriptyline, imipramine, sertraline and nortriptyline that inhibit 5-HT and/or N.E. reuptake.... The inventor has further discovered that such treatment using naltrexone in combination with lithium and/or 5-HT or N.E. reuptake inhibitors is effective even where benzodiazepines are concurrently administered to treat anxiety. Additionally, the inventor has discovered that lithium in combination with naltrexone in some cases reduces manic and manic depressive bipolar symptoms.... A general discussion of the effectiveness of tricyclic antidepressants and non-tricyclic a-typical antidepressants in inhibiting 5-HT and/or N.E. neuronal synaptic reuptake and in treating depression, along with the pharmacology of these compounds is found in Goodman and Gillman, The Pharmacological Basis of Therapeutics, 7th and 8th Eds. (MacMillan Publ. Co.) Chapt. 19, Section 11 "Drugs Used in the Treatment of Disorders of Mood", incorporated by reference herein. According to the present invention, tricyclic antidepressants include, but are not limited to, imipramine, amitriptyline, trimipramine, doxepin, desipramine, nortriptyline, protriptyline, amoxapine, clomipramine, maprotriline, and carbamazepine, and their pharmaceutically effective salts and esters, such as, but not limited to their hydrochlorides, maleates, tartrates and lactates. Although carbamazepine is approved in the U.S. as antiepileptic, it is chemically related to tricyclic antidepressants, its actions on human brain neurons are not completely known, and for the present invention it is classified as a tricyclic antidepressant. See, Goodman and Gillman, The Pharmacological Basis of Therapeutics, referenced above, 7th Ed., page 457 et seq. Web site: http://www.delphion.com/details?pn=US05817665__

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Composition for relieving stress anxiety, grief, and depression Inventor(s): Sahley; Billie J. (5426 King Albert, San Antonio, TX 78229) Assignee(s): none reported Patent Number: 5,681,578 Date filed: January 22, 1996 Abstract: A composition for relieving stress, anxiety, grief, and depression includes GABA (gamma amino butyric acid), glutamine, glycine, magnesium, passion flower, primula officinalis, and vitamin B-6. Excerpt(s): The present invention relates to a composition of matter for enhancing the body's ability to cope with stress, anxiety, grief, and depression and, more particularly, but not by way of limitation, to a compositional blend of amino acids, herbs, and vitamin B-6 that reduces stress, anxiety, grief, and depression by aiding the natural inhibitory neurotransmitter system of the brain.... The brain controls the human body and is responsible for every thought, sensation, behavior, and memory. For the brain to control the human body, its individual cells must be in constant communication. That communication occurs through the release of neurotransmitters at the synapse between two neurons of individual brain cells. Neurotransmitters chemically transmit necessary information such as emotional responses, pain sensations, and voluntary muscle movements. Furthermore, certain neurotransmitters are inhibitory and actually prevent responses such as the emotional ones of anxiety and/or grief. Thus, neurotransmitters are essential to the mental, emotional, and physical well being of any person because, without sufficient levels, the brain cells do not properly communicate.... Although neurotransmitters are extremely important, few people receive sufficient amounts of the nutrients necessary to stimulate proper neurotransmitter production. Thus, if a person experiences stress, anxiety, grief, and/or depression, associated mental and emotional responses are magnified, particularly when certain inhibitory neurotransmitters are deficient. Current treatments for the above conditions, which consist primarily of prescription drugs, only provide temporary relief and often exacerbate the problem. Prescription drugs either stimulate the excessive release of pre-existing neurotransmitters or serve as a substitute for them. That excessive release or substitution relieves the condition, however, such relief is only temporary because, once the drug wears off, the condition returns. Furthermore, excessive release of neurotransmitters often produces a more acute condition because it depletes available neurotransmitters without satisfactory replenishment. Thus, prescription drugs, which only temporarily relieve the condition without providing a lasting cure, often facilitate a chronic condition requiring prolonged drug use. Web site: http://www.delphion.com/details?pn=US05681578__

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Compositions and method of treating cardio-, cerebro-vascular and alzheimer's diseases and depression Inventor(s): Tashiro; Renki (Asahichyo 2-24-15, Fuchyu, Tokyo, JP), Pater; Ruth H. (106 Tuckahoe Trace, Yorktown, VA 23693) Assignee(s): none reported Patent Number: 5,589,182 Date filed: December 6, 1993

Patents 441

Abstract: A pharmaceutical composition suitable for the treatment of a condition selected from the group consisting of cardiovascular disease, cerebrovascular disease, Alzheimer's disease, depression or combinations thereof comprising various mixtures of the aqueous extracts of tissue of specific Chinese plants and herbs. A method of preparing the pharmaceutical compositions of the invention and a method for treating a patient therewith are also disclosed. Excerpt(s): The present invention relates to a therapeutic composition derived from Chinese herbs and plants.... There is a current revival of interest in Chinese folk medicines which are principally derived from Chinese herbs or other types of plants. This interest in Chinese herbs was prompted by Chinese folklore wherein a number of such herbs have been reputed to have anti-infective activity and to be well-tolerated by humans. A subset of these herbs also appears to exhibit anti-HIV activity [Chang et al, Antiviral Research, Vol. 9, pages 163-176 (1988); and Chang et al, Antiviral Research, Vol. 11, page 263-273 (1989)].... However, Chinese folk medicine is based largely on anecdotal observations spanning the past several thousands of years. Hence, the effectiveness of the medicinal herbs used by folk medicine practitioners has, for the most part, not been substantiated by scientific methods. Despite this lack of scientific proof, it is quite possible that some herbal remedies may have specific therapeutic action, as was proven to be the case with the anti-malarial, qinghaosu, and perhaps even anti-HIV activity [Klayman, Science, vol. 228, pages 1049-1055 (1985)]. Consequently, with regard to the possible anti-HIV activity among Chinese herbal extracts, an urgent need exists for: (1) the identification of effective therapeutic herbal extracts, (2) the substantive documentation, by modern scientific methods, of the effectiveness of these herbal extracts against various pathological states, and (3) the identification of effective therapeutic Chinese herbal extracts that are less toxic than the currently available agents. Web site: http://www.delphion.com/details?pn=US05589182__ •

Cyclohexadiene derivatives useful in the treatment of depression Inventor(s): Urbahns; Klaus (Wuppertal, DE), Heine; Hans-Georg (Krefeld, DE), Junge; Bodo (Wuppertal, DE), Schohe-Loop; Rudolf (Wuppertal, DE), Wollweber; Hartmund (Wuppertal, DE), Sommermeyer; Henning (Koln, DE), Glaser; Thomas (Overath, DE), Wittka; Reilinde (Koln, DE), De Vry; Jean-Marie-Viktor (Rosrath, DE) Assignee(s): Bayer Aktiengesellschaft (Leverkusen, DE) Patent Number: 5,652,264 Date filed: March 27, 1996 Abstract: The cyclohexadiene derivatives are prepared by reaction of cyclohexanones with amines and subsequent dehydration. The compounds are effective in the treatment of depression on account of their property of being selective modulators of calcium channel-dependent potassium channels. Excerpt(s): The present invention relates to cyclohexadiene derivatives, a process for their preparation and their use as medicaments, in particular as cerebrally active agents.... It is already known that 3,6-cyclohexadiene-2-phenyl-1,3-dicarboxylic acid esters have a muscle contraction-inhibiting action [cf. for this Chem. Pharm. Bull., 39 (11), 2915-23, 1991; GB 87-18906 870810/GB 87-19441 870817].... and their salts. Web site: http://www.delphion.com/details?pn=US05652264__

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Diagnosis of depression by linkage of a polymorphic marker to a segment of chromosome 19P13 bordered by D19S247 and D19S394 Inventor(s): Peroutka; Stephen J. (1025 Tournament Dr., Hillsborough, CA 94010) Assignee(s): none reported Patent Number: 5,879,884 Date filed: June 7, 1995 Abstract: The invention maps a gene (dep) associated with depression to the p13 region of chromosome 19. The invention exploits this discovery to provide methods of diagnosing depression, methods of screening for the dep gene, and libraries of cloned segments including the dep gene. Excerpt(s): The present invention relates generally to the diagnosis and treatment of depression.... Depression is a clinical disorder that may begin at any age, although it usually begins in the mid-20s and 30s. The Diagnostic and Statistical Manual-IV (DSMIV) criteria used to diagnose depression are provided in Table 1. These symptoms may develop over days to weeks. Some people have only a single episode, with a full return to premorbid function. However, more than 50 percent of those who initially suffer a single major depressive episode eventually develop another.... The point prevalence for major depressive disorder in the Western industrialized nations is 2.3 to 3.2 percent for men and 4.5 to 9.3 percent for women. The lifetime risk for major depressive disorder is 7 to 12 percent for men and 20 to 25 percent for women. Risk factors for major depressive disorder include female gender (especially during the postpartum period), a history of depressive illness in first-degree relatives and prior episodes of major depression. Patients with major depressive disorder have substantial amounts of physical and psychological disability, as well as occupational difficulties. Untreated major depressive disorder has a substantial effect on health and functioning. Physical complaints are also common during a major depressive episode. Web site: http://www.delphion.com/details?pn=US05879884__

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Materials and methods for the treatment of depression Inventor(s): Druzgala; Pascal (Santa Rosa, CA) Assignee(s): Aryx Therapeutics (Sunnyvale, CA) Patent Number: 6,469,064 Date filed: April 24, 2001 Abstract: The subject invention provides compounds which are easily metabolized by the metabolic drug detoxification systems. Particularly, fluvoxamine analogs which have been designed to include esters within the structure of the compounds are taught. Also provided are methods of treating depression and affective disorders, such as obsessive compulsive disorder. Pharmaceutical compositions of the fluvoxamine analogs are also taught. Excerpt(s): Major depression represents one of the most common mental illness, affecting between 5-10% of the population. The disease is characterized by extreme changes in mood which may also be associated with psychoses. It has generally been found that most antidepressant agents exert significant effects on the regulation of monoamine neurotransmitters, including serotonin.... A number of types of antidepressants have been developed in recent years. Many of these compounds

Patents 443

regulate serotonin (5-hydroxytryptamine; 5-HT). Trazodone controls the actions of 5-HT while fluoxetine is a potent and selective inhibitor of 5-HT reuptake. 3Chloroimipramine which inhibits both 5-HT and norepinephrine reuptake has been extensively used as an antidepressant in Europe and Canada. Other compounds which are of current interest or have been examined as antidepressants include fluvoxamine, citalopram, zimeldine, sertraline, bupropion and nomifensine. Fluvoxamine facilitates serotoninergic neurotransmission via potent and selective inhibition of serotonin reuptake into presynaptic neurons.... The serotonergic neural system of the brain have been shown to influence a variety of physiologic functions, and the compounds of the present invention are predicted to have the ability to treat in mammals, including humans, a variety of disorders associated with this neural system, such as eating disorders, depression, obsessive compulsive disorders, panic disorders, alcoholism, pain, memory deficits and anxiety. Other indications for antidepressants, such as fluvoxamine, include unipolar depression, dysthymia, bipolar depression, treatmentresistant depression, depression in the medically ill, panic disorder, obsessivecompulsive disorder, eating disorders, social phobia, and premenstrual dysphoric disorder. Web site: http://www.delphion.com/details?pn=US06469064__ •

Method and compositions for controlling pain, depression and sedation Inventor(s): Crosby; Martin G. (Mt. Pleasant, SC) Assignee(s): Serotonin Industries of Charleston (Charleston, SC) Patent Number: 4,698,342 Date filed: May 20, 1986 Abstract: Compositions are disclosed for controlling pain, depression, and sedation. The compositions comprise a serotonin precursor such as L-tryptophan or L-5hydroxytryptophan in combination with a serotonin-specific reuptake inhibitor such as trazodone. In a preferred embodiment, the compositions are coadministered with a narcotic, the composition substantially potentiating the analgesic effect of the narcotic. Excerpt(s): This invention relates to medicinal compositions comprising a serotinin precursor such as L-tryptophan and a serotonin-specific reuptake inhibitor such as trazodone. The compositions are useful in controlling pain sedation, and depression in animals. This invention further relates to a method of controlling pain, depression and sedation in animals which comprises admininstering the medicinal compositions of this invention or components thereof internally. The invention also relates to the method of coadministering the compositions of this invention or components thereof with narcotics to achieve potentiation of the analgesic effect of the narcotic.... The use of narcotics is widespread for the control of chronic pain such as that sometimes encountered n advanced disease states of cancer patients. However, long term use of narcotics is met with increasing tolerance in most patients, requiring increased dosages and more frequent administration to achieve a reasonable comfort level. The opiate effects thereof produce a depressant effect with limits dosages and interrupts normal sleep patterns with long term use. Additionally, it frequently becomes impossible to ease the patient's pain to any reasonable degree.... In addition to the opiate effects, it is known that there is a transient increase in brain serotonin levels following administration of a narcotic, e.g., (at an interval of approximately thirty minutes). This increase in brain serotonin levels produced by the administered narcotics produces an

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analgesic effect. Serotonin is a known calmative neurotransmitter and produces a certain degree of sedation as well. Web site: http://www.delphion.com/details?pn=US04698342__ •

Method and compositions using 1-aryl-1,2,3,4-tetrahydro-.beta.-carboline-3-carboxylic acid for treating depression Inventor(s): Payne; Alan J. (Noblesville, IN), Aylott; Michael V. (Thorntown, IN), Moore; Jimmie L. (Indianapolis, IN), Yokley; Edward M. (Cambridge, MA) Assignee(s): The Dow Chemical Company (Midland, MI) Patent Number: 4,336,260 Date filed: March 2, 1979 Abstract: Treatment of central nervous system depression in a mammal using method and compositions employing 1-aryl-1,2,3,4-tetrahydro-.beta.-carboline-3-carboxylic acids, esters and pharmaceutically-acceptable salts. Excerpt(s): The synthesis of various 1-aryl-1,2,3,4-tetrahydro-.beta.-carboline-3carboxylic acids have been described in the literature. See J. Biol. Chem. 113, 759 (1936) and J. Amer. Chem. Soc. 70, 219 (1948). Other.beta.-carboline derivatives lacking the aryl substitution serve as intermediates in the preparation of compounds having psychoactive properties. See U.S. Pat. Nos. 3,644,384 and 3,717,638. Compounds less closely related in structure have been found to possess central nervous activity. See U.S. Pat. Nos. 3,478,051 and 3,551,450.... The invention also includes the pharmaceuticallyacceptable salts of the.beta.-carboline carboxylic acids, i.e. where R is hydrogen, used in the practice of the present invention. Pharmaceutically-acceptable salts refer to the acid addition salts of those bases which will form a salt with a carboxylic acid and which will not cause an adverse physiological effect when administered to an animal at dosages consistent with good pharmacological activity. Suitable bases thus include, for example, the alkali metal and alkaline earth metal hydroxides, carbonates, and bicarbonates such as sodium hydroxide, potassium hydroxide, calcium hydroxide, potassium carbonate, sodium bicarbonate, magnesium carbonate and the like, ammonia, primary, secondary, and tertiary amines and the like. Also aluminum salts of the instant compounds may be obtained by treating the corresponding sodium salt with an appropriate aluminum complex such as aluminum chloride hexahydrate, etc.... In general, the compounds of the present invention are effective when administered in daily dosages of from about 0.5 mg to about 80 mg of active ingredient per kilogram of body weight to relieve depression in a mammal. The compounds are administered internally as a psychoactive composition to a mammal either orally or parenterally by subcutaneous, intravenous or intraperitoneal injection or the like, or by implantation or the like, oral administration being preferred. The effective antidepressant amount of the compounds of the invention to be administered internally to a mammal, that is the amount which is effective to substantially relieve a mammal of the symptoms of depression, can vary depending upon such factors as the animal treated, the particular compound administered, the period of administration, and the method of administration. Web site: http://www.delphion.com/details?pn=US04336260__

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Method for alleviating depression Inventor(s): Sagen; Jacqueline (2509 W. Farwell, Chicago, IL 60645), Sortwell; Caryl E. (4548 N. Sheridan, Chicago, IL 60640), Pappas; George D. (506 W. Roscoe St., Chicago, IL 60657) Assignee(s): none reported Patent Number: 4,980,174 Date filed: December 23, 1988 Abstract: A novel method for alleviating depression comprises implanting monoamine producing living cells in the CNS of depressive subjects. Excerpt(s): Depression is the most common of the major mental illnesses. It is characterized by feelings of prolonged intense sadness and despair without an apparent cause, and is often accompanied by mental and physical disruption, including loss of concentration, pessimism, insomnia, weight loss, and decreased energy. A significant percentage of patients with this disorder display suicidal behavior during their lifetime. Many of these patients respond well to tricyclic antidepressants, the treatment of choice for this condition. Although quite effective in many patients, the efficacy is dependent on continued long-term drug usage. This condition cannot always be guaranteed due to patient non-compliance and numerous unpleasant side effects.... It has been reported that behavior can be altered by transplanting pharmacologically relevant tissues into the central nervous system (for review, see Azmitia and Bjorklund, 1987 Ann. N.Y. Acad. Sci. 495: 813). For example, it has been shown that sensitivity to pain can be reduced by transplanting opioid peptide-containing cells into pain modulatory regions of the CNS (Sagen et al. 1987 Exp. Brain Res. 67: 373-379). Other laboratories have shown that it is possible to alleviate cognitive or motor deficits in lesioned animals following neural transplantation. The latter studies have led to clinical trials for the alleviation of Parkinson's disease symptoms using neutral transplantation (Backlund et al. 1987 Ann. N.Y. Acad. Sci. 495: 658-670). However, there is no prior report that depression can be alleviated by CNS transplantation.... It is, therefore, an object of the present invention to provide a method for alleviating depression by transplanting live monoaminecontaining cells into the central nervous system (CNS) where a source of monoamines is needed. Web site: http://www.delphion.com/details?pn=US04980174__

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Method for preventing or treating depression employing a combination of an ace inhibitor and a drug that acts at serotonin receptors Inventor(s): Horovitz; Zola P. (Princeton, NJ) Assignee(s): E. R. Squibb & Sons, Inc. (Princeton, NJ) Patent Number: 5,032,578 Date filed: September 17, 1990 Abstract: A method is provided for inhibiting onset of or treating depression by administering an ACE inhibitor, such as captopril, fosinopril, zofenopril or ceranapril in combination with a drug that acts at serotonin receptors such as zacopride, over a prolonged period of treatment. Excerpt(s): The present invention relates to a method for inhibiting onset of or treating depression employing an angiotensin converting enzyme (ACE) inhibitor such as

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captopril, SQ 29,852, zofenopril, fosinopril or enalapril, in combination with a drug that interacts with serotonin receptors in the brain, such as zacopride.... U.S. Pat. No. 4,912,096 to Sudilovsky discloses a method for preventing or treating depression employing an angiotensin converting enzyme inhibitor which is ceranapril (SQ29,852), zofenopril or fosinopril.... U.S. Pat. Nos. 4,046,889 and 4,105,776 to Ondetti et al discloses proline derivatives, including captopril, which are angiotensin converting enzyme (ACE) inhibitors useful for treating hypertension. Web site: http://www.delphion.com/details?pn=US05032578__ •

Method for the diagnosis of depression based on monitoring blood levels of arginine vasopressin and/or thymopoietin Inventor(s): Goldstein; Gideon (30 Dorison Dr., Short Hills, NJ 07078), Culler; Michael D. (Easton, PA) Assignee(s): Goldstein; Gideon (Short Hills, NJ) Patent Number: 5,591,588 Date filed: September 20, 1994 Abstract: The invention provides a novel means of diagnosing, or confirming a diagnosis of, affective disorders, such as depression, based on the blood levels of arginine vasopressin and thymopoietin, either alone or in combination. Excerpt(s): The present invention relates generally to methods for diagnosis of disorders characterized by depression and stress. More particularly, the invention provides a novel means of making or confirming a diagnosis of an affective disorder, such as depression, based on the blood levels of arginine vasopressin and thymopoietin, either individually or in combination.... Arginine vasopressin (AVP), a neurohormone also known as anti-diuretic hormone, is characterized by a nine amino acid, partially cyclic structure. AVP has been reported to be associated in serum with a binding protein, called neurophysin [Brain Peptides, (D. T. Krieger et al, eds.), John Wiley & Sons, New York, pp. 598-611 (1983)]. AVP is secreted from two major locations in the brain, from hypothalamic parvicellular neurons in the paraventricular nucleus, which also produce corticotropin releasing factor (CRF), and from magnocellular neurons in the supraoptic and paraventricular nuclei [F. A. Antoni, in Frontiers in Neuroendocrinology, 14(2):76122 (1993)]. CRF is known to synergize with AVP to stimulate ACTH release.... It has been demonstrated that, following the application of chronic stress paradigms in laboratory animals, there is an increase in the level of AVP in the paraventricular nucleus of the hypothalamus. This AVP level is disproportionately large compared with the increase observed in CRF levels [Antoni, cited above; D. C. De Goeij et al, Endocrinol., 131:847 (1992)]. Following chronic stress, AVP levels within CRF-containing neurons within the paraventricular nucleus of the hypothalamus of laboratory animals have been reported to increase by over 8 fold, while the increase in CRF levels was 1.5 fold. This disproportionate increase in the level of AVP in this portion of the hypothalamus as compared with CRF has also been observed to be maintained at the level of the median eminence, the terminal bed from which AVP and CRF are released to stimulate ACTH secretion from the pituitary. Web site: http://www.delphion.com/details?pn=US05591588__

Patents 447

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Method for the treatment of depression Inventor(s): Tyers; Michael B. (Ware, GB2) Assignee(s): Glaxo Group Limited (London, GB2) Patent Number: 5,246,941 Date filed: January 15, 1993 Abstract: The invention relates to the use of compounds which act as antagonists of 5hydroxytryptamine (5-HT) at 5-HT.sub.3 receptors for the treatment of depression. Excerpt(s): This invention relates to a new medical use for certain chemical compounds and pharmaceutical compositions containing them. In particular it relates to the use in the treatment of depression of compounds which act as antagonists of 5hydroxytryptamine (5-HI) at receptors known in the art as 5-HT.sub.3, 5-HT`M` or 5-HI `M`-like' receptors. Such receptors have been described for example by Forzard et al., Eur. J. Pharmacol., 1979, 59, 195-210; Ireland, Straughan and Tyers, Br. J. Pharmacol., 1982, 75, 16P; Humphrey, Neuropharm., 1984, 23, 1503-1570; Richardson et al., Nature, 1985, 316, 126-131; and Bradley et al., Neuropharm., 1986, 25, 563-576. Receptors of this type are now designated as 5-HT.sub.3 receptors.... 5-HT receptors of this type are located, for example, on the terminals of afferent sensory neurones, in the isolated guinea-pig ileum preparation and are also present in the central nervous system. Compounds which act an antagonists of 5-HT at 5-HT.sub.3 receptors may be identified using standard tests, for example, in vitro by measuring their inhibition of the depolarising effect of 5-HT on the rat or rabbit isolated vagus nerve, or the tachycardia produced by 5-HT in the rabbit isolated heart or the contraction produced by 5-HT in the guinea-pig isolated ileum, or in vivo by measuring their effect on the Von BezoldJarisch reflex (induced by 5-HT) as described, for example, in the above-mentioned references.... A variety of compounds which act as antagonists of 5-HT at 5-HT.sub.3 receptors have been described in the art. These compounds are generally azabicyclo derivatives and/or benzoic acid derivatives, or imidazole derivatives. The azabicyclo derivatives include compounds containing a bridged piperidyl group, such as a tropyl, pseudotropyl, homotropyl or quinucilindyl group, and they preferably contain a carbocyclic or heterocyclic aromatic group linked, for example as an ester or amide, to the azabicyclic ring. The aromatic group may be for example an optionally substituted phenyl, indolyl, benzofuranyl, benzothienyl, benzisoxazolyl, indazolyl or pyrimidinyl group. Web site: http://www.delphion.com/details?pn=US05246941__

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Method for the treatment of depression Inventor(s): Hammarberg; Eva Maria (Sodertalje, SE), Johansson; Lars George (Sodertalje, SE), Larsson; Lars-Gunnar (Holo, SE), Noreen; Rolf (Huddinge, SE), Renyi; Lucy Anna (Skarholmen, SE), Ross; Svante Bertil (Sodertalje, SE), Sohn; Daniel Dungan (Sodertalje, SE), Svensson; Bjorn Eric (Sodertalje, SE), Thorberg; Seth-Olov (Jarna, SE) Assignee(s): Astra Aktiebolag (Sodertalje, SE) Patent Number: 5,641,807 Date filed: May 30, 1995

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Abstract: A method is disclosed for the treatment of depression by the administration of 3-amino-5-carbamoylchromans and 8-fluoro-3-amino-5-carbamoylchromans or enantiomers or salts thereof. Excerpt(s): The present invention relates to new substituted-3-amino-chromans and thiochromans, enantiomers and salts thereof, processes for their preparation, pharmaceutical compositions containing said therapeutically active compounds as well as new intermediates useful in the preparation of the therapeutically active compounds and to the use of said active compounds in therapy.... An object of the invention is to provide compounds for therapeutic use, especially compounds having a therapeutic activity via the central nervous system (CNS). A further object is to provide compounds having a selective effect on the 5-hydroxy-tryptamine receptors in mammals including man.... It is also an object of the invention to provide a compound with a therapeutic effect after oral administration. Web site: http://www.delphion.com/details?pn=US05641807__ •

Method for treating depression Inventor(s): Palfreyman; Michael G. (Fegersheim, FR), McDonald; Ian A. (Truchtersheim, FR) Assignee(s): Merrell Toraude et Compagnie (Strasbourg, FR) Patent Number: 4,413,012 Date filed: May 26, 1982 Abstract: 2-Amino-3-(3'-hydroxyphenyl)-3-butenoic acid or 2-amino-3-(3', 4'dihydroxyphenyl)-3-butenoic acid can be used to treat depression either alone or in combination with an extracerebrally acting AADC inhibitor. Excerpt(s): This invention relates to a novel method for treating depression.... The class of compounds known as monoamine oxidase inhibitors (MAO inhibitors) has been employed in psychiatry for over 20 years for the treatment of depression, [See Goodman and Gilman, The Pharmacological Basis of Therapeutics, 6th Ed, McMillan Publishing Co., Inc., N.Y., 1980, pages 427-430]. MAO inhibitors currently used in the USA for treating depression are tranylcypromine (PARNATE, SKF), phenelzine (NARDIL, Parke-Davis), and isocarboxazid (MARPLAN, Roche). In addition, another MAO inhibitor, pargyline (EUTRON, Abbott), is available for the treatment of hypertension [See Physicians' Desk Reference, 34th Ed., Medical Economics Co., Oradell, N.J., 1980, pages 1327-1328 (phenelzine), pages 1466-1468 (isocarboxazid), pages 1628-1630 (tranylcypromine) and pages 521-522 (pargyline)]. MAO inhibitors can also be employed to treat other psychiatric disorders, such as phobic anxiety states.... It is believed that the MAO inhibitors act to alleviate psychiatric disorders, such as depression, by increasing the concentration of one or more biogenic monoamines in the central nervous system. The monoamine oxidase enzyme (MAO) plays an important role in the metabolic regulation of the monoamines since it catalyzes the biodegradation of the monoamines through oxidative deamination. By inhibiting MAO, the degradation of the monoamines is blocked, and the result is an increase in the availability of the monoamines for their physiological functions. Among the physiologically active monoamines which are known substrates for MAO are: (a) the so-called "neurotransmitter" monoamines, such as the catecholamines (e.g. dopamine, epinephrine, and norepinephrine) and the indoleamines (e.g. tryptamine and 5-

Patents 449

hydroxytryptamine), (b) the so-called "trace" amines (e.g. o-tyramine, phenethylamine, tele-N-methylhistamine), and (c) tyramine. Web site: http://www.delphion.com/details?pn=US04413012__ •

Method for treating depression Inventor(s): Sabelli; Hector C. (2400 Lakeview, #2802, Chicago, IL 60614) Assignee(s): none reported Patent Number: 5,455,276 Date filed: May 20, 1993 Abstract: Pharmaceutical compositions for treating psychiatric disorders are provided. The compositions include 2-phenylethylamine ("PEA") and at least one inhibitor of monoamine oxidase B. Methods for the treatment of psychiatric disorders, including depression, using the disclosed pharmaceutical compositions are also provided. Excerpt(s): The present invention relates to pharmaceutical compositions and their use in the treatment of psychiatric disorders. More particularly, the invention relates to pharmaceutical compositions that include 2-phenylethylamine and at least one inhibitor of monoamine oxidase B, and to methods of using such compositions in the treatment of psychiatric disorders.... The need for new antidepressant agents arises from the limited efficacy, slowness of action, and adverse side-effects of many currently available compounds. For instance, some tricyclic antidepressants can cause sedation and atropine-like effects. Still other antidepressants can produce agitation that some persons feel lead them to increase suicidal ideation.... L-phenylalanine is an essential amino acid which is decarboxylated in the brain and peripheral tissues to form 2-phenylethylamine ("PEA"). PEA is then metabolized by monoamine oxidase type B [Yang and Neff, J. Pharmacol. Exp. Ther., 187:365-371 (1973)] to form phenylacetic acid ("PAA"). PEA is normally found stored and metabolized in brain and peripheral tissues. [Sabelli et al., Acta Physiological Polonica, 24:33-40 (1973); Inwang et al., J. Neurochem., 20:1469-1473 (1973); Mosnain et al., Biol. Psychiatry, 6:235-257 (1973a); Boulton et al., Br. J. Pharmacol., 59:209-214 (1977); Jackson and Temple, Comp. Gen. Pharmacol., 1:155- 157 (1970); Phillips et al., J. Neurochem., 33:159-161 (1979); Durden and Phillips, J. Neurochem., 34:1725-1732 (1980)]. Web site: http://www.delphion.com/details?pn=US05455276__

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Method for treating depression Inventor(s): Oxenkrug; Gregory (Newton, MA) Assignee(s): St. Elizabeth's Medical Center of Boston, Inc. (Boston, MA) Patent Number: 6,562,858 Date filed: April 12, 2001 Abstract: The present invention discloses a method for the treatment of depression in a human being identified as having depression. This method comprises the administration of a therapeutically effective depression treatment amount of M-3 agonists, 5-MCA-NAT or an analog, to said human being. The 5-MCA-NAT, or an analog, thereof may be administered alone or in combination with other agents, as Ca.sup.++ antagonists.

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Excerpt(s): The present invention relates to the method of treatment of depression in a human being identified as having depression. This method comprises the administration of a therapeutically effective depression treatment amount of agonists of melatonin-type 3 receptors (MT-3); 5 MCA-NAT and its analogs. MT-3 agonists may be administered alone or in combination with other agents, e.g. Ca.sup.++ antagonists.... Depression is a difficult mental disorder to treat. Patients having such a disorder are often reluctant to seek the medical attention necessary to diagnose the disorder. Such reluctance is often related to the patient's fear of the stigma associated with seeking psychiatric help or to the patient's feeling of worthlessness associated with depression. Moreover, once the patients seek competent psychiatric help, it is difficult to successfully treat the disorder through psychoanalytic approach alone.... In the Diagnostic and Statistical Manual of Mental disorders, Fourth Edition, (DSM IV published by the American Psychiatric Association, depressive disorders are classified under mood disorders and are divided into three types: major depressive disorder, dysthymic disorder and depressive disorder not otherwise specified. Major depressive disorder and dysthymic disorder are differentiated based on chronicity, severity and persistence. In major depression, the depressed mood must be present for two weeks. In dysthymic disorder, the depressed mood must be present for two weeks. In dysthymic disorder the depressed mood must be present most days over a period of two years. Usually, major depressive disorder is characterized by its sharp contrast to usual functioning. A person with a major depressive episode can be functioning and feeling normal and suddenly develop severe symptoms of depression. By contrast, a person with dysthymic disorder has chronic depression with less severe symptoms than major depression. Web site: http://www.delphion.com/details?pn=US06562858__ •

Method for treating depression and anxiety using phenyl hydrazo compounds Inventor(s): Abdallah; Abdulmuniem H. (Midland, MI), Shea; Philip J. (Midland, MI) Assignee(s): The Dow Chemical Company (Midland, MI) Patent Number: 4,150,133 Date filed: April 18, 1978 Abstract: Methods and pharmaceutical compositions using substituted phenyl hydrazo compounds for the treatment of depression and/or anxiety in a mammal. Excerpt(s): Halo-substituted phenylazoimidazoles are described at CA 72:111427a (Khim. Geterotsikl Soedin 916-22, 1969). Other substituted phenylazoimidazoles are shown in J. Chem. Soc., 115, 226 (1919) and in J. Chem. Soc., 117, 1426 (1920). None of the references cited disclose the use of the compounds to treat an animal.... U.S. Pat. No. 3,480,630 discloses the use of 2-arylhydrazino-imidazoline-(2) as a hypotensive in warmblooded animals.... The invention also includes the pharmaceutically-acceptable salts of the compounds used in the practice of the present invention. As used in the specification and claims, the term "pharmaceutically-acceptable salts" refers to non-toxic acid addition salts of the active compounds, the anions of which are relatively innocuous to animals at dosages consistent with good antidepressant and antianxiety activity so that the beneficial effects of the free base are not vitiated by the side effects ascribable to the anions. Pharmaceutically-acceptable salts include those derived from mineral acids such as hydrochloric and sulfuric and from organic acids such as lactic, maleic, succinic, fumaric, glutaric, citric, malic, p-toluenesulfonic, methanesulfonic, and tartaric acid and the like.

Patents 451

Web site: http://www.delphion.com/details?pn=US04150133__ •

Method for treating depression and other maladies by means of patient-created symptom graphs Inventor(s): Cohen; Kopel H. (58 Kettle Creek Rd., Weston, CT 06880) Assignee(s): none reported Patent Number: 4,346,697 Date filed: March 5, 1979 Abstract: The invention relates to a patient symptom chart on which symptom related graphs are created by the patient and a process of using these graphs in the treatment of various maladies including depression. Decision point plans or charts can also be used by the consulting physician in conjunction with the patient created graphs. Excerpt(s): This invention relates to a process of treating individuals afflicted by maladies and, in particular, by depression by means of symptom charts which are used in conjunction with the administration of medications. The invention also includes a decision point plan chart to be used by the physician in charge of the patient's treatment in interpreting and prescribing medication based on patient-created graphs.... According to a preferred embodiment of the invention, depression is treated by administering to the patient on a periodic basis, such as a daily basis, anti-depression medication, such as a tricylic, the dosages of which will depend upon the patient's long-term reaction to the medication as indicated by the patient-created symptom graphs, which graphs are conveniently interpreted by the physician with the help of a decision point plan chart.... The patient is provided with a depression symptom chart which includes a plurality of symptom fields with each field corresponding to one particular symptom which is associated with depression, such as, for example, sleeplessness, loss of appetite, loss of energy, or inability to concentrate. Each of the symptom fields which relates to one of these symptoms would include a plurality of symptom indicatives arranged in a progressive series ranging from a symptom indicative relating to an extreme depressive state, through intermediate depressive states indicating improvement relative to the extreme state, up through a positive condition indicative which would generally correspond to the absence of depression. These symptom indicatives are arranged as one coordinate of a graph which is to be completed by the patient during this treatment period when he will be receiving medication. The other coordinate of the graph would correspond to the time period of treatment. Each day the patient would indicate on the graph the symptom indicative within each symptom field which most closely corresponds to his condition on that particular day. After a period of time there will be thereby created a graph of the patient's reaction to the medication. The fact that the graph is patient-created fosters a therapeutic alliance between the patient and the physician which can independently aid in the treatment of the patient in that the patient will participate actively in his treatment and this can improve ultimate patient progress. Web site: http://www.delphion.com/details?pn=US04346697__

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Method for treating depression using optically pure (-)-bupropion Inventor(s): Young; James W. (Palo Alto, CA) Assignee(s): Sepracor, Inc. (Marlborough, MA) Patent Number: 6,369,113 Date filed: June 27, 2001 Abstract: Methods and compositions are disclosed utilizing the optically pure (-)-isomer of bupropion, which is a potent drug for treating depression. Excerpt(s): This invention relates to methods of treatment and pharmaceutical compositions employing the compound (-)-buproplon.... Many organic compounds exist in optically active forms, i.e., they have the ability to rotate the plane of plane-polarized light. In describing an optically active compound, the prefixes D and L or R and S are used to denote the absolute configuration of the molecule about its chiral center(s). The prefixes (+) and (-) or d and 1 are employed to designate the sign of rotation of planepolarized light by the compound, with (-) or 1 meaning that the compound is levorotatory. A compound prefixed with (+) or d is dextrorotatory. For a given chemical structure, these compounds, called stereoisomers, are identical except that they are mirror images of one another. A specific stereoisomer may also be referred to as an enantiomer, and a mixture of such isomers is often called an enantiomeric or racemic mixture.... Stereochemical purity is of importance in the field of pharmaceuticals, where 16 of the 20 most prescribed drugs exhibit chirality. A case in point is provided by the Lform of the.beta.-adrenergic blocking agent, propranolol, which is known to be 100 times more potent than the D-enantiomer. Web site: http://www.delphion.com/details?pn=US06369113__

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Method for treating depression with d-fenfluramine Inventor(s): Wurtman; Richard J. (Boston, MA), Wurtman; Judith J. (Boston, MA), O'Rourke; Dermot (Charlestown, MA) Assignee(s): Massachusetts Institute of Technology (Cambridge, MA) Patent Number: 4,649,161 Date filed: June 16, 1986 Abstract: D-fenfluramine is administered to a human patient having seasonal depression or other forms of bipolar depression in order to alleviate or cure the depression. Excerpt(s): This invention relates to a method for treating depression in humans with dfenfluramine.... Bipolar depressions often, but not always, are characterized by alternating periods of depression and hypomania. At the present time, there are available a wide variety of modes of treating patients afflicted with bipolar depression including psychiatric treatment and the administration of pharmaceutical compositions to the patient.... Prior to the present invention, the efficacy of d-fenfluramine in treating depression is specifically contraindicated, Physician's Desk Reference, 1985, page 1658. The d-fenfluramine has been disclosed in U.S. Pat. No. 3,198,834 to have an anorexigenic effect. In addition, U.S. Pat. No. 4,309,445 discloses that d-fenfluramine can be administered to patients having a syndrome of abnormal carbohydrate craving between meals in order to reduce the craving of carbohydrate without inhibiting the intake of protein by the patient.

Patents 453

Web site: http://www.delphion.com/details?pn=US04649161__ •

Method for treating depression with olanzapine Inventor(s): Tollefson; Gary D (Indianapolis, IN) Assignee(s): Eli Lilly and Company (Indianapolis, IN) Patent Number: 5,958,921 Date filed: June 18, 1998 Abstract: This invention relates to the use of the antipsychotic drug olanzapine for the treatment of depression, including depressive signs and symptoms and Major Depression. Excerpt(s): This invention relates to a method for treating depression using 2-methyl-4(4-methyl-1-piperazinyl)-10H-thieno›2,3-b!›1,5!benzodiazepine.... Major Depressive Disorder is associated with a high mortality. Up to 15% of individuals with severe Major Depressive Disorder die by suicide. Epidemiological evidence also suggests that there is a fourfold increase in death rates in individuals with Major Depressive Disorder who are over age 55 years. Individuals admitted to nursing homes with Major Depressive Disorder have a markedly increased likelihood of death in the first year.... Depression is a prevalent condition. The lifetime risk for Major Depressive Disorder in community samples has varied from 10% to 25% for women and 5% to 12% for men. The prevalence of Major Depressive Disorder appear to be unrelated to ethnicity, education, income, or marital status. Web site: http://www.delphion.com/details?pn=US05958921__

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Method for treating depression, obsessive compulsive disorder, and anxiety with N-acetyl serotonin Inventor(s): Oxenkrug; Gregory F. (Newton, MA), Requintina; Pura J. (West Kingston, RI) Assignee(s): St. Elizabeth's Medical Center of Boston (Boston, MA) Patent Number: 6,011,054 Date filed: November 4, 1998 Abstract: The present invention relates to a method of treatment of depression in a human being identified as having depression. This method comprises the administration of a therapeutically effective depression treatment amount of N-acetylserotonin (NAS), also referred to as N-acetyl-5-hydroxytryptamine, to a human being identified as having depression. The NAS may be administered alone or in combination with other agents, e.g., Ca.sup.++ antagonists. Excerpt(s): The present invention relates to a method of treatment of depression in a human being identified as having depression. This method comprises the administration of a therapeutically effective depression treatment amount of Nacetylserotonin (NAS) to a human being identified as having depression. NAS may be administered alone or in combination with other agents, e.g., Ca.sup.++ antagonists.... Serotonin has been long ago considered to have the important role in the mechanism of antidepressant effect (see Lapin & Oxenkrug, 1969). Pineal gland has the highest concentration of serotonin in comparison with the other brain structures. Pineal

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serotonin is acetylated with the formation of N-acetylserotonin (NAS). NAS is further methylated by the hydroxy-indole-O-methyltransferase (HIOMT) to produce melatonin (5-methoxy-N-acetyltryptamine) (see Reiter, 1991). Melatonin exerted antidepressantlike activity in the "frog" test: potentiated the sedative effect of reserpine (Skene & Potgieter, 1981) and of selective MAO-A inhibitors (Requintina et al., 1994). We have recently observed the antidepressant-like activity of melatonin in the mouse tail suspension test (Prahie et al., in preparation). Selective MAO-A inhibitors (and some other antidepressants) stimulate the pineal NAS and melatonin production (Oxenkrug et al., 1994: see for rev. Oxenkrug, 1991). It was suggested that selective MAO-A inhibitors (and some other antidepressants) might correct the circadian rhythms abnormalities (and, thus, exert their antidepressant action) via their melatoninergic effects (Oxenkrug et al., 1986; see Oxenkrug, 1991).... Although NAS was viewed mainly only as an intermediate product of melatonin biosynthesis from serotonin, it was reported that some of its effects (i.e., hypothermic and analgesic) differed (qualitatively or quantitatively) from that of serotonin and melatonin (Morton, 1987; Psarakis et al., 1988). Web site: http://www.delphion.com/details?pn=US06011054__ •

Method for treatment of anxiety and depression Inventor(s): Molinoff; Perry B. (Weston, CT), Dunbar; Geoffrey C. (Middleton, CT) Assignee(s): Bristol-Myers Squibb Company (Princeton, NJ) Patent Number: 6,312,717 Date filed: June 14, 1999 Abstract: An improved method of treatment for anxiety and/or depression provides a quicker and more robust anxiolytic/antidepressant activity to a patient suffering from depression. The method comprises the concurrent administration of effective doses of certain azapirones, such as buspirone, given in a manner that suppresses formation of the 1-(2-pyrimidinyl)piperazine metabolite; and a 5-HT1A autosomal receptor antagonist, such as pindolol. Excerpt(s): The present invention relates to an improved method for treating anxious and/or depressed patients. Concurrent administration of certain azapirones with a 5HT1A autosomal receptor antagonist provides faster onset of anxiolytic and antidepressant actions. By administering the azapirone in such a manner that formation of the 1-(2-pyrimidinyl)piperazine metabolite (1-PP) is minimized, a more robust therapeutic effect is achieved.... These particular azapirones containing the pyrimidinylpiperazine moiety as an integral part of their molecular structure give rise to 1-(2-pyrimidinyl)piperazine (1-PP) as their major metabolite. This metabolite is seen in greatest abundance following oral administration. The most studied and well-known member of this compound class is buspirone, an important antianxiety agent first approved for use in anxious patients in 1986. Although buspirone has been disclosed as having antidepressant properties by Robinson, et al., J. Clin. Psychopharmacol. , 1990, 10:675-765; it has not been generally considered to be as efficacious as classical antidepressant agents.... However, Blier, et al. in Neuropsychopharmacol. , 1997, 16:333338; reported that buspirone exhibited both an efficacy and onset of action that was superior to classical antidepressants when the buspirone was combined with the 5HT1A autosomal receptor blocker, pindolol. Both agents were administered separately by the oral route to a group of depressed patients in the study described by Blier.

Patents 455

Web site: http://www.delphion.com/details?pn=US06312717__ •

Method for treatment of depression Inventor(s): Tyers; Michael Brian (Ware, GB) Assignee(s): Glaxo Group Limited (GB) Patent Number: 6,221,878 Date filed: March 10, 1995 Abstract: The invention relates to the use of compounds which act as antagonists of 5hydroxytryptamine (5-HT) at 5-HT.sub.3 receptors for the treatment of depression. Excerpt(s): This invention relates to a new medical use for certain chemical compounds and pharmaceutical compositions containing them. In particular it relates to the use in the treatment of depression of compounds which act as antagonists of 5hydroxytryptamine (5-HT) at receptors known in the art as 5-HT.sub.3, 5-HT`M` or 5HT `M'-like` receptors. Such receptors have been described for example by Fozard et al., Eur. J. Pharmacol., 1979, 59, 195-210; Ireland, Straughan and Tyers, Br. J. Pharmacol., 1982, 75, 16P; Humphrey, Neuropharm., 1984, 23, 1503-1570; Richardson et al., Nature, 1985, 316, 126-131; and Bradley et al., Neuropharm., 1986, 25, 563-576. Receptors of this type are now designated as 5-HT.sub.3 receptors.... 5-HT receptors of this type are located, for example, on the terminals of afferent sensory neurones, in the isolated guinea-pig ileum preparation and are also present in the central nervous system. Compounds which act as antagonists of 5-HT at 5-HT.sub.3 receptors may be identified using standard tests, for example, in vitro by measuring their inhibition of the depolarising effect of 5-HT on the rat or rabbit isolated vagus nerve, or the tachycardia produced by 5-HT in the rabbit isolated heart or the contraction produced by 5-HT in the guinea-pig isolated ileum, or in vivo by measuring their effect on the Von BezoldJarisch reflex (induced by 5-HT) as described, for example, in the above-mentioned references.... A variety of compounds which act as antagonists of 5-HT at 5-HT.sub.3 receptors have been described in the art. These compounds are generally azabicyclo derivatives and/or benzoic acid derivatives, or imidazole derivatives. The azabicyclo derivatives include compounds containing a bridged piperidyl group, such as a tropyl, pseudotropyl, homotropyl or quinoclidinyl group, and they preferably contain a carbocyclic or heterocyclic aromatic group linked, for example as an ester or amide, to the azabicyclic ring. The aromatic group may be for example an optionally substituted phenyl, indolyl, benzofuranyl, benzothienyl, benzisoxazolyl, indazolyl or pyrimidinyl group. Web site: http://www.delphion.com/details?pn=US06221878__

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Method of detecting depression Inventor(s): Correa; Elsa I. (11726 Greenspring Ave., Lutherville, MD 21093), Barrick; Christina Barrett (305 Chestnut Glen Garth, Towson, MD 21204) Assignee(s): none reported Patent Number: 5,882,203 Date filed: May 31, 1995

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Abstract: The present invention relates to a method of detecting depression and its severity. A series of statements formulated to detect the presence and severity of depression are presented to the subject in a multiple item visual analog format. The subject's answers are given a numerical value. The total score is then normatively ranked to determine the presence and severity of the depression. Excerpt(s): This invention relates methods of psychological evaluation, and more particularly to a method of psychological testing that detects depression.... Depression is a prevalent condition that affects more than six million Americans each year. (Weissmian et al., 1988). Depression is a mental disorder involving complex behavioral, psychological, and physiological systems. (DSM-IV). Depression can impair functional capacity, cause distress or increase the risk of suffering pain, disability and death. (DSMIV) When depression is detected it can be treated with psychotherapy and/or medication.... It is, of course, known in the art to determine characteristics of human test subjects by asking them to select appropriate responses to printed statements, as disclosed in U.S. Pat. No. 4,627,010 issued to Von Fellenberg. Web site: http://www.delphion.com/details?pn=US05882203__ •

Method of diagnosing, tracking, and treating depression Inventor(s): Sparhawk, Jr. G. Roger (10015 Crestridge Dr., Chardon, OH 44024) Assignee(s): none reported Patent Number: 6,322,503 Date filed: February 17, 2000 Abstract: The present invention relates to a method of diagnosing, tracking, and rating depressive symptoms in order to predict responses to specific treatments and guide further adjustments and interventions to treatments. The present invention permits rapid and meaningful depressive symptom severity ratings even when conventional or verbal symptom descriptions are difficult or impossible. The present invention further provides a means for detecting and quantifying intense emotional pain, including depression subtypes and major depressions with psychotic features. The present invention also provides a means of quantitative comparisons for the results of successive treatment trials. The present invention covers the whole range of depression symptom diagnosis and requires no literacy or minimal mental capacities from the patients. Furthermore, the present invention minimizes bias in order to avoid over or under diagnosis and treatments. In addition, the present invention provides a method by which immediate feedback and/or immediate outcome data may be gathered regarding the existence or non-existence of depressive symptoms in an individual. Excerpt(s): The present invention relates generally to a method of psychiatric treatment, and in particular to tracking and rating depressive symptoms in a rapid, meaningful, and quantitative comparable way for treatment.... Cost effectiveness has always been emphasized in the healthcare industry. With an estimated of $44 billion spent annually in the US to treat depression while only 6% of the health insurance policies provide outpatient benefits for psychiatric disorders, cost effectiveness is even more urgent in the psychiatric field.... Many rating scales measuring symptoms of mental disorders and depressions have been developed over the years in order to achieve cost effectiveness in the psychiatric field. These rating scales act as check-lists for clinicians and diagnosticians, monitoring patients' responses to certain treatments or reactions to environmental changes. These rating scales generally adopt a verbal symptom

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description method, relying on patients to verbally describe their feelings or elect from one of the verbally-described scenarios to match their feelings. Then, these rating scales rely on clinicians or diagnosticians to `rate` the patients based on patients' responses. Web site: http://www.delphion.com/details?pn=US06322503__ •

Method of treating depression Inventor(s): Gahwyler; Max (Darien, CT) Assignee(s): American Home Products Corporation (New York, NY) Patent Number: 4,110,438 Date filed: March 21, 1977 Abstract: A method of treating depression using luteinizing hormone-releasing hormone is disclosed. Excerpt(s): This invention relates to a method of treating depression with luteinizing hormone-releasing hormone.... The most extensively used method for treating moderate to severe depression involves the administration of tricyclic antidepressant agents. Examples of such agents are amitriptyline, nortriptyline, imipramine, desipramine and doxepin. These drugs, however, have several disadvantages. Among the serious disadvantages are a delayed onset of effectiveness of one to two weeks, and side effects such as atropine-like side effects, e.g., dry mouth, tachycardia, etc., and central nervous system side effects, e.g., parkinsonism, drowsiness, etc.... Consequently, efforts have recently been made to develop an improved method for treating depression. For example, see N. P. Plotalkoff, U.S. Pat. No. 3,737,549, issued June 5, 1973 relating to the treatment of depression with thyrotropin releasing agent. However, none of these recent efforts have replaced or supplemented the above mentioned method. Web site: http://www.delphion.com/details?pn=US04110438__

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Method of treating depression Inventor(s): Valle; Ronald (36 Fitch St., Carteret, NJ 07008) Assignee(s): none reported Patent Number: 4,260,600 Date filed: October 22, 1979 Abstract: A method of treating depression by administering several active compounds throughout the day to a patient in need of such treatment. Also included are pharmaceutical composition claims incorporating these compounds. Excerpt(s): This invention relates to a method of treating depression by administering to a patient in need thereof several active compounds forming a novel combination. The invention also relates to pharmaceutical composition claims which incorporate the novel combination of active compounds. The compounds which form this novel combination are all known and are known for their adrenergic, antihistamine, analgesic or antipyretic uses, such as for example to relieve the symptons of a common cold.... I have found that by using a particular combination of these compounds, in a particular dosage range an antidepressive yet tranquilizing effect results. As such using my combination for this use avoids the use of other well known, costly, prescription only tranquilizers or

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antidepression drugs with their resultant potentially dangerous and in many cases unknown side effects and habit forming tendencies. The compounds which make up my combination are readily available, are quite safe for their uses, and are not as costly as the prescription tranquilizers and antidepressants.... (1) Phenylephrine hydrochloride which is (R)-3-hydroxy-.alpha.-[(methylamino)methyl]benzenemethanol hydrochloride. This compound alone has a therapeutic use as an adrenergic. Web site: http://www.delphion.com/details?pn=US04260600__ •

Method of treating depression Inventor(s): Lahti; Robert A. (Galesburg, MI) Assignee(s): The Upjohn Company (Kalamazoo, MI) Patent Number: 4,386,079 Date filed: November 23, 1981 Abstract: A method of treating depression in humans which comprises administering orally to humans an antidepressant effective amount of a compound having the formula I.sub.1 wherein Y is alkyl of from 1 to 3 carbons, inclusive; A is ethylene or --CH.sub.2 CH(CH.sub.2 Cl)--, T and T.sub.1 are the same or different and are SR.sub.3, OR or NR.sub.1 R.sub.2; R is hydrogen, alkyl of from 1 through 6 carbons, aryl, aralkyl or I(a) with the proviso that when one of T or T.sub.1 is NR.sub.1 R.sub.2 then the other cannot be SR.sub.3 or OR. Excerpt(s): This invention pertains to novel processes for preparing phosphorus derivatives of metronidazole. The invention is also particularly directed to the use of novel chloro containing phosphorus derivatives of metronidazole as intermediates in these processes. Furthermore, the intermediates are compounds which insofar as is presently known no one has previously prepared. Finally, the phosphorus derivatives of metronidazole prepared by the novel processes of the invention include novel analogs thereof.... The compounds of formula I.sub.1 include metronidazole phosphate and its salts which are disclosed in U.S. Pat. No. 4,160,827, which in turn are derivatives of the antibiotic compound metronidazole which is disclosed in U.S. Pat. No. 2,944,061. Furthermore, Belgian Pat. No. 873,973 which is equivalent to U.S. Pat. No. 4,160,827 discloses the use of pyrophosphoryl tetrachloride in a process which phosphorylates metronidazole. However, the process disclosed in the Belgian patent is distinguishable from that of the present invention. Particularly, the crystalline intermediates of the present invention have not previously been known. Therefore, it is now understood that the process conditions of the present invention are not appreciated in the prior art. Numerous advantages accrue from use of the invention process and novel intermediates therein such as purification of metronidazol phosphate and preparation of additional analogs not known in previous processes.... In general, phosphorylations of alcohols with phosphoryl trichloride and pyrophosphoryl tetrachloride are well known. Representative references of such phosphorylations include Koransky, W. et al., "Phosphorylation of Nucleosides with Pyrophosphoryl Chloride", Z. Naturforsch, 17, pp. 291-5 (1962), CA, 57, 12609D (1962); Miki, P. et al., "A Phosphorylation of Steroids and A Dienone-Phenol Rearrangement leading to a Secosteroidal Aldehyde Which Has a Strong Toxicity", Chem. Pharm. Bull., Vol. 22, No. 7, pp. 1439-50 (1974); Cremlyn, R. J. W. et al., "A Simple Phosphorylation Procedure for Cyclic Alcohols", Synthesis, pp. 64850 (1971). Additionally, hydrolysis of phosphorus dichlorides are also known. For example, see Koransky et al. cited above, as well as, Lacey, et al., "A Simple Synthesis of Choline Alkyl Phosphates", Tetrahedron Letters, Vol. 21, pp. 2017-20 (1980). However,

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none of the above references teach the phosphorylation of metronidazole or the novel compounds of the present invention. Web site: http://www.delphion.com/details?pn=US04386079__ •

Method of treating depression Inventor(s): Griffith; Robert W. (Basking Ridge, NJ), Singer; Jack (Short Hills, NJ) Assignee(s): Sandoz, Inc. (E. Hanover, NJ) Patent Number: 4,593,031 Date filed: June 5, 1985 Abstract: This invention relates to a composition and method for potentiating the antidepressant effect of dibenzocycloheptadiene-type antidepressant agents, for example, nortriptyline, in the treatment of depression, especially geriatric depression, by administering them in combination with an approximately 1:1:1 by weight mixture of dihydroergocryptine (2:1.alpha.:.beta.), dihydroergocornine and dihydroergocristine. Excerpt(s): This invention relates to a method of potentiating the antidepressant effect of dibenzocycloheptadiene-type antidepressant agents, for example, nortriptyline, in the treatment of depression, especially geriatric depression, and in particular, senile dementia with depression, by administering them in combination with an essentially 1:1:1 by weight mixture of dihydroergocryptine (2:1.alpha.:.beta.), dihydroergocornine and dihydroergocristine or a pharmaceutically acceptable acid addition salt thereof, which is referred to herein as the ergopeptide component.... This invention further relates to a composition useful in treating depression, in particular, geriatric depression, comprising a therapeutic effective amount of a dibenzocycloheptadiene antidepressant and a potentiating effective amount of the ergopeptide component. The composition is especially useful in treating senile dementia with depression, e.g., as defined by DMS-III Diagnostic Criteria, American Psychiatric Association (290.21) Diagnostic and Statistical Manual of Mental Disorders (Third Edition).... Depression is one of the most common psychiatric disturbances seen by the physician, especially in the elderly patient. The treatment of depression has generally been improved dramatically by the development of tricyclic antidepressive agents such as the benzocycloheptadiene-type antidepressants. Unfortunately, the therapeutic effect of such agents is often accompanied by troublesome side effects such as anticholinergic, cardiovascular and central nervous system (CNS) reactions. In the geriatric patient, these side effects are especially problematical, necessitating the use of lower daily doses of the antidepressant. At the lower doses, the effect of the drug is often less than that desired. Web site: http://www.delphion.com/details?pn=US04593031__

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Method of treating depression Inventor(s): Buyske; Donald A. (18 Sherman Ave., Morris Plains, NJ 07950) Assignee(s): none reported Patent Number: 4,868,218 Date filed: April 18, 1989 Abstract: The monamine oxidase inhibitor drug L-deprenyl (phenylisopropyl methyl propynyl amine) is safely and conveniently used for the treatment of mental depression

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in a formulation applied to the skin of the patient. In this way the danger of side reaction due to the consumption of foods containing tyramine (the cheese effect) is minimized. Unlike other monamine oxidase drugs, such as Parnate, L-deprenyl does not cause skin irritation when used in this way. Excerpt(s): My present invention relates to the therapeautic administration of the drug L-deprenyl a method of treating human subjects suffering from depression and, more particularly, to (levo phenyl isopropyl methyl propynyl amine) for this purpose. For brevity, L-deprenyl will often be denoted below as LDY.... Two general classes of organic pharmaceuticals useful in the treatment of the mental disease depression in humans have been recognized: (1) tricyclic antidepressants, as exemplified by amitriptyline and protriptylene, and (2) monoamine oxidase inhibitors (MAOI), as exemplified by the commercially available drugs Nardil, Parnate, and L-deprenyl.... Because the cheese effect can cause very serious medical problems, including death in severe cases, MAOI drugs are little used, even though they are generally free from the other more common side effects of the tricyclic drugs and are believed to have at least equal effectiveness in the treatment of most types of depression. Web site: http://www.delphion.com/details?pn=US04868218__ •

Method of treating depression Inventor(s): Wallace; Jan D. (Ann Arbor, MI) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,025,035 Date filed: October 12, 1990 Abstract: The instant invention is a novel use of known cyclic amino acids. Such compounds, including gabapentin, are useful for treating major and minor forms of depression. Excerpt(s): The present invention relates to a novel therapeutic use of a known compound, gabapentin, its derivatives, and pharmaceutically acceptable salts. The present invention concerns a method for treating depression in a mammal in need of such treatment.... U.S. Pat. No. 4,024,175 and its divisional 4,087,544 cover the compounds of the instant invention, methods for preparing them, and several uses thereof. The uses disclosed are: protective effect against cramp induced by thiosemicarbazide; protective action against cardiazole cramp; the cerebral diseases epilepsy, faintness attacks, hypokinesia, and cranial traumas; and improvement in cerebral functions. The compounds are useful in geriatric patients. The patents are hereby incorporated by reference.... There is no disclosure in the above references to make obvious the present invention of novel uses of compounds of U.S. Pat. No. 4,024,175 to treat depression. Web site: http://www.delphion.com/details?pn=US05025035__

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Method of treating depression Inventor(s): Buyske, deceased; Donald A. (late of Lake Worth, FL), Buyske, administratrix; by Susan G. (New York, NY) Assignee(s): Somerset Pharmaceuticals, Inc. (Tampa, FL) Patent Number: RE34,579 Date filed: August 27, 1991 Abstract: The monamine oxidase inhibitor drug L-deprenyl (phenylisopropyl methyl propynyl amine) is safely and conveniently used for the treatment of mental depression in a formulation applied to the skin of the patient. In this way the danger of side reaction due to the consumption of foods containing tyramine (the cheese effect) is minimized. Unlike other monamine oxidase drugs, such as Parnate, L-deprenyl does not cause skin irritation when used in this way. Excerpt(s): My present invention relates to the therapeutic administration of the drug Ldeprenyl a method of treating human subjects suffering from depression and, more particularly, to (levo phenyl isopropyl methyl propynyl amine) for this purpose. For brevity, L-deprenyl will often be denoted as LDY.... Two general classes of organic pharmaceuticals useful in the treatment of the mental disease depression in humans have been recognized: (1) tricyclic antidepressants, as exemplified by amitriptyline and protriptylene, and (2) monoamine oxidase inhibitors (MAOI), as exemplified by the commercially available drugs Nardil, Parnate, and L-deprenyl.... Both types of drugs are generally regarded as effective, but both have undesirable side effects. For tricyclic drugs, recognized side effects include dry mouth, orthostatic hypotension, and impotence, and these effects are frequent. The most significant side effect of the MAOI drugs is a rare but serious one: sudden and dangerous life-threatening elevation of blood pressure when the patent taking such drugs also consumes foods high in the naturally occurring substance tyramine. Cheese is the most common food containing large amounts of tyramine, so that this side effect is often known colloquially in the medical profession as the "cheese effect". Web site: http://www.delphion.com/details?pn=US0RE34579__

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Method of treating depression and pre-menstrual syndrome using chromium Inventor(s): McLeod; Malcolm N. (419 Lakeshore La., Chapel Hill, NC 27514) Assignee(s): none reported Patent Number: 5,972,390 Date filed: February 19, 1998 Abstract: The method of this invention is directed to a treatment of depression in men and women and to a treatment of pre-menstrual syndrome (PMS) in women by administering to a patient a therapeutically effective amount of chromium in a pharmaceutically acceptable form either alone or in conjunction with the administration of a standard antidepressant composition, such as a selective serotonin reuptake inhibitor composition. Chromium, preferably in the form of chromium picolinate, is administered to the patient at dosages in a preferred range of about 200 to about 500 micrograms chromium. Excerpt(s): The present invention relates generally to a treatment for depression and to a treatment of pre-menstrual syndrome, and more particularly to the treatment of

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depression using chromium and to the treatment of pre-menstrual syndrome using chromium. The present invention also particularly relates a method of improving the effectiveness of an antidepressant composition by administering chromium to a patient concurrently with the administration of an antidepressant composition to the patient.... It will be appreciated by those having ordinary skill in the art that depression is a difficult mental disorder to treat. Patients having such a disorder are often reluctant to seek the medical attention necessary to diagnose the disorder. Such reluctance is often related to the patient's fear of the stigma associated with seeking psychiatric help or to the patient's feelings of worthlessness associated with depression. Moreover, once patients seek competent psychiatric help, it is difficult to successfully treat the disorder through psychoanalytic approaches alone.... In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM IV) published by the American Psychiatric Association, depressive disorders are classified under mood disorders and are divided into three types: major depressive disorder, dysthymic disorder and depressive disorder not otherwise specified. Major depressive disorder and dysthymic disorder are differentiated based on chronicity, severity and persistence. In major depression the depressed mood must be present for two weeks. In dysthymic disorder the depressed mood must be present most days over a period of two (2) years. Usually major depressive disorder is characterized by its sharp contrast to usual functioning. A person with a major depressive episode can be functioning and feeling normally and suddenly develop severe symptoms of depression. By contrast a person with dysthymic disorder has chronic depression with less severe symptoms than major depression. Web site: http://www.delphion.com/details?pn=US05972390__ •

Method of treating depression and tri-substituted amines therefor Inventor(s): Minchin; Michael C. W. (Oxford, GB2), White; John F. (Wokingham, GB2) Assignee(s): John Wyeth & Brother, Limited (Maidenhead, GB2) Patent Number: 5,527,955 Date filed: December 23, 1993 Abstract: The invention concerns a method for treating depression or senile dementia using a compound which acts selectively as an agonist of gamma aminobutyric acid (GABA) at GABA autoreceptors with the proviso that the compound is not fengabine and progabide. Excerpt(s): This invention relates to use of a new pharmacological activity and to certain amines possessing said pharmacological activity, to processes for preparing them and to pharmaceutical compositions containing them. More particularly this invention relates to the treatment of depression.... In the UK the annual referral rate for depression is around 300-400 per 10.sup.5 population of whom 10-15% require hospitalisation. At present the most effective and safe treatment for severe depression involves electroconvulsive therapy (ECT) where the patient receives a series of controlled electric shocks. However such treatment understandably engenders an atavistic fear and apprehension in many patients. It also has undesirable side-effects, notably disturbance of memory.... The mode of action of ECT remains unknown but in recent years much has been learnt about the biological effects of electroconvulsive shock (ECS) in animals. In particular, repeated ECS, given in ways closely mimicking those used to administer ECT clinically, elicits in rodents changes in monoamine functions. These include: increased 5-HT-mediated behaviour, increased dopaminergic behaviour and depressed

Patents 463

beta-adrenoceptor binding and sensitivity of the coupled adenylate cyclase. The last is also seen following chronic treatment with a number of antidepressant drugs. Web site: http://www.delphion.com/details?pn=US05527955__ •

Method of treating depression using 1-threo-methylphenidate Inventor(s): Midha; Kamal K. (Hamilton, BM), Teicher; Martin (Waltham, MA), Kumar; Vijai (Morris Plains, NJ) Assignee(s): Pharmaquest Limited (Hamilton, BM) Patent Number: 6,395,752 Date filed: August 11, 2000 Abstract: A method of treating dysphoria or depression is disclosed in a patient which comprises the step of administering orally or non-orally to said patient, a therapeutically effective amount of 1-threo-methylphenidate or a pharmaceutically acceptable acid addition salt thereof. Excerpt(s): This invention relates to a method of treating depression in a patient by oral or non-oral administration of 2S,2'S-methyl 2-phenyl-2-(2'-piperidyl) acetate, commonly known as 1-threo-methylphenidate, hereinafter referred to as 1-MPH and to pharmaceutical compositions containing 1-MPH designed to deliver 1-MPH to the central nervous system. More particularly the method of treatment is designed to provide relief to a depressed patient who is awaiting the onset of the antidepressive action of an antidepressant such as a selective serotonin re-uptake inhibitor, or any other class of antidepressant that requires administration over 2 to 6 weeks to demonstrate therapeutic effect.... Orally administered racemic d1-threo-methylphenidate (d1-MPH) is widely used in the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children and adults and also in the treatment of depression in patients suffering from cancer or AIDS, compulsive shopping disorder, narcolepsy, and hypersomnia. It is known that the therapeutic effect of d1-MPH in the treatment of ADHD in children is attributable to d-MPH (Srinivas et al, Clin. Pharmacol. Therap. 52, 561 to 568, 1992). Until recently, however, little was known about the potential pharmacological and/or therapeutic roles of 1-MPH because concentrations of 1-MPH in plasma and brain are very low due to extensive enantioselective first pass metabolism of 1-MPH after oral administration of d1-MPH (Srinivas et al, Pharm. Res. 10, 14 to 21, 1993). After intravenous administration of d1-MPH, however, both enantiomers of threomethylphenidate are taken up into the brain although their patterns of distribution are different (Ding et al, Psychopharmacology 131, 71 to 78, 1997).... The use of oral stimulants such as dextroamphetamine or d1-MPH in the treatment of severe depressive disorders in the elderly or terminally ill depressed patients has been the subject of many studies over the years. After reviewing 85 publications on the subject, Satel and Nelson (J. Clin. Psychiat. 50, 241 to 249, 1989) were critical of the fact that many of the studies reported were methodologically unsophisticated and/or uncontrolled. They concluded that while stimulants are no more effective than a placebo in the treatment of primary depression, stimulants may be of value in the treatment of refractory patients and medically ill patients. Similarly, Chiarello and Cole (Arch. Gen. Psychiat. 44, 276 to 285, 1997) reviewed 81 publications and concluded that many of the older studies are inadequate although there was some evidence to support the use of psychostimulants in selected clinical instances. Emptage and Smith (Annals of Pharmacotherapy, 30, 151 to 157, 1996) reviewed 43 studies published from 1986 to 1995 and concluded that oral-MPH appears to be a safe and effective treatment for depressed, medically ill, elderly

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patients to provoke a rapid onset of antidepressant activity. Recently Wallace and coworkers (Am. J. Psychiat. 152, 929 to 931, 1995) conducted what they termed the first placebo-controlled double blind trial to demonstrate the efficacy of oral d1-MPH in older, medically ill depressed patients. The benefit of oral d1-MPH was statistically and clinically significant despite the small number of patients in the study (n=16). Depressive symptoms decreased markedly in 7 subjects (Hamilton depression scale decreased by >55%), moderately in a further 3 subjects (Hamilton depression scale decreased by 30 to 55%), minimally in 3 subjects (Hamilton depression scale decreased by <30%) and three patients were dropped from the study. Web site: http://www.delphion.com/details?pn=US06395752__ •

Method of treating depression using azabicyclohexanes Inventor(s): Epstein; Joseph W. (Monroe, NY), Osterberg; Arnold C. (Pearl River, NY), Brabander; Herbert J. (Nanuet, NY) Assignee(s): American Cyanamid Company (Stamford, CT) Patent Number: 4,435,419 Date filed: May 10, 1982 Abstract: The present invention concerns certain novel substituted 3azabicyclo[3.1.0]hexanes and a method of treating depression and stress in a warmblooded animal, comprising the administration of substituted 3azabicyclo[3.1.0]hexanes. Excerpt(s): This invention relates to certain novel substituted 3-azabicyclo[3.1.0]hexanes and to compositions of matter containing said novel compounds.... This invention further relates to a novel method of treating depression and stress in warm-blooded animals, and particularly to a method of treating depression and stress by the administration of substituted 3-azabicyclo[3.1.0]hexanes.... The 3azabicyclo[3.1.0]hexanes of Formulas II, III, IV, and V below are disclosed in U.S. Pat. No. 4,131,611, incorporated herein by reference, where their utility is given as anxiolytic and analgesic agents. See also J. W. Epstein et al., "1-Aryl-3-azabicyclo[3.1.0]hexanes, a New Seris of Nonnarcotic Analgesic Agents", J. Med. Chem. 24: 481(1981), incorporated herein by reference. Web site: http://www.delphion.com/details?pn=US04435419__

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Method of treating depression using chromium Inventor(s): McLeod; Malcolm N. (419 Lakeshore La., Chapel Hill, NC 27514) Assignee(s): none reported Patent Number: 6,034,125 Date filed: February 19, 1998 Abstract: The method of this invention is directed to a treatment of depression in men and women by administering to a patient a therapeutically effective amount of chromium in a pharmaceutically acceptable form. Chromium, preferably in the form of chromium picolinate, is administered to the patient at dosages in a preferred range of about 200 to about 500 micrograms chromium.

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Excerpt(s): The present invention relates generally to a treatment for depression and to a treatment of pre-menstrual syndrome, and more particularly to the treatment of depression using chromium and to the treatment of pre-menstrual syndrome using chromium. The present invention also particularly relates a method of improving the effectiveness of an antidepressant composition by administering chromium to a patient concurrently with the administration of an antidepressant composition to the patient.... It will be appreciated by those having ordinary skill in the art that depression is a difficult mental disorder to treat. Patients having such a disorder are often reluctant to seek the medical attention necessary to diagnose the disorder. Such reluctance is often related to the patient's fear of the stigma associated with seeking psychiatric help or to the patient's feelings of worthlessness associated with depression. Moreover, once patients seek competent psychiatric help, it is difficult to successfully treat the disorder through psychoanalytic approaches alone.... In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM IV) published by the American Psychiatric Association, depressive disorders are classified under mood disorders and are divided into three types: major depressive disorder, dysthymic disorder and depressive disorder not otherwise specified. Major depressive disorder and dysthymic disorder are differentiated based on chronicity, severity and persistence. In major depression the depressed mood must be present for two weeks. In dysthymic disorder the depressed mood must be present most days over a period of two (2) years. Usually major depressive disorder is characterized by its sharp contrast to usual functioning. A person with a major depressive episode can be functioning and feeling normally and suddenly develop severe symptoms of depression. By contrast a person with dysthymic disorder has chronic depression with less severe symptoms than major depression. Web site: http://www.delphion.com/details?pn=US06034125__ •

Method of treating depression using l-threo-methylphenidate Inventor(s): Midha; Kamal K. (Hamilton, BM), Teicher; Martin (Waltham, MA), Kumar; Vijai (Morris Plains, NJ) Assignee(s): Pharmaquest Limited (Hamilton, BM) Patent Number: 6,127,385 Date filed: March 4, 1999 Abstract: A method of treating depression to elicit prompt relief from depression is disclosed. The method comprises the step of administering orally or non-orally to said patient, a therapeutically effective amount of l-threo-methylphenidate or a pharmaceutically acceptable salt thereof. Excerpt(s): This invention relates to a method of treating depression in a patient by oral or non-oral administration of 2S,2'S-methyl 2-phenyl-2-(2'-piperidyl)acetate, commonly known as 1-threo-methylphenidate, hereinafter referred to as 1-MPH and to pharmaceutical compositions containing 1-MPH designed to deliver 1-MPH to the central nervous system. More particularly the method of treatment is designed to provide relief to a depressed patient who is awaiting the onset of the antidepressive action of an antidepressant such as a selective serotonin re-uptake inhibitor, or any other class of antidepressant that requires administration over 2 to 6 weeks to demonstrate therapeutic effect.... Orally administered racemic dl-threo-methylphenidate (dl-MPH) is widely used in the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in children and adults and also in the treatment of depression in patients suffering from cancer or AIDS, compulsive shopping disorder, narcolepsy, and hypersomnia. It is

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known that the therapeutic effect of dl-MPH in the treatment of ADHD in children is attributable to d-MPH (Srinivas et al, Clin. Pharmacol. Therap. 52, 561 to 568, 1992). Until recently, however, little was known about the potential pharmacological and/or therapeutic roles of 1-MPH because concentrations of 1-MPH in plasma and brain are very low due to extensive enantioselective first pass metabolism of 1-MPH after oral administration of dl-MPH (Srinivas et al, Pharm. Res. 10, 14 to 21, 1993). After intravenous administration of dl-MPH, however, both enantiomers of threomethylphenidate are taken up into the brain although their patterns of distribution are different (Ding et al, Psychopharmacology 131, 71 to 78, 1997).... The use of oral stimulants such as dextroamphetamine or dl-MPH in the treatment of severe depressive disorders in the elderly or terminally ill depressed patients has been the subject of many studies over the years. After reviewing 85 publications on the subject, Satel and Nelson (J. Clin. Psychiat. 50, 241 to 249, 1989) were critical of the fact that many of the studies reported were methodologically unsophisticated and/or uncontrolled. They concluded that while stimulants are no more effective than a placebo in the treatment of primary depression, stimulants may be of value in the treatment of refractory patients and medically ill patients. Similarly, Chiarello and Cole (Arch. Gen. Psychiat. 44, 276 to 285, 1997) reviewed 81 publications and concluded that many of the older studies are inadequate although there was some evidence to support the use of psychostimulants in selected clinical instances. Emptage and Smith (Annals of Pharmacotherapy, 30, 151 to 157, 1996) reviewed 43 studies published from 1986 to 1995 and concluded that oral MPH appears to be a safe and effective treatment for depressed, medically ill, elderly patients to provoke a rapid onset of antidepressant activity. Recently Wallace and coworkers (Am. J. Psychiat. 152, 929 to 931, 1995) conducted what they termed the first placebo-controlled double blind trial to demonstrate the efficacy of oral dl-MPH in older, medically ill depressed patients. The benefit of oral dl-MPH was statistically and clinically significant despite the small number of patients in the study (n=16). Depressive symptoms decreased markedly in 7 subjects (Hamilton depression scale decreased by >55%), moderately in a further 3 subjects (Hamilton depression scale decreased by 30 to 55%), minimally in 3 subjects (Hamilton depression scale decreased by <30%) and three patients were dropped from the study. Web site: http://www.delphion.com/details?pn=US06127385__ •

Method of treating depression using neurotrophins Inventor(s): Siuciak; Judith (Tarrytown, NY) Assignee(s): Regeneron Pharmaceuticals, Inc. (Tarrytown, NY) Patent Number: 5,599,560 Date filed: November 10, 1994 Abstract: Infusion of neurotrophins, preferably brain-derived neurotrophic factor, are shown to be effective agents for use in the alleviation of symptoms of depression, as demonstrated by reduction of "despair" in the animal forced swim test. Alterations in serotonin levels brought about by neurotrophins suggest use of these factors for the treatment of other disorders caused by defects in serotonin activity. Excerpt(s): The present invention relates to a method of treating or alleviating the symptoms of depression. It is based, in part, on the discovery that midbrain infusions of specific neurotrophic factors results in a reduction in depression, as measured by identifiable behavior in animal systems used to identify therapeutically effective antidepressive agents.... It has been estimated that approximately 4% of the people in the

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world suffer from depression which is not caused by any underlying neurological disease. Depression effects people in all walks of society, from the very young to the very old. It often occurs without the presence of a precipitating event, and is frequently unresponsive to psychotherapy or environmental changes.... The cluster of symptoms associated with depression suggests that it is caused by a defect which affects the regulation of neurotransmitters. Neurotransmitters are substances that are synthesized and released synaptically by one neuron and which effect a postsynaptic cell through a specific receptor. The major small molecule transmitter substances include acetylcholine, the biogenic amines such as dopamine, norepinephrine, serotonin and histamine, as well as amino acids such as glutamate. Neurons also communicate with other neurons or target cells through the neuroactive peptides, which include somatostatin and (.beta.endorphin. Neuronal cells often produce a combination of small molecule transmitters and neuroactive peptides at their synapses. Web site: http://www.delphion.com/details?pn=US05599560__ •

Method of treating manic depression by brain infusion Inventor(s): Rise; Mark T. (7745 Aetna Ave. NE., Monticello, MN 55432) Assignee(s): none reported Patent Number: 6,176,242 Date filed: April 30, 1999 Abstract: Techniques using one or more drugs, electrical stimulation or both to treat depression or manic depression by means of an implantable signal generator and electrode and/or an implantable pump and catheter. A catheter is surgically implanted in selected sites in the brain to infuse the drugs, and one or more electrodes are surgically implanted in the brain at selected sites to provide electrical stimulation. Excerpt(s): This invention relates to nerve tissue stimulation and infusion techniques, and more particularly relates to such techniques for treating depression and manic depression.... A persons immediate emotional state is referred to as their affective state. Two normal emotions or affective states are eurphoria and depression. These affective states are experienced transiently by all persons in response life situations. For some individuals however, these normal emotional responses may become sustained for long periods of time. The general affective state may not reflect the momentary expeiences of the individual. Two affective disorders involving the emotions of eurphoria and depression are unipolar or major depression and bipolar depression or manic depression.... Unipolar depression manifests as episodes of dysphoria (unpleasant mood) and anhedonia (inability to experience pleasure) which may last for months. Symptoms may include a loss of energy, changes in weight (most often weight loss but possibly weight gain) insomnia or sometimes oversleeping, restlessness, and inability to concentrate, loss of sex drive, negative thoughts, feelings of worthlessness and suicidal ideation. Unipolar depression is characterized by subtypes. The estimates are that there may be as many as 4 million people in the United States suffering from depression. Web site: http://www.delphion.com/details?pn=US06176242__

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Method of treating schizophrenia, depression and other neurological conditions Inventor(s): Marston; Hugh M. (East Lothian, GB), Kelly; John S. (Edinburgh, GB) Assignee(s): Fujisawa Pharmaceutical Co., Ltd. (Osaka, JP) Patent Number: 6,284,760 Date filed: June 24, 1999 Abstract: This application relates to the use of aminopiperazine derivatives for the treatment of schizophrenia, depression, and other neurological conditions. Excerpt(s): The aminopiperazine derivatives used in this invention are known as described in PCT International Publication No. WO 91/01979 that said aminopiperazine derivatives possess the potentiation of the cholinergic activity and are useful in the treatment of disorders in the central nervous system for human beings, and more particularly in the treatment of amnesia, dementia, senile dementia and the like.... The present invention relates to a new use of aminpiperazine derivatives and pharmaceutically acceptable salts thereof for the treatment and/or prevention of schizophrenia, depression, stroke, head injury, nicotine withdrawal, spinal cord injury, anxiety, pollakiuria, incontinence of urine, myotonic dystrophy, attention deficit hyperactivity disorder, excessive daytime sleepiness (narcolepsy), Parkinson's disease or autism for mammals.... Accordingly, this invention is to provide a new use of aminopiperazine derivatives and pharmaceutically acceptable salts thereof for treating and/or preventing schizophrenia, depression, stroke, head injury, nicotine withdrawal, spinal cord injury, anxiety, pollakiuria, incontinence of urine, myotonic dystrophy, attention deficit hyperactivity disorder, excessive daytime sleepiness (narcolepsy), Parkinson's disease or autism. Web site: http://www.delphion.com/details?pn=US06284760__

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Method of treatment for depression Inventor(s): Amento; Edward P. (Portola Valley, CA), Bauer; Eugene A. (Los Altos, CA) Assignee(s): Connetics Corporation (Palo Alto, CA) Patent Number: 5,753,623 Date filed: June 7, 1995 Abstract: Depression, particularly disease- and medical treatment-related depression, and especially postpartum depression, is treated by the administration of a therapeutically effective amount of relaxin. A treatment regimen and dosage form for gradual withdrawal from relaxin therapy is also disclosed. Excerpt(s): The present invention relates to treatments for depression and/or anxiety, particularly for disease- and medical treatment-related depression, and for postpartum depression, and specifically to such a treatment employing the administration of relaxin.... As described in Textbook of INTERNAL MEDICINE, Kelley, et al. (eds.), Part X: Neurology, Chapter 469: Major Psychiatric Disorders, (J. Lippincott Co., Philadelphia), pp. 2198-2199 (1992), unipolar affective disorder (i.e., depression without episodes of mania or "major depression") can occur throughout life and is at least twice as common in women as in men. Patients often present without the subjective sense of being depressed but complaining of somatic symptoms of depression, most commonly fatigue, sleep disturbances, or impotence. Patients may describe feeling sad, blue, low, irritable, or anxious, as well as being depressed. Diagnosis of major depression is based

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either on a distinct change of mood that is prominent, generally persists throughout the day, and occurs each day for at least 2 weeks or on markedly diminished interest or pleasure in most activities over a similar period. The diagnosis requires that at least four of the following symptoms be present nearly every day for a period of 2 weeks: significant weight loss (or weight gain in some younger patients), prominent sleep disturbance, agitation or retardation with slow speech, fatigue, feelings of worthlessness and guilt, slowed thinking, and hopelessness.... Depression can likewise be associated with the symptoms of disease (e.g., systemic lupus erythematosus) or as a side effect of the treatment of disease (e.g., with antihypertensive therapy). One form of depression, postpartum depression, has been commonly found in women during the period following childbirth. Web site: http://www.delphion.com/details?pn=US05753623__ •

Methods and materials for treating depression and mood disorder Inventor(s): Cho; Suk H. (Idaho Falls, ID), Perkes; Lynn (Rexburg, ID) Assignee(s): Melaleuca, Incorporated (Idaho Falls, ID) Patent Number: 6,068,846 Date filed: August 5, 1999 Abstract: The present invention provides methods and materials for the treatment of depression or mood disorder. Specifically, the invention involves the use of 5-HTP and an extract to treat depression or mood disorders when administered orally. In addition, the invention provides less expensive, naturally derived dietary supplements to treat mild to moderate depression or mood disorder. Excerpt(s): The present invention relates to methods and materials for the treatment of depression or mood disorder. More particularly, the invention relates to the treatment of mild to moderate depression or mood disorder by a novel composition of Hypericum perforalum, Griffonia Simplicifolia, and/or specific vitamins. The present invention relates to tablets, capsules, tinctures, or syrup containing a specific amount of Hypericum perforalum, Griffonia Simplicifolia, and/or specific vitamins for internal use.... Depression is the most common mood disorder in the modern world. There are a variety of types and levels of depression. The spectrum of depression can range from a condition that is temporary, lasting a few days, to clinical depression that can be a much more serious disorder. This medical disorder can be characterized by persistent severe feelings of worthlessness, guilt, sadness, helplessness, and hopelessness. Common symptoms can include inactivity, difficulty thinking or concentrating, appetite changes, sleep disturbances, and suicidal tendencies. There are several theories that postulate why depression exists. Stressful life style, diet, chemical imbalances, and traumatic events are all thought to cause depression. Although the mechanisms of depression are not completely understood, therapies are available to treat this disorder. Treatments typically involve using antidepressant drugs in combination with counseling.... Approximately seventeen million Americans suffer from clinical depression and over twenty-eight million Americans take antidepressant drugs. Modern drugs focus on manipulating neurotransmitter levels in the brain. The most commonly used drugs are Prozac, Zoloft, and Paxil, which predominately work by increasing serotonin levels either by inhibiting the reuptake of serotonin or preventing serotonin breakdown. Most prescriptions can be expensive and patients can experience unwanted side effects from these medications. In addition, some of these medications can become ineffective after prolonged use.

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Web site: http://www.delphion.com/details?pn=US06068846__ •

Methods for improving the therapeutic response of humans having major depression and carrying the gene for apolipoprotein E4 Inventor(s): Murphy, Jr. Greer M. (Stanford, CA), Schatzberg; Alan F. (Los Altos, CA) Assignee(s): Akzo Nobel N.V. (NL) Patent Number: 6,399,310 Date filed: February 12, 2001 Abstract: This invention relates to methods for improving the therapeutic response of human patients with major depression by determining the apolipoprotein E genotype of a human patient and administering mirtazapine, in an amount effective to treat major depression, to those patients who are found to carry the gene for apolipoprotein E4. Also disclosed are methods for improving the therapeutic response of a human patient with major depression comprising administering mirtazapine, in an amount effective to treat major depression, to a human patient who is a carrier of the gene for apolipoprotein E4. Excerpt(s): The present invention relates to methods for improving the therapeutic response of human patients with major depression, particularly those carrying the gene for apolipoprotein E4.... Psychiatric diseases generally provide a unique set of complications for clinicians, patients, and care givers. Major depression, for instance, is a major health problem and poses a tremendous financial burden on society due to lost self-support of individuals suffering from depression. Such individuals are often simply unable to function in everyday life situations, in part because of feelings of extreme hopelessness and worthlessness. There is also a serious risk of suicide among such individuals. The various forms of depression are defined and are separately diagnosed according to criteria given in handbooks for psychiatry, for example in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) published by the American Psychiatric Association, Washington, D.C. (1994). The diagnostic criteria for major depression are well known to those skilled in the art, and comprise the criteria set forth, for example, at DSM-IV 296.2 and 296.3. Major depression, defined in more detail below, is also known as major depressive disorder and is estimated to affect between 5 to 10% of the human population.... Although treatments for different types of depression do exist, there is a continuous search for new methods of treatment of depression because existing methods still have disadvantages, such as the side effects of drugs, the long duration of treatments, and, more importantly, the partial efficacy (or inefficacy) of treatments. For example, there is wide variation in the response of patients with major depression to antidepressant pharmacotherapy. Some of this variation may be due to genetic differences among patients. Regardless, the result is that about 30% of patients with major depression who are treated with existing antidepressant drugs do not improve. Web site: http://www.delphion.com/details?pn=US06399310__

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Methods for treating depression and other disorders using optically pure (-)bupropion Inventor(s): Young; James W. (Palo Alto, CA) Assignee(s): Sepracor, Inc. (Marlborough, MA) Patent Number: 6,451,860 Date filed: February 19, 2002 Abstract: Methods are disclosed utilizing the optically pure (-)-isomer of bupropion, which is a potent drug for treating depression, Parkinson's disease, obesity, weight gain and other disorders. Excerpt(s): This invention relates to methods of treatment and pharmaceutical compositions employing the compound (-)-bupropion.... Many organic compounds exist in optically active forms, i.e., they have the ability to rotate the plane of plane-polarized light. In describing an optically active compound, the prefixes D and L or R and S are used to denote the absolute configuration of the molecule about its chiral center(s). The prefixes (+) and (-) or d and l are employed to designate the sign of rotation of planepolarized light by the compound, with (-) or l meaning that the compound is levorotatory. A compound prefixed with (+) or d is dextrorotatory. For a given chemical structure, these compounds, called stereoisomers, are identical except that they are mirror images of one another. A specific stereoisomer may also be referred to as an enantiomer, and a mixture of such isomers is often called an enantiomeric or racemic mixture.... Stereochemical purity is of importance in the field of pharmaceuticals, where 16 of the 20 most prescribed drugs exhibit chirality. A case in point is provided by the Lform of the.beta.-adrenergic blocking agent, propranolol, which is known to be 100 times more potent than the D-enantiomer. Web site: http://www.delphion.com/details?pn=US06451860__

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Methods of treating depression and psychoses Inventor(s): Coughenour; Linda L. (Ann Arbor, MI), Davis; Robert E. (Ann Arbor, MI), Downs; David A. (Ann Arbor, MI), Heffner; Thomas G. (Ann Arbor, MI), Meltzer; Leonard T. (Ann Arbor, MI), Moos; Walter H. (Ann Arbor, MI), Moreland; David W. (Ann Arbor, MI), Tecle; Haile (Ann Arbor, MI) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,073,561 Date filed: March 5, 1990 Abstract: Certain N-substituted 1-(1,2,3,6-tetrahydro-3-pyridinyl)oximes and Nsubstituted 1-(1,2,3,6-tetrahydro-4-pyridinyl)oximes are useful as sigma binding agents for the treatment of depression, psychoses and/or inflammatory diseases. Excerpt(s): The present invention relates to chemical compounds, pharmaceutical compositions, and to a method of treatment employing the compounds and compositions. More particularly, the present invention is concerned with certain 1,2,5,6tetrahydro-1-substituted 3- or 4-pyridine oximes, to pharmaceutical compositions containing these compounds, and to a pharmaceutical method of treatment.... Disorders of cognition are generally characterized by symptoms of forgetfulness, confusion, memory loss, attentional deficits and/or, in some cases, affective disturbances. These symptoms may arise as a result of the general aging process and/or from organic brain

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disease, cerebrovascular disease, head injury or developmental or genetic defects.... The general decrease in cognitive function which accompanies the aging process is well accepted. The same phenomenon has been observed and documented in many lower mammals, including those routinely employed in pharmacological testing programs for screening and predicting usefulness for particular drugs in higher animals, including humans. Web site: http://www.delphion.com/details?pn=US05073561__ •

N.sup.1 -propargylhydrazines, N.sup.2 -propargylhydrazines and their analogs for the treatment of depression, anxiety and neurodegeneration Inventor(s): Coutts; Ronald (Edmonton, CA), Baker; Glen (Edmonton, CA), Sloley; Duff (Edmonton, CA), Shan; Jacqueline (Edmonton, CA), Pang; Peter K. T. (Sherwood Park, CA) Assignee(s): CV Technologies, Inc. (Alberta, CA) Patent Number: 6,060,516 Date filed: February 17, 1998 Abstract: The present invention is directed to novel N.sup.1 -propargylhydrazines, N.sup.2 -propargylhydrazines and their salts in pharmaceutical compositions. The compounds according to the present invention have at least one of the following activities: monoamine oxidase-A inhibiting, monoamine oxidase-B inhibiting, antidepressant, anti-anxiety and neuroprotectant activities. These compounds are useful as monoamine oxidase inhibitors and should be useful for the treatment of depression, anxiety and of neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease. Excerpt(s): The present invention is directed to N.sup.1 -propargylhydrazines, N.sup.2 propargylhydrazines and their salts in pharmaceutical compositions. The compounds according to the present invention have at least one of the following activities monoamine oxidase-A inhibiting, monoamine oxidase-B inhibiting, anti-depressant, anti-anxiety and neuroprotectant activities. These compounds are useful as antidepressants, anxiolytics monoamine oxidase inhibitors and for the treatment of neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease.... Neither the N.sup.1 -propargylhydrazines nor N.sup.2 -propargylhydrazines listed here have been used as monoamine oxidase-A inhibiting, monoamine oxidase-B inhibiting, anti-depressant, anti-anxiety or neuroprotective compounds.... N-Propargyl-Nmethylalkylamines have been used as selective monoamine oxidase-B inhibiting and neuroprotective compounds (Birkmayer et al., Journal of Neurotransmission 64 (1985) pages 113-127; Yu et al., Journal of Medicinal Chemistry Volume 35 (1992), pages 37053713; Yu et al., Journal of Neurochemistry 63 (1994) pages 1820-1828). However, the activity of the compounds according to the present invention would not have been predicted from the activity of N-propargyl-N-methylalkylamines. Web site: http://www.delphion.com/details?pn=US06060516__

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N-aryloxyethyl-indoly-alkylamines for the treatment of depression Inventor(s): Mewshaw; Richard E. (Princeton, NJ), Zhou; Dahui (Highland Park, NJ) Assignee(s): American Home Products Corp. (Madison, NJ) Patent Number: 6,121,307 Date filed: April 7, 1999 Abstract: Compounds useful for alleviating symptoms of depression are provided which have the following formula: wherein:R.sub.1 is hydrogen, lower alkyl or aryl;R.sub.2 is hydrogen, lower alkyl, phenyl or substituted phenyl;X and Y are each, independently, hydrogen, lower alkyl, lower alkoxy, or halogen, or together combine with the carbon atoms to which they are attached to complete a pyranyl, dihydrofuranyl, furanyl, or dioxanyl, group;Z is hydrogen, halogen or lower alkoxy; with the proviso that when X, Y or Z represent lower alkoxy, they are not present at the ortho position;W is hydrogen, halogen, lower alkyl, cyano or a trifluoromethyl group; andn is 2-5; orpharmaceutically acceptable salts thereof. Excerpt(s): The present invention relates to compounds useful for the treatment of diseases affected by disorders of the serotonin-affected neurological systems. More specifically, the present invention is directed to aryloxyethyl-indoly-alkylamine derivatives useful for the treatment of such diseases.... Pharmaceuticals which enhance neurotransmission of serotonin (5-HT) are useful for the treatment of many psychiatric disorders, including depression and anxiety. The first generation of non-selective serotonin-affecting compounds operated through a variety of physiological means which caused them to possess numerous undesired side effects, such as dry mouth, blurred vision, and sedation due to multiple receptor activities. The more recently introduced compounds, i.e., the selective serotonin reuptake inhibitors (SSRIs), act predominately by inhibiting 5-HT, which is released at the synapses, from being actively removed from the synaptic cleft via a presynaptic serotonin transport carrier. As SSRIs require several weeks before they exert their full therapeutic effect, this 5-HT blockade mechanism cannot fully account for their therapeutic activity. It is speculated that this two week induction which occurs before a full antidepressant effect is observed, is due to the involvement of the 5-HT1A autoreceptors which suppress the firing activity of the 5-HT neurons, causing a dampening of the therapeutic effect. Studies suggest that after several weeks of SSRI administration, a desensitization of the 5-HT autoreceptors occurs allowing a full antidepressant effect in most patients, see Le Poul et al., Arch. Pharmacol., 352:141 (1995). Hence, it is believed that overriding this negative feedback by using 5HT1A antagonists would increase and accelerate the clinical antidepressant response. Recent studies by Artigas et al., Trends Neurosci., 19:378-383, (1996) suggest that a combination of 5-HT1A activity and inhibition of 5-HT uptake within a single molecular entity can achieve a more robust and fast-acting antidepressant effect.... The present invention relates to a new class of molecules which have the ability to act concommitantly at the 5-HT1A autoreceptors and with the 5-HT transporter. Such compounds are therefore potentially useful for the treatment of anxiety or depression, as well as other serotonin disorders. Web site: http://www.delphion.com/details?pn=US06121307__

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Neuroprotective composition for the prevention and/or treatment of nervous and behavioural alterations due to anxiety states or depression, comprising acetyl-Lcarnitine and hypericin Inventor(s): Cavazza; Claudio (Rome, IT) Assignee(s): Sigma-Tau Healthscience S.p.A. (Pomezia, IT) Patent Number: 6,346,282 Date filed: December 26, 2000 Abstract: This invention relates to a composition of acetyl-L-carnitine in combination with hypericin and/or Hypericum extract (Hypericum perforatum L. (St. John's Wort)) in synergistically effective amounts. The composition is effective at treating a nervous alteration due to an anxiety state, irritability, or depression. Excerpt(s): The present invention relates to a composition for the prevention and/or treatment of nervous and behavioural alterations due to anxiety states or depression.... Accordingly the composition may take the form and exert the action of a dietary supplement or of an actual medicine, depending upon the support or preventive action, or the strictly therapeutic action, which the composition is intended to exert in relation to the particular individuals it is to be used in.... (b) 1,3,4,6,8,13-hexahydroxy-10,11dimethylphenanthro[1,10,9,8-opqra]perylene- 7,14-dione (hypericin) or Hypericum extract (Hypericum perforatum L., "Saint-John's-wort") comprising at least 0.3% by weight of hypericin. Web site: http://www.delphion.com/details?pn=US06346282__

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Paroxetine in the treatment of depression associated with withdrawal from heroin abuse and post-traumatic stress disorder Inventor(s): Gleason; Maurice (Newbury, GB) Assignee(s): SmithKline Beecham plc (Brentford, GB) Patent Number: 6,121,291 Date filed: February 11, 1999 Abstract: This invention relates to the use of paroxetine or a pharmaceutically acceptable salt thereof for the treatment of post-traumatic stress disorder and depression associated with withdrawal from heroin abuse. Excerpt(s): The present invention relates to the treatment and/or prevention of specific types of depression.... U.S. Pat. No. 4,007,196 discloses the compound, (-)-trans-4-(4'fluorophenyl)-3-(3'4'-methylenedioxy-phenoxymethyl) piperidine, and, in Example 2, a process by which it can be prepared. The compound, which is referred to herein by its common name, paroxetine, is described in the patent as an inhibitor of 5hydroxytryptamine uptake and, therefore, is of use in the treatment of depression in general.... It has now been surprisingly discovered that paroxetine has particularly effective therapeutic utility for treating and/or preventing specific types of depression. Web site: http://www.delphion.com/details?pn=US06121291__

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Pharmaceutical composition comprising at least tyrosine and an iron compound for treating Parkinson's disease or depression Inventor(s): Bridgeman; Keith (19 Westminster Close, Eastbourne, East Sussex BN22 OLQ, GB) Assignee(s): none reported Patent Number: 6,200,607 Date filed: September 13, 1999 Abstract: A pharmaceutical product comprises the use of a combination of tyrosine and iron for separate, sequential or simultaneous administration for the treatment of Parkinson's disease or depression. In a preferred embodiment the product also contains at least one of a vitamin B6 (e.g. pyridoxine), a folate (e.g. folic acid), a vitamin B3 (e.g. nicotinamide), or zinc. The product enables the natural biosynthesis, secretion, transport and action of dopamine. Excerpt(s): The invention herein relates to the treatment of Parkinson's disease and/or depression.... Parkinson's disease is a medical disorder whose characteristic symptoms are due to excessive muscle contraction. This often begins as a tremor, which can develop into muscle rigidity, and then to a complete lack of physical movement. Usually, it does not develop until adulthood and becomes progressively more common with age.... It is caused by the insufficient action of dopamine, which normally acts by preventing excessive muscle contraction. Although dopamine is produced in the dopaminergic neurons in the brain, it is not normally administered to treat the disorder since dopamine does not easily pass between the blood brain barrier. Web site: http://www.delphion.com/details?pn=US06200607__

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Pharmaceutical compositions for treatment of depression and low blood pressure Inventor(s): Al-Damluji; Saad (London, GB2) Assignee(s): National Research Development Corporation (London, GB2) Patent Number: 5,240,930 Date filed: February 22, 1991 Abstract: A pharmaceutical composition which comprises a mixture of an alpha-2 adrenoceptor antagonist, preferably idazoxan, or a pharmaceutically acceptable salt thereof, and either a catecholamine precursor or an inhibitor of aromatic L-amino acid decarboxylase, preferably carbidopa. The compositions can be used for treatment of endogenous depression or low blood pressure. Excerpt(s): This invention relates to pharmaceutical compositions.... Adrenaline and noradrenaline are substances that are released from nerve endings in the brain and in the periphery, and from the adrenal glands. They act as chemical messengers or `neurotransmitters`. Adrenaline, noradrenaline and a related substance, dopamine, belong to a class of chemicals known as the catecholamines. They are synthesised in the body from the amino acid tyrosine. Tyrosine is a natural dietary amino acid, but the body can also synthesise tyrosine from the amino acid phenylalanine. Tyrosine is converted into dihydroxyphenylalanine, which is in turn converted to dopamine, noradrenaline, and finally to adrenaline.... Adrenergic receptors (usually known as adrenoceptors) are the sites of action of adrenaline and noradrenaline. They mediate physiological or pharmacological effects upon stimulation by an appropriate chemical,

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be it an endogenous substance or a synthetic drug with similar activity (agonist drug). By using a variety of pharmacological techniques, these receptors have been classified into alpha and beta adrenoceptors. Alpha adrenoceptors have in turn been subdivided into alpha-1 and alpha-2 adrenoceptor subtypes. Alpha-2 adrenoceptors are located in the membranes both of the target cells for adrenaline and noradrenaline (known as post synaptic alpha-2 adrenoceptors), and in the noradrenergic neurones themselves (known as presynaptic alpha-2 adrenoceptors). The presynaptic alpha-2 adrenoceptors inhibit the release of noradrenaline from its nerve terminals and act as a `negative feedback` mechanism following the release of noradrenaline from its nerve terminals. Thus, stimulation of alpha-2 adrenoceptors by agonists, including the endogenous neurotransmitters adrenaline and noradrenaline, reduces the amount of neurotransmitter released from the neuron. Conversely, administration of an alpha-2 adrenoceptor antagonist drug will increase the amount of neurotransmitter released from the neuron, by blocking the presynaptic alpha-2 adrenoceptors. Alpha-2 adrenoceptor antagonists are currently being investigated for a possible therapeutic effect in illnesses that are believed to be associated with reduced noradrenaline activity, such as endogenous depression. It has also been proposed that alpha-2 adrenoceptor antagonists may be therapeutically useful in the treatment of low blood pressure states, by increasing the output of noradrenaline, which increases the blood pressure. Web site: http://www.delphion.com/details?pn=US05240930__ •

Process for reducing depression Inventor(s): Wurtman; Richard J. (Waban, MA) Assignee(s): Massachusetts Institute of Technology (Cambridge, MA) Patent Number: 4,377,595 Date filed: May 29, 1980 Abstract: The level of norepinephrine in neuronal synapses is regulated in order to treat depression by administering a neutral amino acid composition to a human wherein an increased brain level of norepinephrine is effected when the composition contains increased amounts of tyrosine and/or phenylalanine. Increased or decreased brain levels of serotonin are obtained when the amino acid composition contains increased or decreased amounts of tryptophan.The neutral amino acid composition can be administered alone or concomitantly with a drug which increases or decreases noradrenergic neurotransmission. Excerpt(s): This invention relates to a method and composition for treating depression in humans by increasing the level of norepinephrine in neuronal synapses.... It is well known that the neutrotransmitters dopamine and nonrepinephrine are derived from dihydroxyphenylalanine (DOPA). DOPA is, in turn, produced in neurons by the enzymatic hydroxylation of the amino acid tyrosine. This process is catalyzed by the enzyme tyrosine hydroxylase. The DOPA is decarboxylated to dopamine by the enzyme aromatic L-amino acid decarboxylase (AAAD) and norepinephrine is produced from dopamine in neurons that also contain the enzyme dopamine betahydroxylase. It is also known that within this reaction chain, the rate-limiting step is the conversion of tyrosine to DOPA. For this reason, DOPA has been administered to patients who suffer medical disability resulting from dopamine deficiency in diseases such as Parkinson's Disease. Unfortunately, DOPA, when administered, is taken up by cells throughout the body and converted to dopamine and this interferes with the normal metabolic processes in these other cells. In addition, DOPA interferes with the body's normal storage of the

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neurotransmitter serotonin, and lowers brain levels of the compound Sadenosylmethionine. It is believed that these effects contribute to such unwanted sideeffects as the "On-Off Phenomenon" and, in some patients, psychotic symptoms. Other types of drugs that act by increasing dopamine and norepinephrine levels in synapses include the Monoamine Oxidase Inhibitors (which slow the destruction of these neurotransmitters) and the tricyclic antidepressants; these compounds, which are used in treating diseases like depression, also relatively non-specific--producing many chemical effects besides increasing synaptic dopamine and norepinephrine levels and thus have a range of unwanted side-effects such as the dangerous increases in blood pressure that occur when people receiving monoamine oxidase inhibitors eat certain foods.... Other diseases appear to be caused by the presence of excessive quantities of dopamine or norepinephrine within synapses including psychosis (too much dopamine), and hypertension and cardiac arrhythmias (too much norepinephrine released from sympathetic neurons). These diseases now usually are treated by drugs that block the interactions of dopamine or norepinephrine with their post-synaptic receptors, such as phenothiazines or butyrophenones. However, these agents all exhibit some non-specific actions as well, and thus cause side-effects. Web site: http://www.delphion.com/details?pn=US04377595__ •

Psychoactive 1,3,4-benzotriazepine-2-thiones and a method for treating central nervous system depression and anxiety Inventor(s): Trepanier; Donald L. (Midland, MI), Britton; Thomas C. (Midland, MI) Assignee(s): The Dow Chemical Company (Midland, MI) Patent Number: 4,194,000 Date filed: February 13, 1978 Abstract: Novel 1,3,4-benzotriazepine-2-thiones and related tricyclic derivatives having central nervous system activity and a method of use for treating the symptoms of central nervous system depression and anxiety. Excerpt(s): A number of methods for preparing 1,3,4-benzotriazepine-2-ones have been described in the literature. In general, the compounds are prepared by either of two methods from a 2-aminobenzophenone. In the first method the 2-aminobenzophenone is treated with semicarbazide to give an aminobenzophenone semicarbazone. This product is cyclized to give the benzotriazepine-2-one. See Bull. Chem. Soc. Jap. 43, 135-138 (1970); Japanese publications 70 11,148 (CA73:25544a) and 70 11,147 (CA73:25545b). Alternately, a 2-aminobenzophenone hydrazone is treated with phosgene to give the desired benzotriazepine-2-one. See U.S. Pat. No. 3,176,008; J. Pharm. Sci. 63(6), 838-41 (1974); and J. Med. Chem. 7(3), 386 (1964). Despite the reported central nervous system activity of the 1,3,4-benzotriazepine-2-ones, the thio analogues are unknown and no satisfactory method for their preparation has been described in the literature.... The present invention is directed to novel 1,3,4-benzotriazepine-2-thiones, related tricyclic derivatives and their method of use as psychoactive agents.... The invention also includes the pharmaceutically-acceptable salts of the benzotriazepine-2-thiones and tricyclic used in the practice of the present invention. As used in the specification and claims, the term "pharmaceutically-acceptable salts" refers to non-toxic acid addition salts of the compounds, the anions of which are relatively innocuous to animals at dosages consistent with good anti-depressant activity so that the beneficial effects of the free base are not vitiated by the side effects ascribable to the anions. Pharmaceuticallyacceptable salts include those derived from mineral acids such as hydrochloric and

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sulfuric and from organic acids such as lactic, maleic, succinic, fumaric, glutaric, citric, malic, p-toluenesulfonic, methanesulfonic, and tartaric acid and the like. Web site: http://www.delphion.com/details?pn=US04194000__ •

Remediation of depression through computer-implemented interactive behavioral training Inventor(s): Merzenich; Michael M. (San Francisco, CA), Blake; David T. (San Francisco, CA) Assignee(s): Scientific Learning Corporation (Berkeley, CA), The Regents of the University of California (Oakland, CA) Patent Number: 6,165,126 Date filed: September 15, 1998 Abstract: A computer-implemented technique for remediating depression in a person which includes assessing, using a computer-implemented interactive behavioral assessment regime, a depression index for the person. If the depression index is above a predefined benchmark, the computer-implemented technique includes periodically reassessing the depression index by waiting for at least a predefined period of time, and performing the above assessing step after the predefined period of time expires. If the depression index is below the predefined benchmark, treating the person by administering computer-implemented interactive behavioral training to the person. The computer-implemented interactive behavioral training is sufficiently intensive during each training day to create a permanent change in modulatory functions of neurotransmitters of one of norepinephrine and serotonin in the person. Excerpt(s): The present invention relates to computer-implemented interactive training techniques for treating depression. More specifically, the present invention relates to intensive computer-implemented behavioral training techniques that effectively remediate symptoms of clinical depression and of depressive personality disorders.... Depression in its manifold specific forms is the most common form of diagnosed mental illness. Although the symptoms may vary in different individuals, a common distinction between depressives differentiates `unipolar` from `bipolar` individuals. The former have a single-polar (depressed) disorder of mood. The latter swing alternatively (commonly with a cycle period of days to weeks in duration) between depression and mania. Within these simple distinctions and under the broad umbrella term `depression` fall many depression subtypes and an overlapping classification of an often-milder `depressive personality`.... There are many thousands of published reports on the epidemiology, neurology, and treatment of this commonly occurring illness, and many thousands more publications relate to the study of its underlying neurology. Generally speaking, there are two primary treatment strategies that have been effective for very large populations of depressives. These two primary treatment strategies involve phamacological therapies and psychological therapies. Generally speaking, there are three primary treatment strategies that have been effective for large populations of depressives. These three treatments are pharmacotherapy, psychotherapy, and electroconvulsive therapy. Web site: http://www.delphion.com/details?pn=US06165126__

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Therapeutic uses of a diphenylsulfide compound to treat depression and effect serotonin uptake Inventor(s): Mehta; Nariman B. (Leesburg, FL), Brieaddy; Lawrence E. (Raleigh, NC) Assignee(s): Burroughs Wellcome Co. (Research Triangle Park, NC) Patent Number: 5,216,028 Date filed: July 3, 1991 Abstract: A halogen-substituted diphenylsufide compound is disclosed which produce a large selective inhibition of serotonin uptake in brain. This compound is useful in the treatment of depression as well as anxiety, obsessive compulsive disorders and alcoholism. Excerpt(s): The present invention relates to a 5-chloro-substituted diphenylsulfide, processes for its preparation, pharmaceutical formulations containing it, and its use in medicine, in particular, for the treatment of depression.... Certain 2-hydroxymethyl diphenylsulfides with antidepressant activity are disclosed in U.K. Patent Specification 1,561,072 (U.S. Pat. No. 4,056,632). Compounds which inhibit serotonin uptake are described in U.S. Pat. No. 4,194,009. The use of serotonin uptake inhibitors for treatment of depression is discussed by Benfield et al., Drugs, 32, 481 (1986) and Burrows et al., J. Clin. Psychiatry, 49 Suppl., 18 (1988).... The compound of the present invention is useful in the treatment of depression in mammals. It produces a surprising and large selective inhibition of serotonin uptake in brain. In the compound of formula (I), below, this serotonin uptake inhibition is unexpectedly and surprisingly better than the serotonin uptake inhibition produced by the corresponding non-halogen substituted compounds of U.S. Pat. No. 4,056,632. Web site: http://www.delphion.com/details?pn=US05216028__

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Treating depression by administering an antidepressant Inventor(s): Dudley; Mark W. (Hamilton, OH) Assignee(s): Merrell Pharmaceuticals, Inc. (Cincinnati, OH) Patent Number: 5,880,120 Date filed: September 11, 1997 Abstract: The present invention provides novel compounds such as certain aryloxy indanamines which are useful as anti-depressants and as inhibitors of synaptic norepinephrine and serotonin uptake. The present invention also provides an improvement in the treatment of depression which comprises inhibiting synaptic serotonin and epinepherine uptake. Excerpt(s): or an acid addition salt thereof.... R.sub.1 is a divalent alkylene group comprised of 1 to 3 carbon atoms of straight or branched chain configuration including, for example, --CH.sub.2 --, --CH.sub.2 CH.sub.2 --, --CH.sub.2 CH.sub.2 CH.sub.2 --, -C(CH.sub.3).sub.2 --, and --CH(CH.sub.3)CH.sub.2 --. Where R.sub.1 is --CH.sub.2 --, the compounds of formula (1) are aryloxy indanamine derivatives; where R.sub.1 is -CH.sub.2 CH.sub.2 --, the compounds of formula (1) are aryloxy-1,2,3,4tetrahydronapthylamine derivatives; where R.sub.1 is --CH.sub.2 CH.sub.2 CH.sub.2 --, the compounds of formula (1) are aryloxy-5,6,7,8-benzocycloheptenamine derivatives.... The aryloxy moiety of compounds of formula (1) can be mono- or di-substituted at any feasible position(s) in the ring (when q is 1 or 2, respectively) or it can be unsubstituted

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(when q is 0). X is independently chosen each time it is taken so that when q is 2 the aryloxy moiety is di-substituted with the same or different substituents. Likewise, the fused-ring moiety can be mono- or di-substituted at any of the 4, 5, 6, or 7 position(s) (when p is 1 or 2, respectively) or it can be unsubstituted (when p is 0). Y is independently chosen each time it is taken so that when p is 2 the fused-ring moiety is di-substituted with the same or different substituents. R.sub.2 and R.sub.3 can be independent moieties or they can be taken together with the nitrogen to which they are attached to form a pyrrolidino, morpholino, piperidino, piperazino, or 4methylpiperazino group. Web site: http://www.delphion.com/details?pn=US05880120__ •

Treating depression with alcohol extracts of tobacco Inventor(s): Williams; Jonnie R. (Manakin-Sabot, VA), Delorenzo; Robert J. (Richmond, VA), Burton; Harold R. (Lexington, KY) Assignee(s): Regent Court Technologies (Town and Country, MI) Patent Number: 6,350,479 Date filed: June 4, 1999 Abstract: The present invention provides a group of tobacco alkaloids, tobacco extract, Yerbamate extract, and an extract of chewing gum and lozenges which are modulators of monoamine oxidase (MAO) activity (i.e., compounds and substances which inhibit MAO enzyme and prevent its biological activity). The MAO inhibitors of the present invention can cause an increase in the level of norepinephrine, dopamine, and serotonin in the brain and other tissues, and thus can cause a wide variety of pharmacological effects mediated by their effects on these compounds. The MAO inhibitors of the present invention are useful for a variety of therapeutic applications, such as the treatment of depression, disorders of attention and focus, mood and emotional disorders, Parkinson's disease, extrapyramidal disorders, hypertension, substance abuse, smoking substitution, antidepression therapy, eating disorders, withdrawal syndromes, and the cessation of smoking. Excerpt(s): The present invention relates to the novel use of compounds and substances which are capable of modulating monoamine oxidase (MAO) activity by inhibiting the MAO enzyme. The present invention also relates to MAO inhibitors and their therapeutic use as a drug or dietary supplement in the treatment of various conditions or disorders, including psychiatric and neurological illnesses. More particularly, the present invention relates to the therapeutic use of tobacco alkaloids, Yerbamate (Ilex paraguariensis) extract, or tobacco extracts to inhibit MAO activity to provide a treatment for various disorders or conditions.... By inhibiting MAO activity, MAO inhibitors can regulate the level of mono amines and their neurotransmitter release in different brain regions and in the body (including dopamine, norepinephrine, and serotonin). Thus, MAO inhibitors can affect the modulation of neuroendocrine function, respiration, mood, motor control and function, focus and attention, concentration, memory and cognition, and the mechanisms of substance abuse. Inhibitors of MAO have been demonstrated to have effects on attention, cognition, appetite, substance abuse, memory, cardiovascular function, extrapyramidal function, pain and gastrointestinal motility and function. The distribution of MAO in the brain is widespread and includes the basal ganglia, cerebral cortex, limbic system, and mid and hind-brain nuclei. In the peripheral tissue, the distribution includes muscle, the gastrointestinal tract, the cardiovascular system, autonomic ganglia, the liver, and the

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endocrinic system.... It has been suggested that cigarette smoke may have irreversible inhibitory effect towards monoamine oxidase (MAO). A. A. Boulton, P. H. Yu and K. F. Tipton, "Biogenic Amine Adducts, Monoamine Oxidase Inhibitors, and Smoking," Lancet, 1(8577): 114-155 (Jan. 16, 1988), reported that the MAO-inhibiting properties of cigarette smoke may help to explain the protective action of smoking against Parkinson's disease and also observed that patients with mental disorders who smoke heavily do not experience unusual rates of smoking-induced disorders. It was suggested that smoking, as an MAO inhibitor, may protect against dopaminergic neurotoxicity that leads to Parkinson's disease and that the MAO-inhibiting properties of smoking may result in an antidepressive effect in mental patients. Web site: http://www.delphion.com/details?pn=US06350479__ •

Treatment of depression Inventor(s): Sanchez; Connie (Glostrup, DK) Assignee(s): H. Lundbeck A/S (Valby-Copenhagen, DK) Patent Number: 6,358,966 Date filed: March 15, 2001 Abstract: The compound 1'-[4-[1-(4-fluorophenyl)-1H-indole-3-yl]-1-butylspiro[isobenzo-furan-1(3 H,4'-piperidine] is active in models predictive of antidepressant effects and is useful for the preparation of a medicament for the treatment of depression or diseases associated with depressive symptoms. Excerpt(s): The present invention relates to the use of the compound 1'-[4-[1-(4fluorophenyl)-1H-indole-3-yl]-1-butyl]-spiro[isobenzofuran-1(3 H),4'-piperidine] or a pharmaceutically acceptable salt thereof for the preparation of medicaments for the treatment of depression.... International Patent Publication No. WO 92/22554 describes a series of sigma receptor ligands considered useful for the treatment of a range of psychic and neurological disorders. The structure activity relationship of these compounds has been further investigated by Perregaard, J. et al., J. Med. Chem., 1995, 38, 11, p. 1998-2008.... which is the subject of the present invention. This compound was shown in Perregaard, J. et al., J Med. Chem., 1995, 38, 11, p. 1998-2008 to be a potent and selective sigma ligand, in particular a sigma.sub.2 ligand. Furthermore, the anxiolytic potential of the compound was tested in the black/white exploration test in rats, which is an animal model predictive for effect in the treatment of generalised anxiety disorder. It was found to be active over a large dose range. Results of further tests in generalised anxiety disorder models are reported in J Pharmacol. Exp. Ther., 1997, 283, No. 2. Web site: http://www.delphion.com/details?pn=US06358966__

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Treatment of depression and anxiety with fluoxetine and an NK-1 receptor antagonist Inventor(s): Carlson; Emma Joanne (Puckeridge, GB), Rupniak; Nadia Melanie (Bishops Stortford, GB) Assignee(s): Merck Sharp & Dohme Ltd. (Hoddesdon, GB) Patent Number: 6,319,953 Date filed: December 8, 1999

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Abstract: The present invention relates to the treatment or prevention of depression and/or anxiety by the administration of a combination of a specific class of NK-1 receptor antagonists and fluoxetine. Excerpt(s): This invention relates to the treatment or prevention of depression and/or anxiety by the administration of a combination of a specific class of NK-1 receptor antagonists and an antidepressant or anti-anxiety agent. The present invention also provides preclinical screens for anxiolytic and antidepressant activity of NK-1 receptor antagonists.... Major depression is characterised by feelings of intense sadness and despair, mental slowing and loss of concentration, pessimistic worry, agitation, and selfdeprecation. Physical changes also occur, especially in severe or "melancholic" depression. These include insomnia or hypersomnia, anorexia and weight loss (or sometimes overeating), decreased energy and libido, and disruption of normal circadian rhythms of activity, body temperature, and many endocrine functions.... Treatment regimens commonly include the use of tricyclic antidepressants, monoamine oxidase inhibitors, some psychotropic drugs, lithium carbonate, and electroconvulsive therapy (ECT) (see R. J. Baldessarini in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Edition, Chapter 19, McGraw-Hill, 1996 for a review). More recently, new classes of antidepressant drugs are being developed including selective serotonin reuptake inhibitors (SSRIs), specific monoamine reuptake inhibitors and 5-HT.sub.1A receptor agonists, antagonists and partial agonists. Web site: http://www.delphion.com/details?pn=US06319953__ •

Treatment of depression and pharmaceutical preparations therefor Inventor(s): Coppen; Alec James (Epsom, GB) Assignee(s): Scarista Limited (Douglas, GB) Patent Number: 6,191,133 Date filed: June 24, 1998 Abstract: It has been found that the treatment of depression using known serotonin reuptake inhibitors (SRIs) and noradrenaline reuptake inhibitors (NRIs) may be improved by the administration therewith of folic acid or a precursor which produces folate in the patient. The daily dose of NRI or SRI is as prescribed for treatment of depression in the usual way. The daily dose of the folic acid or precursor should be such as to provide a folate dosage of 300-5000 micrograms/day. Excerpt(s): This invention relates to the treatment of depression, and to pharmaceutical preparations for use therein.... Depression is one of the most important health care problems, especially in developed countries. At some time in their lives, about 5-10% of the population goes through a major depressive illness while minor depressive episodes may affect 25% or more of the population. The World Health Organisation has estimated that depression causes more global distress than any other illness.... Depression seriously disrupts people's lives, rendering existence both at home and at work difficult. Depression is the commonest reason for suicide. Depression is also associated with other illnesses, particularly cardiovascular diseases. People with a history of major depression were over four times more likely to have a myocardial infarction than normal individuals, even after allowing for known coronary disease risk factors (L A Pratt et al, Circulation 1996; 3123-3129). After a myocardial infarction, people with major depression are 3.5 times more likely to die than those who are not depressed (N Frasure-Smith et al, JAMA 1993; 1819-1825). There is therefore a particular

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need for effective treatments for depression which may be applied in particular to people with cardiovascular problems. Web site: http://www.delphion.com/details?pn=US06191133__ •

Treatment of depression by using a fluorophenacylamine derivative Inventor(s): Lafon; Louis (Paris, FR) Assignee(s): Lafon; Laboratoire L. (FR) Patent Number: 4,861,801 Date filed: March 10, 1989 Abstract: The present invention relates to a process for the treatment of depression comprising administering to a human in need thereof an antidepressant amount of a compound selected from 1-(2-fluorophenyl)-2-tertiobutylamino-1-ethanol and an addition salt thereof. Excerpt(s): In the following specification, fluorophenacylamine derivatives are understood to mean not only compounds having a fluorophenacyl group or formula F-C.sub.6 H.sub.4 --CO--CH.sub.2 --, but also a.beta.-hydroxyfluorophenethyl group of formula F--C.sub.6 H.sub.4 --CHOH--CH.sub.2 --, which derives from the preceding one by reduction of the carbonyl function into alcohol function.... Compounds of the 2amino-1-(halogenophenyl)-1-ethanol type are included in the formula of French patent No. 1 503 517 and presented as antidiuretic agents. However, it should be noted that this French patent describes no 1-(fluorophenyl), 1-(chlorophenyl), 1-(bromophenyl) and 1(iodophenyl) derivatives, nor does it suggest their potential actions on the CNS.... It is known that fluorophenacyl-amine derivatives belonging to the family of 2-amino-1(fluorophenyl)-1-ethanols have already been described. In particular, the article by A.M. Lands, J. Pharmacol. Exptl. Therap. 106, 440-443 (1952) discloses 1-(3-fluorophenyl)-2isopropylamino-1-ethanol and 1-(3-fluorophenyl)-2-tertiary-butylamino-1-ethanol as being weak pressor agents. The article by L. Villa, et al., Il Farmaco Ed. Scientifica, 24 (No. 3), 329-340 (1969), discloses 1-(4-fluoropyhenyl)-2-isopropylamino-1-ethanol and 1(2-fluorophenyl)-2-isopropylamino-1-ethanol. These known fluorinated products act on the CNS but they have no, or only slight, aggression-reducing effect. Further, analogous compounds are also disclosed as being adrenergic blocking agents in the article by B. Levy, et al., J. Pharamacol. Exptl. Therap., 133, 202-210 (1961); as appetite-supressing agents in U.S. Pat. Nos. 3,313,687 (Siemer) and 3,465,039 (Seimer); as CNS-stimulant and antidepressant agents in U.S. Pat. No. 3,819,706 (Mehtay) and as anti-diuretic agents in British Patent No. 1,043,510. Web site: http://www.delphion.com/details?pn=US04861801__

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Treatment of depression with kappa receptor antagonists Inventor(s): Carlezon, Jr. William A. (Belmont, MA) Assignee(s): The McLean Hospital Corporation (Belmont, MA) Patent Number: 6,528,518 Date filed: December 20, 2001 Abstract: The invention features the treatment of depression using kappa opioid receptor antagonists.

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Excerpt(s): The mesolimbic dopamine system, which originates in the ventral tegmental area and projects to the nucleus accumbens (NAc), is involved in the pleasurable (hedonic) and rewarding effects of a variety of substrates, including drugs of abuse, food, and sexual behavior. Drugs of abuse cause complex neuroadaptations in this system, some of which are associated with altered drug sensitivity. One neuroadaptation involves cAMP response element-binding protein (CREB), a transcription factor that is activated in striatal regions by psychostimulants. CREB in the NAc appears to regulate the rewarding and aversive effects of cocaine. Stimulation of cAMP-dependent protein kinase A (PKA), which activates CREB, in the NAc decreases cocaine reward. Similarly, elevation of CREB expression in the NAc decreases cocaine reward and makes low doses of the drug aversive. Conversely, blockade of PKA activity or overexpression of a dominant-negative CREB, which functions as a CREB antagonist, in the NAc increase cocaine reward. These findings suggest that CREB activation in the NAc counteracts drug reward and increases drug aversion.... Cocaine alters neuronal excitability and neurotransmitter levels in the brain, particularly the mesolimbic dopamine system. Cocaine withdrawal is accompanied by signs of depression and other mood disorders in humans. The biological basis of mood disorders like depression is not understood, but may be caused by genetic and environmental factors. Physically and emotionally stressful events can also influence the etiology of depression, possibly causing subtle brain changes and alterations in gene expression. Thus, depression may have an important acquired component, caused by neuroadaptations in response to environment and experience.... The therapeutic actions of antidepressants appear to involve neuroadaptations. Most antidepressant treatments (including tricyclic and atypical antidepressants, selective serotonin reuptake inhibitors, electroconvulsive therapy) have common actions on components of the cAMP pathway. Common actions include activation of PKA and the transcription factor CREB in the hippocampus, a brain region associated with emotion. CREB plays a critical role in the expression of numerous genes. Understanding causal relations among CREB function, gene expression, and the therapeutic effects of antidepressants might provide explanations for why antidepressants require sustained treatment for effectiveness. Additionally, because some genes regulated by CREB may be therapeutic while others may be pathophysiological, a more general understanding of the role CREB in behavior might help to elucidate the biological basis of depressive syndromes. Web site: http://www.delphion.com/details?pn=US06528518__ •

Treatment of mental conditions including depression Inventor(s): Renshaw; Perry F. (Arlington, MA) Assignee(s): The McLean Hospital Corporation (Belmont, MA) Patent Number: 6,258,794 Date filed: October 17, 2000 Abstract: The invention provides methods of treating a patient suffering from depression by increasing circulating adenosine levels in the patient. The invention also features diagnostic methods for depression which involve measuring purine or NTP resonance intensity. Excerpt(s): Major depression has been associated with both global and regional decreases in cerebral blood flow and glucose metabolism, assessed using emission tomography methods (reviewed in 1). In parallel, single voxel phosphorus-31 MRS has been used to document decreased levels of beta and total NTP in the basal ganglia (2; -

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16% and -6%) and the bilateral frontal lobes (3; -17% and -8%). Although these results are somewhat surprising, they are consistent with observations obtained from the cerebral cortex of polysubstance abusers (5; -10% and -7%) and decline in beta NTP in the basal ganglia of schizophrenics (4; -11%), disorders which have also been associated with sustained cerebral hypometabolism.... Over the last several years, van Zijl and colleagues (6,7,8) have clearly demonstrated that a.sup.1 H MRS resonance which arises from purines may be detected in the range 7.8-8.8 PPM using short echo times. This resonance arises primarily from adenosine phosphates, with a smaller contribution from NAA at 7.8-8.0 PPM.... We have reanalyzed the low field purine resonance in short echo time STEAM spectra acquired from the basal ganglia of depressed and healthy subjects (9). As a subset of these subjects also participated in a.sup.31 P MRS study (2), the relationship between the.sup.1 H MRS purine-resonance and the.sup.31 PNTP resonance was assessed. Finally, as all of the depressed study subjects were enrolled in a standardized clinical trial,.sup.1 H MRS purine measures were correlated with the clinical response to treatment. Web site: http://www.delphion.com/details?pn=US06258794__ •

Treatment of mild depression and restoration of IGF-I levels in aging by dehydroepiandrosterone Inventor(s): Morales; Arlene J. (San Diego, CA), Yen; Samuel S. C. (La Jolla, CA) Assignee(s): The Regents of the University of California (Oakland, CA) Patent Number: 5,407,927 Date filed: April 16, 1993 Abstract: This invention relates to the treatment of mild depression in an aging patient population. The invention specifically relates to daily treatment with dehydroepiandrosterone to increase insulin-like growth factor-I serum levels and increase psychological well-being in these patients. Excerpt(s): This invention relates to the treatment of mild depression in an aging patient population. The invention specifically relates to daily treatment with dehydroepiandrosterone to increase insulin-like growth factor-I serum levels and increase psychological well-being in these patients.... This invention provides for a method of increasing endogenous levels of insulin-like growth factor-I (IGF-I) in mature humans by treatment with daily doses of 15-150 mg of dehydroepiandrosterone (DHEA). Preferentially the treated humans are from 40-80 years of age, and more preferentially from 50-70 years of age. The dose of DHEA is preferentially from 15-100 mg, and more preferentially from 40-100 mg. The method of administration of DHEA is either oral or sublingual, and the time period of daily administration exceeds 3 months.... This invention also provides for a method of treating mature humans with mild depression by treatment with daily doses of DHEA. Preferentially the humans are from 40-80 years of age and more preferentially from 50-70 years of age. The dose of DHEA is preferentially between 15-150 mg, and more preferentially between 40 and 100 mg. The method of administration of DHEA is either oral or sublingual, and the time period of daily administration exceeds 3 months. Web site: http://www.delphion.com/details?pn=US05407927__

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Tropane derivatives with selective binding to the serotonin reuptake transporters for treatment of mental illness and as intermediates in the formation of imaging diagnostic agents for depression Inventor(s): Davies; Huw M. L. (Clarence Center, NY), Kong; Norman (Lincoln Park, NJ), Childers; Steven R. (Winston-Salem, NC) Assignee(s): Wake Forest University (Winston-Salem, NC), The Research Foundation of State University of New York (Amherst, NY) Patent Number: 6,013,242 Date filed: January 13, 1998 Abstract: Biologically active derivatives of the tropane ring system are provided which selectively bind either to the 5-HT or DA reuptake site, leading to compounds which have use for the treatment of clinical depression, attention deficit disorder, obesity and cocaine addiction. Excerpt(s): The tropane skeleton is a basic structural unit that can lead to compounds with diverse central nervous system (CNS) activity. Due to the rigid nature of the structure, the possibility exists for the preparation of highly selective compounds. This application describes the synthesis of tropane derivatives that selectively bind to the serotonin (5-HT) transporter and thus have the potential for the treatment of major depression, attention-deficit hyperactivity disorder, obesity and cocaine addiction. Furthermore, it describes the synthesis of trialkyltin and iodinated derivatives, that are useful for the preparation of radiolabeled compounds that can be used to map the 5-HT transporters and are therefore useful as diagnostic agents for depression.... Major depression represents one of the most common mental illnesses, affecting between 510% of the population. The disease is characterized by extreme changes in mood which may also be associated with psychoses. It has generally been found that most antidepressant agents exert significant effects on the regulation of monoamine neurotransmitters. The tricyclic antidepressants, such as imipramine, are the most commonly used drugs for the treatment of depression. Their ability to inhibit the neuronal uptake of norepinephrine is believed to be a major factor behind their efficacy.... A number of new types of antidepressants have been developed in recent years. Two compounds that are currently marketed in the United States are trazodone and fluoxetine. Both of these compounds interact with the regulation of 5-HT. Trazodone controls the actions of 5-HT while fluoxetine is a potent and selective inhibitor of 5-HT reuptake. 3-Chloroimipramine which inhibits both 5-HT and norepinephrine reuptake has been extensively used as an antidepressant in Europe and Canada. Other compounds which are of current interest or have been examined as antidepressants include fluvoxamine, citalopram, zimeldine, sertraline, bupropion and nomifensine. All of these drugs inhibit monamine uptake mechanisms, but differ in selectivity between the dopamine, 5-HT and norepinephrine transporters. Web site: http://www.delphion.com/details?pn=US06013242__

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Use of 5-(substituted phenyl)-oxazolidinone derivatives for treatment of depression Inventor(s): Wachtel; Helmut (Berlin, DE), Schneider; Herbert H. (Berlin, DE) Assignee(s): Schering Aktiengesellschaft (Berlin and Bergkamen, DE) Patent Number: 4,824,838 Date filed: November 16, 1987

Patents 487

Abstract: 5-(substituted phenyl)-oxazolidinones are useful for treatment of depression. Excerpt(s): The invention relates to the provision of medicaments useful in treating depression.... It is known from U.S. Pat. No. 4 186 129 that 5-(substituted phenyl)oxazolidinone derivatives have phospho- diesterase-inhibiting properties and moreover have central depressive, antidopaminergic, antinociceptive and anticonvulsive effects. Further, in German patent application No. 3438839 other 5-(substituted phenyl)oxazolidinones are described which have anti-inflammatory properties in topical application.... It is an object of this invention to provide medicaments which are valuable antidepressants. Web site: http://www.delphion.com/details?pn=US04824838__ •

Use of a compound for the treatment of sleep disorders and depression Inventor(s): Blanchard; Jean-Charles (Saint Mande, FR), Laduron; Pierre (Paris, FR), Stutzmann; Jean-Maris (Villecresnes, FR) Assignee(s): Rhone-Poulenc Sante (Antony, FR) Patent Number: 4,906,649 Date filed: August 22, 1988 Abstract: 2-amino-6-(trifluoromethoxy)benzothiazole may be used in the production of a sleep-regulating medicinal product, which is useful in the treatment of sleep disorders and in the treatment of depression. Excerpt(s): The present invention relates to the application of 2-amino-6(trifluoromethoxy)benzothiazole or a pharmaceutically acceptable salt thereof for obtaining a sleep-regulating medicinal product which is useful in the treatment of sleep disorders and in the treatment of depression.... It is known from European Patent 50,551 that 2-amino-6-(trifluoromethoxy)benzothiazole is useful as an anticonvulsant, anxiolytic and hypnotic medicinal product.... It has now been found that 2-amino-6(trifluoromethoxy)benzothiazole or a pharmaceutically acceptable salt thereof has an action on slow-wave sleep and also on paradoxical sleep. It is hence useful in the treatment of sleep disorders and the treatment of depression, a disease in which it is known that the amount of paradoxical sleep and the latency of onset of the paradoxical sleep phases are reduced (MENDLEWICZ et al., Acta Psychiat. Scand. 320, 26-29, 1985). Web site: http://www.delphion.com/details?pn=US04906649__

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Use of isoflavonoids in the treatment or prevention of postpartum depression Inventor(s): Gorbach; Sherwood L. (31 Perry La., Weston, MA 02193) Assignee(s): none reported Patent Number: 6,083,526 Date filed: May 22, 1997 Abstract: A method of treating or preventing postpartum depression by administration of a composition containing one or more purified, naturally-occurring isoflavonoids. Excerpt(s): The present invention relates to therapies for the prevention and treatment of postpartum depression, as well as other psychological disturbances that develop after childbirth.... It has long been recognized that psychological disturbances are very

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common in the postpartum period, usually beginning within 6 weeks after delivery. The psychological conditions can range from "maternity blues," which are usually mild, to a more severe depression, which is known to occur in fully 10% of postpartum women. Depression can have psychological effects that last for several months and occasionally even longer. A related concern is the impaired cognitive abilities and delayed social development that can be seen in the children of women who have experienced postpartum depression. At least a part of the explanation for postpartum depression is the changing hormone milieu in the woman's body following childbirth. Estrogen hormone achieves and maintains a high level during pregnancy and then drops precipitously within 48 hours after delivery to nearly the follicular level, which is the lowest level in a normally menstruating woman. This causes an acute estrogen withdrawal state, which could have effects on psychological and mental functioning. In this regard postpartum depression has been treated successfully with estrogen. In other reports estrogen has been administered immediately after childbirth to prevent recurrence of depression and other psychological disorders in women who are at risk of developing these problems in the postpartum period. Various antidepressant drugs, such as lithium, tricyclic compounds and serotonin-specific reuptake inhibitors (SSRI), have been used in postpartum depression with varying degrees of success. There is, however, concern about their side effects and their safety in breastfeeding women. Treatment with large doses of estrogen is also a concern in breastfeeding women. Safer, effective therapies for treating and preventing postpartum depression continue to be sought.... The invention features a method of treating or preventing postpartum depression in a woman who has recently given birth to a baby; the method involves administering to the woman, within six weeks (and preferably, within 24, or even 12, hours) a composition containing one or more purified isoflavonoids selected from the group consisting of genistein, daidzein, biochanin A, formononetin, Odesmethylangolensin, glycitin, and equol. Preferably, the composition is administered orally, providing a dosage of at least 20 mg of total isoflavonoid per serving. The orallyadministerable composition can be a non-naturally occurring dietary product such as a convectionary bar, cereal, biscuit, or beverage. Alternatively, the composition can take the form of a medicament such as a pill, capsule, tablet, powder, or syrup, in which the total isoflavonoid is present in at least an amount of 20 mg per unit dose. Preferably, the dietary product or medicament is orally consumed by the patient once, twice, or three times per day, to provide a daily oral isoflavonoid dose of between 20 and 300 mg. Preferably, the oral ingestion of the composition is sufficient to produce a transient concentration in the bloodstream of the woman of at least 50 nm of total isoflavonoid per liter of blood. By "purified" isoflavonoid is meant an isoflavonoid in more concentrated form than occurs in plants. Web site: http://www.delphion.com/details?pn=US06083526__

Patent Applications on Depression As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to depression:

10

This has been a common practice outside the United States prior to December 2000.

Patents 489

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Anticonvulsant derivatives useful for the treatment of depression Inventor(s): Bacaltchuk, Josue; (Sao Paulo, BR), Plata-Salaman, Carlos R. (Ambler, PA), Prado-Lima, Pedro A.S. (Porto Alegre, BR) Correspondence: AUDLEY A. CIAMPORCERO JR. JOHNSON & JOHNSON; ONE JOHNSON & JOHNSON PLAZA; NEW BRUNSWICK; NJ; 08933-7003; US Patent Application Number: 20020094960 Date filed: July 27, 2001 Abstract: Anticonvulsant derivatives useful for treating depression as monotherapy or combination therapy are disclosed. Excerpt(s): This application claims priority from U.S. provisional application Serial No. 60/222,489 file Aug. 02, 2000, the contents of which are hereby incorporated by reference.... The present invention is directed to anticonvulsant derivatives useful in the treatment of depression, specifically unipolar depression, treatment-refractory depression, resistant depression, anxious depression and dysthymia. The present invention is further directed to the treatment of depression comprising administration of one or more anticonvulsant derivatives in combination with one or more compounds selected from mono-amine oxidase inhibitors, tricyclics, serotonin reuptake inhibitors, serotonin noradrenergic reuptake inhibitors, noradrenergic and specific serotonergic agents, noradrenaline reuptake inhibitors, natural products, dietary supplements, neuropeptides, compounds targeting neuropeptide receptors or hormones.... are structurally novel antiepileptic compounds that are highly effective anticonvulsants in animal tests (MARYANOFF, B. E, NORTEY, S. O., GARDOCKI, J. F., SHANK, R. P. AND DODGSON, S. P. J. Med. Chem. 1987,30, 880-887; MARYANOFF, B. E., COSTANZO, M. J., SHANK, R. P., SCHUPSKY, J. J., ORTEGON, M. E., AND VAUGHT J. L. Bioorg. Med. Chem. Lett. 1993,3,2653-2656; SHANK, R. P., GARDOCKI, J. F., VAUGHT, J. L., DAVIS, C. B., SCHUPSKY, J. J., RAFFA, R. B., DODGSON, S. J., NORTEY, S. O., MARYANOFF, B. E. Epilepsia 1994, 35,450-460; MARYANOFF B E, COSTANZO M J, NORTEY S O, GRECO M N, SHANK R P, SCHUPSKY J J, ORTEGON M P, VAUGHT J L. J. Med. Chem. 1998,41, 1315-1343). These compounds are covered by three U.S. patents: U.S. Pat. Nos. 4,513,006, 5,242,942, and 5,384,327. One of these compounds 2,3:4,5-bis-O-(1-methylethylidene)-.beta.-D-fructo- pyranose sulfamate, known as topiramate, has been demonstrated in clinical trials of human epilepsy to be effective as adjunctive therapy or as monotherapy in treating simple and complex partial seizures and secondarily generalized seizures (E. FAUGHT, B. J. WILDER, R. E. RAMSEY, R. A. REIFE, L D. KRAMER, G. W. PLEDGER, R. M. KARIM et. al., Epilepsia 1995, 36 (S4), 33; S. K. SACHDEO, R. C. SACHDEO, R. A. REIFE, P. LIM and G. PLEDGER, Epilepsia 1995, 36 (S4), 33; T. A. GLAUSER, Epilepsia 1999, 40 (S5), S71-80; R. C. SACHDEO, Clin. Pharmacokinet. 1998, 34, 335-346), and is currently marketed for the treatment of seizures in patients with simple and complex partial epilepsy and seizures in patients with primary or secondary generalized seizures in the United States, Europe and most other markets throughout the world. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Aryl-8-azabicyclo [3.2.1] octanes for the treatment of depression Inventor(s): Gilbert, Adam M. (Congers, NY) Correspondence: Joseph M. Mazzarese; Wyeth; Patent Law Department; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20030032645 Date filed: May 20, 2002 Abstract: The present invention includes compounds of formula I 1wherein A, X, n, Ar.sub.1, and Ar.sub.2 are defined as set forth herein. These compounds may be used to treat depression. The invention also includes formulations containing these compounds, and methods for making and using compounds of this invention. Excerpt(s): The present invention relates to aryl-8-azabicyclo[3.2.1]octane and aryl-8azabicyclo[3.2.1]oct-2-ene derivatives having pharmacological activity, and to their use in the treatment of diseases affected by disorders of the serotonin affected neurological systems, such as depression and anxiety.... Pharmaceuticals which enhance serotonergic neurotransmission are useful for the treatment of many psychiatric disorders, including depression and anxiety. The first generation of non-selective serotonin-affection drugs operated through a variety of physiological functions which endowed them with several side effect liabilities. The more currently prescribed drugs, the selective serotonin reuptake inhibitors (SSRIs), act predominately by inhibiting 5-HT, which is released at the synapses, from being actively removed from the synaptic cleft via a presynaptic serotonin transport carrier (5-HT-T).... The present invention relates to a new class of molecules which have the ability to act at the 5-HT transporter. Such compounds are therefore potentially useful for the treatment of depression as well as other serotonin disorders. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Aryloxy piperidinyl indoles for treating depression Inventor(s): Zhou, Ping; (Plainsboro, NJ), Zhou, Dahui; (East Brunswick, NJ), Mewshaw, Richard E. (King of Prussia, PA) Correspondence: Joseph M. Mazzarese; American Home Products Corporation; Patent Law Department; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20020099078 Date filed: November 15, 2001 Abstract: This invention provides aryloxy indole derivatives which are useful for the treatment of diseases affected by disorders of the serotonin-affected neurological systems, such as depression and anxiety, the compounds having the formula: 1wherein R.sup.1 is H or alkyl; R.sub.2, R.sub.3, and R.sub.4 are H, alkyl, or halogen; X is H, halogen, CN, or C.sub.1-C.sub.6 alkoxy; Z is (CH.sub.2).sub.n or carbonyl; n is 1 or 2; and the dashed line indicates an optional double bond; or a pharmaceutically acceptable salt thereof. Excerpt(s): This application claims priority from copending provisional application(s) serial No. 60/249,633 filed Nov. 17, 2000, the entire disclosure of which is hereby incorporated by reference.... This invention relates to new aryloxy indole derivatives as pharmaceuticals which are useful for the treatment in mammals of diseases affected by disorders of the serotonin-affected neurological systems, such as depression, anxiety,

Patents 491

panic disorder, obsessive-compulsive disorder, sleep disorders, sexual dysfunction, bipolar disorders, psychosis, stress-related disorders, including post-traumatic stress disorders, Tourettes' syndrome, attention deficit disorder, with and without hyperactivity, alcohol and drug addiction, Alzheimer's disease, Parkinson's disease, obesity and acute and chronic pain, including migraine pain, as well as methods of enhancing cognition.... Pharmaceuticals which enhance serotonergic neurotransmission are of useful benefit for the treatment of many psychiatric disorders, including depression and anxiety. The first generation of non-selective serotonin-affecting drugs operated through a variety of physiological functions which endowed them with several side effect liabilities. The more currently prescribed drugs, the selective serotonin (5-HT) reuptake inhibitors (SSRIs), act predominately by inhibiting 5-HT, which is released at the synapses, from being actively removed from the synaptic cleft via a presynaptic serotonin transport carrier. Since SSRIs require several weeks before they exert their full therapeutic effect, this 5-HT blockade mechanism per se cannot account for their therapeutic activity. It is speculated that this two week induction which occurs before a full antidepressant effect is observed, is due to the involvement of the 5-HT.sub.1A autoreceptors which suppress the firing activity of 5-HT neuron, causing a dampening of the therapeutic effect. Studies suggest that after several weeks of SSRI administration, a desensitization of the 5-HT autoreceptors occurs allowing a full antidepressant effect in most patients. Recent studies by Artigas et al. (Trends Neurosci., 1996, 19, 378-383) suggest a combination of 5-HT.sub.1A activity and inhibition of 5-HT uptake within a single molecular entity can achieve a more robust and fast-acting antidepressant effect. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Association of the muscarinic cholinergic 2 receptor (CHRM2) gene with major depression in women Inventor(s): MacMurray, James P. (Loma Linda, CA), Comings, David E. (Duarte, CA) Correspondence: ROTHWELL, FIGG, ERNST & MANBECK, P.C. 1425 K STREET, N.W. SUITE 800; WASHINGTON; DC; 20005; US Patent Application Number: 20030087267 Date filed: June 11, 2002 Abstract: The present invention relates to the observation that women having an A.fwdarw.T 1890 polymorphism in the 3' UTR of the cholinergic muscarinic receptor 2 (CHRM2) gene have an increased risk for developing major depression. The present invention provides diagnostic, screening and therapeutic methods based on that observation. Excerpt(s): The present application is related to U.S. provisional application Ser. No. 60/298,108 filed Jun. 15, 2001, incorporated herein by reference.... Not applicable.... The present invention relates to screening patients to determine their risk for having major depression. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Combination therapy for treatment of depression Inventor(s): Skolnick, Phil; (Edgewater, NJ) Correspondence: ELI LILLY AND COMPANY; PATENT DIVISION; P.O. BOX 6288; INDIANAPOLIS; IN; 46206-6288; US Patent Application Number: 20030092770 Date filed: October 23, 2002 Abstract: The present invention provides a method for treating depression, comprising administering to a patient an effective amount of a first component which is a suitable antidepressant, in combination with an effective amount of a second component which is a suitable AMPA receptor potentiator. Excerpt(s): In the mammalian central nervous system (CNS), the transmission of nerve impulses is controlled by the interaction between a neurotransmitter, that is released by a sending neuron, and a surface receptor on a receiving neuron, which causes either an excitation or inhibition of this receiving neuron. L-Glutamate, which is the most abundant neurotransmitter in the CNS, mediates the majority of excitatory transmission in mammals, and is referred to as an excitatory amino acid (EAA). The receptors that respond to glutamate are generally referred to as excitatory amino acid receptors (EAA receptors). See Watkins & Evans, Ann. Rev. Pharmacol. Toxicol., 21, 165 (1981); Monaghan, Bridges, and Cotman, Ann. Rev. Pharmacol. Toxicol., 29, 365 (1989); Watkins, Krogsgaard-Larsen, and Honore, Trans. Pharm. Sci., 11, 25 (1990). The excitatory amino acids are of great physiological importance, playing a role in a variety of physiological processes, such as long-term potentiation (learning and memory), the development of synaptic plasticity, motor control, respiration, cardiovascular regulation, and sensory perception.... Excitatory amino acid receptors are classified into two general types.... Receptors that are directly coupled to the opening of cation channels in the cell membrane of the neurons are termed "ionotropic". This type of receptor has been subdivided into at least three subtypes, which are defined by the selective agonists N-methyl-D-aspartate (NMDA), alpha-amino-3-hydroxy-5methylisoxazole-4-propionic acid (AMPA), and kainic acid (KA). The second general type of receptor is the G-protein or second messenger-linked "metabotropic" excitatory amino acid receptor. This second type of EAA receptor is coupled to multiple second messenger systems that lead to enhanced phosphoinositide hydrolysis, activation of phospholipase D, increases or decreases in c-AMP formation, and changes in ion channel function. Schoepp and Conn, Trends in Pharmacol. Sci., 14, 13 (1993). Both types of receptors appear not only to mediate normal synaptic transmission along excitatory pathways, but also participate in the modification of synaptic connections during development and throughout life. Schoepp, Bockaert, and Sladeczek, Trends in Pharmacol. Sci., 11, 508 (1990); McDonald and Johnson, Brain Research Reviews, 15, 41 (1990). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 493

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Combination treatment for anxiety and depression Inventor(s): Howard, Harry R. JR. (Bristol, CT) Correspondence: PFIZER INC; 150 EAST 42ND STREET; 5TH FLOOR - STOP 49; NEW YORK; NY; 10017-5612; US Patent Application Number: 20020165217 Date filed: February 13, 2002 Abstract: The present invention relates to a method of treating depression or anxiety in a mammal, including a human, by administering to the mammal a GABA-A alpha 2/3 agonist in combination with an SRI antidepressant agent with improvement in efficacy. It also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a GABA-A alpha 2/3 agonist, and an SRI antidepressant agent. Excerpt(s): The present invention relates to a method of treating anxiety and depression with improved efficacy in a mammal, including a human, by administering to the mammal a GABA-A alpha 2/3 agonist in combination with a serotonin reuptake inhibitor (SRI). It also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a GABA-A alpha 2/3 agonist and a serotonin reuptake inhibitor (SRI).... Major depression is characterized by feelings of intense sadness and despair, mental slowing and loss of concentration, pessimistic worry, agitation, and self-deprecation. Physical changes also occur, especially in severe or "melancholic" depression. These include insomnia or hypersomnia, anorexia and weight loss (or sometimes overeating), decreased energy and libido, and disruption of normal circadian rhythms of activity, body temperature, and many endocrine functions.... Serotonin Selective Reuptake Inhibitors (SSRIs) currently provide efficacy in the treatment of major depressive disorder (MDD) and are generally perceived by psychiatrists and primary care physicians as effective, well-tolerated and easily administered. However, they are associated with undesirable features, such as high incidence of sexual dysfunction, delayed onset of action and a level of nonresponsiveness estimated to be as high as 30% (see M. J. Gitlin, Journal of Clinical Psychiatry, 1994, 55, 406-413 and R. T. Segraves, Journal of Clinical Psychiatry, 1992, 10(2), 4-10). Preclinical and clinical evidence has indicated that the sexual dysfunction associated with SSRI therapy can be reduced through the use of serotonin reuptake inhibitors (SRI) and dopamine reuptake inhibitors (DRIs), such as bupropion (see A. K. Ashton, Journal of Clinical Psychiatry, 1998, 59(3), 112-115). Furthermore, the combination of SRI and DRI may hasten the onset of action as well as offering relief to refractory patients, possibly through a synergistic mechanism (see R. D. Marshall et al, Journal of Psychopharmacology, 1995, 9(3), 284-286) and prove beneficial in the treatment of substance abuse and attention deficit hyperactivity disorder (ADHD) according to Barrickman et al, Journal of the American Academy of Child and Adolescent Psychology, 1995, 34(5), 649 and Shekim et al, Journal of Nervous and Mental Disease, 1989, 177(5), 296. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Drug combination for the treatment of depression and related disorders comprising mirtazapine Inventor(s): Ward, Nicholas Matthew; (Scotland, GB), Drinkenburg, Wilhelmus; (Molenschot, NL), Andrews, John Stuart; (Dorpstraat Schilde, BE) Correspondence: William M Blackstone; Akzo Nobel; Patent Department Intervet Inc; 405 State Street; Millsboro; DE; 19966; US Patent Application Number: 20030105083 Date filed: October 8, 2002 Abstract: The invention relates to a combination comprising an amount of mirtazapine, or a pharmaceutically acceptable salt or solvate thereof, and an amount of gepirone, or a pharmaceutically acceptable salt or solvate thereof, optionally in association with one or more pharmaceutically acceptable carriers, whereby the amount of gepirone and the amount of mirtazapine are such that the effect of the composition is more favourable than the added effects of the amounts of each drug separately. This combination can be used in the treatment of depression and related disorders, whereby the invention also provides for a new method of treatment of depression and related disorders. Excerpt(s): The invention relates to a combination comprising mirtazapine, to a package containing dosage units comprising mirtazapine, and to a method of treatment of depression and related disorders.... Disorders of the central nervous system, such as depression and anxiety are illnesses that affect people of all ages. Although there are many effective drugs available for treatment of these diseases, the currently available methods of treatment are often still not adequate. Most noteworthy is that there are no positive treatment results in about one third of all subjects with depression or anxiety and recovery in the effectively treated group is slow, with an onset of effect at the earliest two weeks after the start of drug treatment.... Mirtazapine (Org 3770; disclosed in U.S. Pat. No. 4,062,848), or the newly introduced drug gepirone (disclosed in U.S. Pat. No. 4,423,049), are examples of modern drugs for the treatments of depression and anxiety with favourable side effect profiles and very low risks for a lethal overdose. For more effective treatment there is hope that the different mechanisms of action of drugs enables complementary use, in the sense that patients not responding to one drug, may turn out to be responsive to another drug. Sometimes, drugs with the same therapeutic indication are prescribed as combination therapy in order to profit from such a mutually supplementary effect although it is generally not recommended to combine antidepressant drugs in view of risks for cumulative side effects or synergistic toxic interactions (Schweitzer and Tuckwell, in Drug Safety, Vol. 19, pp 455-464, 1998). Usually, if a seemingly positive effect of a known drug combination occurs in an individual patient, the positive effect is due to only one of the drugs in the combination. More desirable is a truly synergistic effect of two drugs with the same indication, in the sense that the effect of the combination is superior over an additive effect of the effects of both drugs in an individual patient. There are only very few synergistic therapeutic drug interactions known which have found acceptance in the area of treatment of central nervous system diseases. Most information is available on so-called augmentation therapy of treatment resistant depression by addition of lithium to antidepressant drugs. The use of such a combination is viewed with caution in view of the side effects of lithium (Hardy et al., Journal Clin. Psychopharmacology, vol. 17, pp 2226, 1997). The results of a combination of lithium with mirtazapine has been disclosed with favourable results, but the augmentation is not so strong that this combination would be selected as first choice treatment of depressive disorders (Bruijn et al., Journal Clin. Psychiatry, Vol. 59, pp 657-663, 1998).

Patents 495

Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Materials and methods for the treatment of depression Inventor(s): Druzgala, Pascal; (Santa Rosa, CA) Correspondence: SALIWANCHIK LLOYD & SALIWANCHIK; A PROFESSIONAL ASSOCIATION; 2421 N.W. 41ST STREET; SUITE A-1; GAINESVILLE; FL; 326066669 Patent Application Number: 20030078284 Date filed: October 18, 2002 Abstract: The subject invention provides compounds which are easily metabolized by the metobolic drug detoxification systems. Particularly, fluvoxamine analogs which have been designed to include esters within the structure of the compounds are taught. Also provided are methods of treating depression and affective disorders, such as obsessive compulsive disorder. Pharmaceutical compositions of the fluvoxamine analogs are also taught. Excerpt(s): This application is a continuation of U.S. Ser. No. 09/841,749, filed Apr. 24, 2001; which claims priority from provisional patent application U.S. Ser. No. 60/199,343, filed Apr. 24, 2000.... Major depression represents one of the most common mental illness, affecting between 5- 10% of the population. The disease is characterized by extreme changes in mood which may also be associated with psychoses. It has generally been found that most antidepressant agents exert significant effects on the regulation of monoamine neurotransmitters, including serotonin.... A number of types of antidepressants have been developed in recent years. Many of these compounds regulate serotonin (5-hydroxytryptamine; 5-HT). Trazodone controls the actions of 5-HT while fluoxetine is a potent and selective inhibitor of 5-HT reuptake. 3Chloroimipramine which inhibits both 5-HT and norepinephrine reuptake has been extensively used as an antidepressant in Europe and Canada. Other compounds which are of current interest or have been examined as antidepressants include fluvoxamine, citalopram, zimeldine, sertraline, bupropion and nomifensine. Fluvoxamine facilitates serotoninergic neurotransmission via potent and selective inhibition of scrotonin reuptake into presynaptic neurons. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method for the treatment of depression by inhibition of NAALADase Inventor(s): Lumley, Lucille A. (Silver Spring, MD), Meyerhoff, James L. (Silver Spring, MD) Correspondence: Nash & Titus, LLC; 3415 Brookeville Road; Brookeville; MD; 20833; US Patent Application Number: 20030013635 Date filed: April 11, 2002 Abstract: A method of treating depression and depression disorders which includes administering a pharmaceutically effective amount of one or more NAALADase inhibitors to a patient. NAALADase is an enzyme that hydrolyzes the peptide NAAG, a good peptide neurotransmitter in the brain. NAAG competes with the excitatory amino acid Glu. The excitatory amino acid Glu is released in the brain upon stress and can lead

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to depression. Hence, the inhibition of NAALADase directly decreases levels of Glu while increasing NAAG levels, contributes to and decreases depression. Excerpt(s): The present invention relates to the treatment of depression by inhibiting the enzyme NAALADase in the brain. NAALADase is an enzyme that hydrolyzes the peptide NAAG, a good peptide neurotransmitter in the brain. NAAG competes with the excitatory amino acid Glu. The excitatory amino acid Glu is released in the brain upon stress and can lead to depression. Hence, the inhibition of NAALADase directly decreases levels of Glu while increasing NAAG levels, contributes toand decreases depression.... Depression affects many people in this country and abroad. Depression is a neurotic or psychotic condition marked by an inability to concentrate, insomnia, and feelings of dejection and guilt. In some cases it is mild and in other cases it can even be debilitating. Depression is now well recognized as an extremely damaging and invalidating disorder and it has a very large prevalence. It is often associated with suicidal behaviour and people afflicted have a very low quality of life. Depression is a different condition than anxiety.... The use of NAALADase inhibition is a totally novel approach to treatment for depression. No other single compound elicits the same cluster of convergent physiological effects. Such a use has not been previously suggested. Other treatments are associated with undesirable profiles or unacceptable side effects. Benzodiazepines also are well-known to be associated with dependence/withdrawal. Drugs which directly block the NMDA-associated ion channel are associated with unacceptable behavioral toxicity [Tricklebank et al., 1989]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for treating depression Inventor(s): Oxenkrug, Gregory; (Newton, MA) Correspondence: NIXON PEABODY LLP; ATTENTION: DAVID RESNICK; 101 FEDERAL STREET; BOSTON; MA; 02110; US Patent Application Number: 20030176488 Date filed: March 18, 2003 Abstract: The present invention relates to a method and composition for the treatment of depression in a human being identified as having depression. This method comprises the administration of a therapeutically effective depression treatment amount of M-3 agonists, 5-MCA-NAT or an analog, to a human being identified as having depression. The 5-MCA-NAT and its analogs may be administered alone or in combination with other agents, e.g. Ca.sup.++ antagonists. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/559,609 filed on Apr. 27, 2000, the content of which is relied upon and incorporated by reference in its entirety, and benefit of priority under 35 USC.sctn. 120 in hereby claimed, which claims the benefit of U.S. Provisional Application No. 60/134,573 filed May 17, 1999.... The present invention relates to the method of treatment of depression in a human being identified as having depression. This method comprises the administration of a therapeutically effective depression treatment amount of agonists of melatonin-type 3 receptors (MT-3); 5 MCA-NAT and its analogs. MT-3 agonists may be administered alone or in combination with other agents, e.g. Ca.sup.++ antagonists.... Depression is a difficult mental disorder to treat. Patients having such a disorder are often reluctant to seek the medical attention necessary to diagnose the disorder. Such reluctance is often related to the patient's fear of the stigma associated with seeking

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psychiatric help or to the patient's feeling of worthlessness associated with depression. Moreover, once the patients seek competent psychiatric help, it is difficult to successfully treat the disorder through psychoanalytic approach alone. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for treating or preventing depression Inventor(s): Robichaud, Annette; (Montreal, CA), Reines, Scott A; (New Hope, PA), Tattersall, Frederick D; (Bishops Stortford, GB) Correspondence: MERCK AND CO INC; P O BOX 2000; RAHWAY; NJ; 070650907 Patent Application Number: 20030022814 Date filed: August 23, 2002 Abstract: A neurokinin-1 antagonist or an alpha-2 adrenoreceptor agonist provide an effective therapy in conjunction with a PDE4 inhibitor for the treatment or prevention of depression and/or anxiety. These combinations minimize the side effects of nausea and/or emesis associated with the PDE4 inhibitor and may also provide beneficial antidepressant and/or anti-anxiety effects. Excerpt(s): Depression is characterised by feelings of intense sadness and despair, mental slowing and loss of concentration, pessimistic worry, agitation, and selfdeprecation. Physical changes also occur, especially in severe or "melancholic" depression. These include insomnia or hypersomnia, anorexia and weight loss (or sometimes overeating), decreased energy and libido, and disruption of normal circadian rhythms of activity, body temperature, and many endocrine functions.... Treatment regimens commonly include the use of tricyclic antidepressants, monoamine oxidase inhibitors, some psychotropic drugs, lithium carbonate, and electroconvulsive therapy (ECT) (see R. J. Baldessarini in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Edition, Chapter 19, McGraw-Hill, 1996 for a review). More recently, new classes of antidepressant drugs are being developed including selective serotonin reuptake inhibitors (SSRIs), specific monoamine reuptake inhibitors and 5-HT1A receptor agonists, antagonists and partial agonists.... Anxiety is an emotional condition characterised by feelings such as apprehension and fear accompanied by physical sympoms such as tachycardia, increased respiration, sweating and tremor. It is a normal emotion but when it is severe and disabling it becomes pathological. Anxiety disorders are generally treated using benzodiazepine sedative-antianxiety agents. Potent benzodiazepines are effective in panic disorder as well as in generalised anxiety disorder, however, the risks associated with drug dependency may limit their long-term use. 5-HT1A receptor partial agonists also have useful anxiolytic and other psychotropic activity, and less likelihood of sedation and dependance (see R. J. Baldessarini in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Edition, Chapter 18, McGraw-Hill, 1996 for a review). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method of treating depression with delta receptor agonist compounds Inventor(s): Gengo, Peter J. (Raleigh, NC), Pendergast, William; (Durham, NC), Chang, Kwen-Jen; (Chapel Hill, NC) Correspondence: INTELLECTUAL PROPERTY / TECHNOLOGY LAW; PO BOX 14329; RESEARCH TRIANGLE PARK; NC; 27709; US Patent Application Number: 20030144299 Date filed: October 29, 2002 Abstract: Compositions and methods for treatment of depression or other affective mood disorders or pathological mental and/or emotional states, by administration to a subject suffering or susceptible to same, of therapeutically effective delta receptor agonist compound(s), optionally in combination with other mood disorder-combating agents. Excerpt(s): This application claims priority from U.S. Provisional Patent Application No. 60/340,084 filed on Oct. 29, 2001 and U.S. Provisional Patent Application No. 60/337,887 filed on Nov. 2, 2001.... The present invention relates to compositions and methods of treatment of depression or other affective mood disorders or pathological mental and/or emotional states, by administration to a subject suffering or susceptible to same, of delta opioid receptor agonist compound(s), optionally in combination with other agents.... Depression is a difficult mental disorder to treat. Patients having such a disorder are often reluctant to seek the medical attention necessary to diagnose the disorder. Such reluctance is often related to the patient's fear of the stigma associated with seeking psychiatric help or to the patient's feeling of worthlessness associated with depression. Moreover, once the patients seek competent psychiatric help, it is difficult to successfully treat the disorder through a psychoanalytic approach alone. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods and compositions for treating depression and other disorders using optically pure (-)-bupropion Inventor(s): Young, James W. (Palo Alto, CA) Correspondence: PENNIE & EDMONDS LLP; 1667 K STREET NW; SUITE 1000; WASHINGTON; DC; 20006 Patent Application Number: 20030022942 Date filed: July 26, 2002 Abstract: Methods and compositions are disclosed utilizing the optically pure (-)-isomer of bupropion, which is a potent drug for treating depression, Parkinson's disease, obesity, weight gain and other disorders. Excerpt(s): This invention relates to methods of treatment and pharmaceutical compositions employing the compound (-)-bupropion.... Many organic compounds exist in optically active forms, i.e., they have the ability to rotate the plane of plane-polarized light. In describing an optically active compound, the prefixes D and L or R and S are used to denote the absolute configuration of the molecule about its chiral center(s). The prefixes (+) and (-) or d and l are employed to designate the sign of rotation of planepolarized light by the compound, with (-) or l meaning that the compound is levorotatory. A compound prefixed with (+) or d is dextrorotatory. For a given chemical structure, these compounds, called stereoisomers, are identical except that they are

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mirror images of one another. A specific stereoisomer may also be referred to as an enantiomer, and a mixture of such isomers is often called an enantiomeric or racemic mixture.... Stereochemical purity is of importance in the field of pharmaceuticals, where 16 of the 20 most prescribed drugs exhibit chirality. A case in point is provided by the Lform of the.beta.-adrenergic blocking agent, propranolol, which is known to be 100 times more potent than the D-enantiomer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods and kits for treating depression or preventing deterioration of cognitive function Inventor(s): Thompson, David D. (Gales Ferry, CT), Petrie, Charles D. (Cranston, RI), Lee, Andrew G. (Old Lyme, CT), Day, Wesley W. (San Diego, CA) Correspondence: PFIZER INC. PATENT DEPARTMENT, MS8260-1611; EASTERN POINT ROAD; GROTON; CT; 06340; US Patent Application Number: 20030092719 Date filed: April 24, 2002 Abstract: The present invention provides methods and kits for treating depression, perimenopausal depression, schizophrenia, anxiety, panic attacks, binge eating, social phobia, or preventing deterioration of cognitive function by administering to a patient in need thereof a therapeutically effect amount of an estrogen agonist/antagonist of formula I 1 Excerpt(s): This application claims priority of U.S. provisional application No. 60/286,433, filed Apr. 25, 2001.... The present invention relates to the use of an estrogen agonist/antagonist for treating depression, perimenopausal depression, schizophrenia, anxiety, panic attacks, binge eating, social phobia, or preventing deterioration of cognitive function.... Estrogen has been associated with affective disorders. Depression is an affective disorder in which a patient feels sadness of such a scope and/or duration as to be clinically distinguishable from normal sadness. Depressed patients can have an overwhelming sense of uselessness and can feel lethargic and possibly suicidal. Unlike normal depression due to causative factors such as a death or bad news, a patient with clinical depression is unable to adjust to the causative factors over time and can remain in the depressed state for long periods of time. Other types of affective disorders can occur at particular time periods in a patient's life. For example, perimenopausal depression can occur in women who are near menopause. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods for improving the therapeutic response of humans having major depression and carrying the gene for apolipoprotein E4 Inventor(s): Schatzberg, Alan F. (Los Altos, CA), Murphy, Greer Marechal JR. (Stanford, CA) Correspondence: INTERVET INC; 405 STATE STREET; PO BOX 318; MILLSBORO; DE; 19966; US Patent Application Number: 20030105082 Date filed: December 3, 2001

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Abstract: This invention relates to a method for improving the therapeutic response of a human patient with major depression, characterised by genotyping said patient to be a carrier of the gene for apolipoprotein E4 and adapting the further treatment of the person differentially depending on the presence or absence of the said gene in the patient. Excerpt(s): The present invention relates to methods for improving the therapeutic response of human patients with major depression, particularly those carrying the gene for apolipoprotein E4.... Psychiatric diseases generally provide a unique set of complications for clinicians, patients, and care givers. Major depression, for instance, is a major health problem and poses a tremendous financial burden on society due to lost self-support of individuals suffering from depression. Such individuals are often simply unable to function in everyday life situations, in part because of feelings of extreme hopelessness and worthlessness. There is also a serious risk of suicide among such individuals. The various forms of depression are defined and are separately diagnosed according to criteria given in handbooks for psychiatry, for example in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) published by the American Psychiatric Association, Washington, D.C. (1994). The diagnostic criteria for major depression are well known to those skilled in the art, and comprise the criteria set forth, for example, at DSM-IV 296.2 and 296.3. Major depression, defined in more detail below, is also known as major depressive disorder and is estimated to affect between 5 to 10% of the human population.... Although treatments for different types of depression do exist, there is a continuous search for new methods of treatment of depression because existing methods still have disadvantages, such as the side effects of drugs, the long duration of treatments, and, more importantly, the partial efficacy (or inefficacy) of treatments. For example, there is wide variation in the response of patients with major depression to antidepressant pharmacotherapy. Some of this variation may be due to genetic differences among patients. Regardless, the result is that about 30% of patients with major depression who are treated with existing antidepressant drugs do not improve. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Omega-3 fatty acids in the treatment of depression Inventor(s): Stoll, Andrew; (Lincoln, MA) Correspondence: Choate, Hall & Stewart; Exchange Place; 53 State Street; Boston; MA; 02109; US Patent Application Number: 20030012827 Date filed: February 27, 2002 Abstract: The present invention is directed to a method of treating patients with major depression by administering omega-3 fatty acids. These may be administered in a substantially purified form, as part of a pharmaceutical composition, or as part of a larger molecule, e.g., a triacylglycerol, which releases free fatty acid after ingestion by a patient.The present invention is also directed to triacylglycerols which are esterified at the gamma cardon of glycerol to phosphocholine and at either the alpha or beta carbon of glycerol to an omega-3 fatty acid. These "omega-3 phoshatidylcholines" are also used in the treatment of patients with major depression. Excerpt(s): This application is a continuation-in-part of U.S. Patent Application entitled "Omega-3 Fatty Acids and Omega-3 Phosphatidylcholine in the Treatment of Bipolar

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Disorder", filed Feb. 5, 2002, using Express Mail No.: ET796587916US, which is a continuation of U.S. Ser. No. 09/269,361, filed Mar. 22, 1999, now issued as U.S. Pat. No. 6,344,482, which claims priority from PCT/US97/06712, filed Apr. 23, 1997. The contents of all of these applications are incorporated herein by reference.... The present invention relates to medical treatments for psychiatric disorders. More specifically, it is concerned with novel methods and compositions for treating patients with unipolar major depression.... Major depression is a neuropsychiatric illness characterized by a persistently low mood or diminished interests in one's surroundings, accompanied by at least several of the following symptoms: Reduced energy and motivation, difficulty concentrating, altered sleep and appetite, and at times, suicidal ideation (American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed. 4. Washington, American Psychiatric Association, 1994). Major depression without a history of abnormally elevated mood and energy (mania) is termed "unipolar major depression."However, a sizeable proportion of depressed patients presenting for treatment have bipolar disorder (also known as manic depressive illness), where there is a history of mania, or a milder form of mood elevation known as hypomania (Goodwin F K, Jamison K R: Manic Depressive Illness. London, Oxford University Press, 1990). Whether part of a unipolar or a bipolar illness, major depression is associated with high rates of morbidity and mortality, with suicide rates of 10-25% (Kaplan H I, Sadock B J (eds): Synopsis of Psychiatry. Baltimore, Williams & Wilkins, 1998, p. 866). According to the World Health Organization (WHO), major depression is the fourth leading cause of vocational disability on earth (Murray C J L, Lopez A D (eds): The Global Burden of Disease. Geneva, World Health Organization, 1996, vol. 1). Furthermore, the incidence of major depression increased and the age of onset of depression decreased with each passing decade of the 20th century (Klerman G L, Weissman M M: Increasing rates of depression. JAMA 1989; 261:2229-2235). Effective psychotherapeutic and pharmacological antidepressant treatments for major depression exist, but each has shortcomings. Two modern forms of psychotherapy, cognitive-behavioral therapy and interpersonal therapy, have shown efficacy in controlled studies of major depression (Kaplan, 1998, pp. 885-931). However, for moderate or severe depression, antidepressant medication is generally more effective, rapidly acting, and less expensive than psychotherapy. The combination of psychotherapy and medications has recently been shown to be superior to either treatment modality (Keller M B, et al.: A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med 2000; 342:14621470). There are more than 20 approved antidepressant drugs available in the United States. All of these medications have proven acute efficacy for major depression. The newer agents, such as the selective serotonin reuptake inhibitors (SSRIs), are far less toxic than the older classes of antidepressants, but even the SSRIs carry a substantial burden of side-effects, including sexual dysfunction, sleep disturbance, and weight gain (Kaplan, 1998). In addition, no currently available antidepressant is acutely effective in more than 60-70% of the patients who receive it. Furthermore, long-term data exists for only a few antidepressant drugs, and it appears that efficacy may diminish over time with some agents (Fredman S J, et al.: Partial response, nonresponse, and relapse with selective serotonin reuptake inhibitors in major depression: a survey of current "next-step" practices. J Clin Psychiatry; 2000, 61:403-408). Thus, there is a need for newer treatments, with greater efficacy and safety, as well as fewer side-effects. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Secreted protein associated with depression, compositions and methods of use thereof Inventor(s): Allen, Keith D. (Cary, NC), Reeder, Thadd C. (San Carlos, CA), Phillips, Russell; (Menlo Park, CA) Correspondence: DELTAGEN, INC. 740 Bay Road; Redwood City; CA; 94063; US Patent Application Number: 20030066098 Date filed: November 5, 2001 Abstract: The present invention relates to compositions and methods relating to the characterization of gene function. More particularly, the present invention relates to the role of secreted protein genes involved in neurobiological disorders, and in particular, depression. In addition, the present invention provides transgenic mice comprising mutations in a secreted protein gene. Such transgenic mice are useful as models for disease and for identifying agents that modulate gene expression and gene function, and as potential treatments for various disease states and disease conditions, including depression. Excerpt(s): This application claims priority to U.S. Provisional Application No. 60/245,852, filed Nov. 3, 2000.... The present invention relates to compositions and methods relating to the characterization of gene function.... Clinical depression is characterized by a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Symptoms include: persistent sad or anxious mood; feelings of hopelessness or pessimism; feelings of guilt, worthlessness or helplessness; loss of interest in pleasure activities; decreased energy; difficulty concentrating, remembering, or making decisions; sleep abnormalities (e.g. insomnia); appetite and/or weight loss; thoughts of death or suicide; restlessness; and irritability. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Treatment of depression Inventor(s): Carlezon, Wiliam A. JR. (Belmont, MA) Correspondence: CLARK & ELBING LLP; 101 FEDERAL STREET; BOSTON; MA; 02110; US Patent Application Number: 20020091075 Date filed: December 20, 2001 Abstract: The invention features the treatment of depression using kappa opioid receptor antagonists. Excerpt(s): This application claims priority from U.S. Provisional Application Serial No. 60/258,029, filed Dec. 21, 2000.... The mesolimbic dopamine system, which originates in the ventral tegmental area and projects to the nucleus accumbens (NAc), is involved in the pleasurable (hedonic) and rewarding effects of a variety of substrates, including drugs of abuse, food, and sexual behavior. Drugs of abuse cause complex neuroadaptations in this system, some of which are associated with altered drug sensitivity. One neuroadaptation involves cAMP response element-binding protein (CREB), a transcription factor that is activated in striatal regions by psychostimulants. CREB in the NAc appears to regulate the rewarding and aversive effects of cocaine. Stimulation of cAMP-dependent protein kinase A (PKA), which activates CREB, in the NAc decreases cocaine reward. Similarly, elevation of CREB expression in the NAc

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decreases cocaine reward and makes low doses of the drug aversive. Conversely, blockade of PKA activity or overexpression of a dominant-negative CREB, which functions as a CREB antagonist, in the NAc increase cocaine reward. These findings suggest that CREB activation in the NAc counteracts drug reward and increases drug aversion.... Cocaine alters neuronal excitability and neurotransmitter levels in the brain, particularly the mesolimbic dopamine system. Cocaine withdrawal is accompanied by signs of depression and other mood disorders in humans. The biological basis of mood disorders like depression is not understood, but may be caused by genetic and environmental factors. Physically and emotionally stressful events can also influence the etiology of depression, possibly causing subtle brain changes and alterations in gene expression. Thus, depression may have an important acquired component, caused by neuroadaptations in response to environment and experience. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Treatment of refractory depression with an opiate antagonist and an antidepressant Inventor(s): Glover, Hillel; (New York, NY) Correspondence: DICKSTEIN SHAPIRO MORIN & OSHINSKY LLP; 2101 L STREET NW; WASHINGTON; DC; 20037-1526; US Patent Application Number: 20030087896 Date filed: August 9, 2001 Abstract: An antidepressant or a pharmaceutically acceptable salt thereof, and an opiate antagonist or a pharmaceutically acceptable salt thereof, are used to treat refractory depression characterized by dissociation. Excerpt(s): The present invention relates to the use of opiate antagonist and an antidepressant to treat psychopathologic conditions, more particularly, the use of an opiate antagonist and an antidepressant to treat refractory depression characterized by dissociation and other psychopathologic conditions.... The use of opiate antagonists to treat psychological conditions is known and has been used by mental health practitioners, as is well known to those skilled in the mental health art. The combined use of such opiate antagonist with antidepressants has also been demonstrated to treat depression, however, has not been heretofore proposed or used to solve problems of treating refractory depression characterized by dissociation, as we presently understand the prior art.... This invention relates to a method of treating refractory depression. It relates particularly to a method of treating refractory depression characterized by dissociation by administering to a patient at least one opiate antagonist, as well as an antidepressant. The invention further relates to treating refractory depression characterized by dissociation by administering to a patient in need thereof at least one opiate antagonist, evaluating the patient for a response to the opiate antagonist, reassessing the patient for depression, and administrating at least one antidepressant to the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Use of GAL3 receptor antagonists for the treatment of depression and/or anxiety and compounds useful in such methods Inventor(s): Packiarajan, Mathivanan; (Saddle Brook, NJ), Jimenez, Hermo; (Hackensack, NJ), Chen, Heidi; (Wyckoff, NJ), Talisman, Ian Jamie; (New York, NY), Boteju, Lakmal W. (Cedar, NJ), Konkel, Michael J. (Garfield, NJ), Blackburn, Thomas P. (Hoboken, NJ), Wetzel, John M. (Fairlawn, NJ) Correspondence: Cooper & Dunham LLP; 1185 Avenue of the Americas; New York; NY; 10036; US Patent Application Number: 20030078271 Date filed: January 31, 2002 Abstract: This invention is directed to pyrimidine and indolone derivatives which are selective antagonists for the GAL3 receptor. The invention provides a pharmaceutical composition comprising a therapeutically effective amount of a compound of the invention and a pharmaceutically acceptable carrier. This invention also provides a pharmaceutical composition made by combining a therapeutically effective amount of a compound of the invention and a pharmaceutically acceptable carrier. This invention further provides a process for making a pharmaceutical composition comprising combining a therapeutically effective amount of a compound of the invention and a pharmaceutically acceptable carrier. This invention also provides a method of treating a subject suffering from depression and/or anxiety which comprises administering to the subject an amount of a compound of the invention effective to treat the subject's depression and/or anxiety. This invention also provides a method of treating depression and/or anxiety in a subject which comprises administering to the subject a composition comprising a pharmaceutically acceptable carrier and a therapeutically effective amount of a GAL3 receptor antagonist. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/265,586, filed Jan. 31, 2001, the contents of which is incorporated by reference into the subject application.... Throughout this application, various publications are referenced in parentheses by author and year. Full citations for these references may be found at the end of the specification immediately preceding the claims. The disclosures of these publications in their entireties are hereby incorporated by reference into this application to describe more fully the art to which this invention pertains.... Depression is the most common of mental disorders and yet is often underdiagnosed and undertreated, inflicting substantial morbidity and psychosocial impairment on its sufferers. Depression is mainly characterized by sadness, flatness, loss of feeling, anhedonia (lack of pleasure), tearfulness, agitation or retardation, thoughts of guilt, and worthlessness; in severe cases, suicide, hallucinations and delusions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Use of saredutant and of its pharmaceutically acceptable salts for the preparation of medicinal products that are useful in the treatment or prevention of all mood disorders, adaptation disorders or mixed anxiety-depression disorders Inventor(s): Soubrie, Philippe; (US), Emonds-Alt, Xavier; (US), Steinberg, Regis; (US) Correspondence: SANOFI-SYNTHELABO INC. 9 GREAT VALLEY PARKWAY; P.O. BOX 3026; MALVERN; PA; 19355; US Patent Application Number: 20030176462 Date filed: April 8, 2003 Abstract: The present invention relates to the use of saredutant and of its pharmaceutically acceptable salts for the preparation of medicinal products that are useful in the treatment or prevention of all mood disorders, adaptation disorders or mixed anxiety-depression disorders. Excerpt(s): The present invention relates to a novel use of saredutant.... This compound and its pharmaceutically acceptable salts are described in patent EP 0 474 561 B1 and in patent U.S. Pat. No. 5,236,921.... These compounds are described as antagonists of neurokinin A receptors and may be useful in any neurokinin A-dependent pathology and more particularly in neurogenic inflammations of the respiratory pathways. These compounds have also been described as powerful and selective non-peptide antagonists of the NK.sub.2 receptors of neurokinin A (Life Sciences, 1992, 50 (15), PL101-PL106). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with depression, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “depression” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on depression. You can also use this procedure to view pending patent applications concerning depression. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 7. BOOKS ON DEPRESSION Overview This chapter provides bibliographic book references relating to depression. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on depression include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “depression” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on depression: •

HIV and Depression: Context and Care Contact: University of California San Francisco, AIDS Health Project, HIV Neuropsychological Assessment and Counseling Program, PO Box 1312, San Francisco, CA, 94143-1312, (415) 476-3902. Summary: This monograph provides guidelines for diagnosing and treating depression in people with human immunodeficiency virus (HIV). It defines depression, and discusses its etiology, factors causing HIV-related depression, and the prevalence of depression. Case examples illustrate the difficulty of diagnosing and managing depression in someone with HIV and of integrating treatment modalities to get the best outcome. The monograph emphasizes that assessment of depressive symptoms is important and that depression should not be dismissed as a result of being seropositive. Symptoms should be explored at all three levels of the biopsychosocial model. Providers should assess biomedical manifestations of HIV, psychosocial components, and sociocultural factors. If clinical depression is diagnosed, the patient should be treated

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with both medication and psychotherapy. Thus the treatment plan should include broadening or deepening the patient's social connections. •

Interface Between Dementia and Depression Source: London, England: Martin Dunitz, Ltd. 1999. 58 p. Contact: Available from Martin Dunitz, Ltd. The Livery House, 7-9 Pratt Street, London NW1 0AE, ENGLAND. +44 020 7482 2202; FAX: +44 020 7267 0159. Internet: http://www.dunitz.co.uk. PRICE: 9.95 British pounds. ISBN: 1853176583. Summary: This book discusses the diagnosis and treatment of elderly patients with symptoms of both depression and dementia. The first section reviews the epidemiology of late-life depression and dementia. The second section addresses the clinical assessment of mixed depressive and cognitive states. It reviews tools and diagnotic criteria used to assess depression and dementia. The third section focuses on the depressed patient with cognitive impairment. It reviews research findings on the effectiveness of selected treatments for depression. The fourth section looks at treatment of depression in patients with dementia, including antidepressants and cognitive enhancers. The final section reviews the neurobiology of late-life depression and dementia, and examines theoretical models of the interface between the two disorders. Includes references.

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Differential Assessment of Dementia and Depression in Elderly People Source: in Safford, F. Krell, G.I., eds. Gerontology for Health Professionals: A Practical Guide. 2nd ed. Washington, DC: National Association of Social Workers. 1997. p. 56-73. Contact: National Association of Social Workers. PO Box 431, Annapolis Junction, MD 20701-0431. (800) 227-3590. PRICE: $24.95. ISBN: 0871012839. Summary: This book chapter is intended to guide health care providers in the differential diagnosis of dementia and depression in older people. It reviews obstacles to an accurate diagnosis and presents definitions of dementia, delirium, and depression. It outlines the cognitive, psychological, and behavioral symptoms of mental impairment and describes some of the assessment tools that may be useful in screening for dementia. It suggests an approach to collecting the types of information needed to make an accurate diagnosis, and compares some of the main features of dementia and depression to aid in the differentiation of the two disorders. A section on the assessment of depression focuses on the symptoms of depression that are more commonly seen in older patients, questions to ask during assessment, classification of types of depression, and some of the medical conditions and drugs that may cause depression. The chapter concludes with a discussion of issues in the treatment of dementia and depression in older patients.

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Neuropsychological Assessment of Dementia and Depression in Older Adults: A Clinician's Guide Source: Washington, DC: American Psychological Association. 1994. 219 p. Contact: American Psychological Association. 750 First Street, NE, Washington, DC 20002-4242. (202) 336-5500. PRICE: $39.95. ISBN: 1557982457. Summary: This book is intended to guide clinicians in the neuropsychological assessment of dementia and depression in older adults. It reviews current research on the diagnosis of dementia and depression, and offers practical recommendations for

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working with patients. It discusses general principles of assessment in older adults, the neuropsychological assessment of people with dementia, the assessment of depression in older adults, the differential diagnosis of dementia and depression, and clinical assessments to determine the legal competency of older adults. It also offers guidance on providing clinical interpretations to older clients and their families, and on applying assessment to therapy and intervention with older adults. Appendices present the results of a survey of clinicians' practices with older adults and a list of references to cognitive test norms for older adults. •

Depression in Neurologic Disease Source: Baltimore, MD: Johns Hopkins University Press. 1993. 246 p. Contact: Johns Hopkins University Press. 2715 North Charles Street, Baltimore, MD 21218-4319. (800) 537-5487; (410) 516-6956. PRICE: $55.00. Summary: This book presents 14 papers on depression in a wide range of neurologic illnesses. Issues of clinical manifestation, prognosis, and treatment are covered for each neurologic disorder. Each chapter addresses the cause of depression in each disorder and varying cause. Many of the papers report frequencies of 25 percent to 50 percent for depression among patient groups with disorders as diverse as stroke, Parkinson's disease, and multiple sclerosis. While depression is a common complication of neurologic disease, the evidence in some papers show it has a significant impact on progression of illness, recovery from illness, and even survival. Three chapters specifically address depression and its manifestation in Alzheimer's disease (AD) and dementia. These chapters report studies on the occurrence of depression in AD patients and correlate the clinical features of depression with the neuropathologic and neurochemical changes found at autopsy; present the relationship of depression to multi-infarct dementia, its frequency, etiology, and treatment; and examine the evidence supporting a phenomenon of depression-related cognitive impairments in patients with neurologic disorders, focusing on stroke and Parkinson's disease.

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Coping with Depression in a Chronic Illness Source: St. Clair Shores, MI: Michigan Lupus Foundation. 1995. 16 p. Contact: Michigan Lupus Foundation, 26202 Harper Avenue, St. Clair Shores, MI 48081. (810) 775-8330. PRICE: $3.00 each for 10 to 49 copies, plus $3.00 for postage and handling; $2.50 each for 50 or more copies, plus $4.00 for postage and handling. Summary: This booklet for individuals with a chronic illness is a revised version of a presentation given at the Annual Meeting of the Michigan Lupus Foundation in 1977. Depression caused by both internal and external sources is described. Factors that lead to depression in individuals with lupus erythematosus or other chronic diseases are discussed, including loss of self-esteem, lack of acceptance of limitations, feelings of guilt, financial stress, and fatigue. The ways in which depression hinders interpersonal relationships are explained. The sexual implications of chronic illness are considered. Suggestions for turning depression into strength are offered.

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Depressive Disorders and Immunity Contact: American Psychiatric Press, Inc., 1400 K St NW, Washington, DC, 20005, (800) 368-5777. Summary: This monograph presents principles of neural-immune integration. It focuses on understanding the immunology of depression to bring new insights into the current

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understanding of depression as a psychiatric disorder. The monograph explains why the study of the immune system is valuable when the primary interest is in the brain and behavior. It highlights major areas of investigation relating neuromotivation to immunity. The first area of interest is the relationship of immune function to the maintenance of health and the development of physical disease. The next area of interest is brain/immune system interactions, including the mechanisms of neural-immune integration and basic neuroimmunology. The final area of interest is the pathogenesis of psychiatric disorders as revealed through immune phenomena.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “depression” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “depression” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “depression” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

"Help Me, I'm Sad": Recognizing, Treating, and Preventing Childhood and Adolescent Depression by David G. Fassler, Lynne S. Dumas (1998); ISBN: 0140267638; http://www.amazon.com/exec/obidos/ASIN/0140267638/icongroupinterna

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100 Ways to Overcome Depression by Frank B. Minrith, et al (1993); ISBN: 0800786130; http://www.amazon.com/exec/obidos/ASIN/0800786130/icongroupinterna

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50 Ways to Fight Depression Without Drugs by M. Sara Rosenthal; ISBN: 0737305576; http://www.amazon.com/exec/obidos/ASIN/0737305576/icongroupinterna

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5-Htp: The Natural Way to Overcome Depression, Obesity, and Insomnia by Michael T. Murray; ISBN: 0553379461; http://www.amazon.com/exec/obidos/ASIN/0553379461/icongroupinterna

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7 Steps To Overcoming Anxiety and Depression by Gary Null; ISBN: 0743458818; http://www.amazon.com/exec/obidos/ASIN/0743458818/icongroupinterna

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A Parent's Guide to Childhood and Adolescent Depression (The Children's Hospital of Philadelphia) by Patricia Gottlieb Shapiro, et al; ISBN: 0440506336; http://www.amazon.com/exec/obidos/ASIN/0440506336/icongroupinterna

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A Woman Doctor's Guide to Depression: Essential Facts and Up-To-The-Minute Information on Diagnosis, Treatment, and Recovery (Books for Women by Women) by Jane S. Ferber, Suzanne Levert (Contributor); ISBN: 0786881461; http://www.amazon.com/exec/obidos/ASIN/0786881461/icongroupinterna

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Active Treatment of Depression by Richard O'Connor; ISBN: 0393703223; http://www.amazon.com/exec/obidos/ASIN/0393703223/icongroupinterna

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Acupuncture in the Treatment of Depression: A Manual for Practice and Research by Rosa N., Diplac Schnyer, et al; ISBN: 0443071314; http://www.amazon.com/exec/obidos/ASIN/0443071314/icongroupinterna

Books 511

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Adolescent Depression: A Guide for Parents by Francis Mark Mondimore (2002); ISBN: 0801870658; http://www.amazon.com/exec/obidos/ASIN/0801870658/icongroupinterna

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Amitriptyline in the management of depression; ISBN: 0911910743; http://www.amazon.com/exec/obidos/ASIN/0911910743/icongroupinterna

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Anxiety and Depression: A Natural Approach by Shirley Trickett, J. W. McDonald; ISBN: 1569752265; http://www.amazon.com/exec/obidos/ASIN/1569752265/icongroupinterna

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Anxiety, Depression, and Anger in Pain: Research Findings and Clinical Options by Ephrem Fernandez; ISBN: 097231640X; http://www.amazon.com/exec/obidos/ASIN/097231640X/icongroupinterna

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Assessing and Treating Late-Life Depression by Michele J. Karel, et al; ISBN: 0465095437; http://www.amazon.com/exec/obidos/ASIN/0465095437/icongroupinterna

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Behind the Smile: My Journey Out of Postpartum Depression by Marie Osmond, et al (2002); ISBN: 044667852X; http://www.amazon.com/exec/obidos/ASIN/044667852X/icongroupinterna

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Being Present in the Darkness: Using Depression As a Tool for Self-Discovery by Cheri Huber (1996); ISBN: 0399522239; http://www.amazon.com/exec/obidos/ASIN/0399522239/icongroupinterna

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Beyond the Baby Blues: Postpartum Depression and Psychosis (The Infinite Mind, Vol. 210) by Lichtenstein Creative Media Inc. ISBN: 1888064870; http://www.amazon.com/exec/obidos/ASIN/1888064870/icongroupinterna

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Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression by Shoshana S. Bennett, Pec Indman; ISBN: 0971712417; http://www.amazon.com/exec/obidos/ASIN/0971712417/icongroupinterna

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Biology of Depressive Disorders: Subtypes of Depression and Comorbid Disorders (The Depressive Illness Series, Vol 4) by J. John, M.D. Mann, David J., M.D. Kupfer (Editor) (1993); ISBN: 0306442965; http://www.amazon.com/exec/obidos/ASIN/0306442965/icongroupinterna

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Bipolar Disorder and Depression (Health Watch) by Susan Dudley Gold, Linda Zamvil; ISBN: 0766016544; http://www.amazon.com/exec/obidos/ASIN/0766016544/icongroupinterna

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Bipolar Disorder Demystified: Mastering the Tightrope of Manic Depression by Lana R. Castle (2003); ISBN: 1569245584; http://www.amazon.com/exec/obidos/ASIN/1569245584/icongroupinterna

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Breaking Free from Depression (Breaking Free Series) by Linda, Ph.D. Mintle (2002); ISBN: 0884198936; http://www.amazon.com/exec/obidos/ASIN/0884198936/icongroupinterna

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Breaking the Patterns of Depression by Michael D. Yapko; ISBN: 0385483708; http://www.amazon.com/exec/obidos/ASIN/0385483708/icongroupinterna

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Caring for Depression (Rand Study) by Kenneth B. Wells, et al (1999); ISBN: 0674097300; http://www.amazon.com/exec/obidos/ASIN/0674097300/icongroupinterna

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Change Your Brain, Change Your Life: The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness by Daniel G. Amen (2000); ISBN: 0812929985; http://www.amazon.com/exec/obidos/ASIN/0812929985/icongroupinterna

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Christmas After All: The Great Depression Diary of Minnie Swift, Indianapolis, Indiana, 1932 (Dear America) by Kathryn Lasky (2001); ISBN: 0439219434; http://www.amazon.com/exec/obidos/ASIN/0439219434/icongroupinterna

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Cognitive Therapy for Depression and Anxiety: A Practitioner's Guide by Kate M. Davidson, et al; ISBN: 0632039868; http://www.amazon.com/exec/obidos/ASIN/0632039868/icongroupinterna

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Cognitive Therapy of Depression by Aaron T. Beck, et al; ISBN: 0898629195; http://www.amazon.com/exec/obidos/ASIN/0898629195/icongroupinterna

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Comparative Treatments of Depression by Mark A., Phd Reinecke (Editor), Michael R., Psyd Davison (Editor); ISBN: 0826146813; http://www.amazon.com/exec/obidos/ASIN/0826146813/icongroupinterna

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Conquering Depression: A 30-Day Plan to Finding Happiness by Bruce Hennigan, Mark A. Sutton (2001); ISBN: 0805421580; http://www.amazon.com/exec/obidos/ASIN/0805421580/icongroupinterna

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Conquering Postpartum Depression: A Proven Plan for Recovery by Ronald Rosenberg, et al (2003); ISBN: 0738208418; http://www.amazon.com/exec/obidos/ASIN/0738208418/icongroupinterna

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Conquering the Beast Within: How I Fought Depression and Won...and How You Can, Too by Cait Irwin (1999); ISBN: 0812932471; http://www.amazon.com/exec/obidos/ASIN/0812932471/icongroupinterna

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Conquering the Fatique, Depression, and Weight Gain by Valerie Saxion (2003); ISBN: 0972456392; http://www.amazon.com/exec/obidos/ASIN/0972456392/icongroupinterna

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Control Your Depression by Peter M. Lewinsohn (Editor), Ricardo Munoz (1992); ISBN: 0671762427; http://www.amazon.com/exec/obidos/ASIN/0671762427/icongroupinterna

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Coping With Depression in the Ministry and Other Helping Professions by Archibald D. Hart; ISBN: 0849903653; http://www.amazon.com/exec/obidos/ASIN/0849903653/icongroupinterna

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Dealing with Depression Naturally : Alternatives and Complementary Therapies for Restoring Emotional Health by Syd Baumel; ISBN: 0658002910; http://www.amazon.com/exec/obidos/ASIN/0658002910/icongroupinterna

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Depression & Anxiety Management: Cognitive Techniques for Managing Emotional Problems by John, Ph.D. Preston; ISBN: 1879237466; http://www.amazon.com/exec/obidos/ASIN/1879237466/icongroupinterna

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Depression : The Secret War (One person's dark poetry composed from adolescent to adult.) by Dr. Satori; ISBN: 0937317020; http://www.amazon.com/exec/obidos/ASIN/0937317020/icongroupinterna

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Depression and Creativity by Andre Haynal (1985); ISBN: 0823612015; http://www.amazon.com/exec/obidos/ASIN/0823612015/icongroupinterna

Books 513

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Depression and the Body: The Biological Basis of Faith and Reality by Alexander Lowen (1993); ISBN: 0140194657; http://www.amazon.com/exec/obidos/ASIN/0140194657/icongroupinterna

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Depression Fallout : The Impact of Depression on Couples and What You Can Do to Preserve the Bond by Anne Sheffield (Author) (2003); ISBN: 0060009349; http://www.amazon.com/exec/obidos/ASIN/0060009349/icongroupinterna

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Depression For Dummies by Laura L. Smith (Author), Charles H. Elliott (Author) (2003); ISBN: 0764539000; http://www.amazon.com/exec/obidos/ASIN/0764539000/icongroupinterna

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Depression in Later Life: A Multidisciplinary Psychiatric Approach (Medical Psychiatry) by James M. Ellison (Editor), Sumer Verma (Editor); ISBN: 082474246X; http://www.amazon.com/exec/obidos/ASIN/082474246X/icongroupinterna

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Depression in Marriage: A Model for Etiology and Treatment by Evelyn E. Sandeen, et al; ISBN: 0898622166; http://www.amazon.com/exec/obidos/ASIN/0898622166/icongroupinterna

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Depression Is a Choice: Winning the Fight Without Drugs by A. B. Curtiss (2001); ISBN: 0786866292; http://www.amazon.com/exec/obidos/ASIN/0786866292/icongroupinterna

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Depression Is the Pits, but I'm Getting Better: A Guide for Adolescents by E. Jane Garland (1998); ISBN: 1557984581; http://www.amazon.com/exec/obidos/ASIN/1557984581/icongroupinterna

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Depression: Causes and Treatment by Theodore D. Irwin, Aaron T. Beck (1972); ISBN: 0812210328; http://www.amazon.com/exec/obidos/ASIN/0812210328/icongroupinterna

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Depression: Finding Hope and Meaning in Life's Darkest Shadow by Donald R. Baker, Emery Nester; ISBN: 0880700114; http://www.amazon.com/exec/obidos/ASIN/0880700114/icongroupinterna

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Depression: From Psychology to Brain State by Paul Gilbert (1984); ISBN: 086377007X; http://www.amazon.com/exec/obidos/ASIN/086377007X/icongroupinterna

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Depression: Psychological Disorders and Their Treatment (Encyclopedia of Health) by Dianne Hales; ISBN: 079100046X; http://www.amazon.com/exec/obidos/ASIN/079100046X/icongroupinterna

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Depression: The Way Out by Neil Nedley (2001); ISBN: 0966197941; http://www.amazon.com/exec/obidos/ASIN/0966197941/icongroupinterna

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Depression: The Way Out of Your Prison by Dorothy Rowe (1996); ISBN: 0415144825; http://www.amazon.com/exec/obidos/ASIN/0415144825/icongroupinterna

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Depression: The Way Up When You Are Down by Edward T. Welch (2000); ISBN: 0875526829; http://www.amazon.com/exec/obidos/ASIN/0875526829/icongroupinterna

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Depression-Free for Life: A Physician's All-Natural, 5-Step Plan by Gabriel Cousens (Author), Mark Mayell (Author) (2001); ISBN: 0060959657; http://www.amazon.com/exec/obidos/ASIN/0060959657/icongroupinterna

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Depression-Free, Naturally: 7 Weeks to Eliminating Anxiety, Despair, Fatigue, and Anger from Your Life by Joan Mathews-Larson, Joan Mathews Larson (2001); ISBN:

514 Depression

0345435176; http://www.amazon.com/exec/obidos/ASIN/0345435176/icongroupinterna •

Dopamine and Mental Depression (Advances in the Biosciences, Vol 77) by G. Serra, Gian Luigi Gessa; ISBN: 0080407625; http://www.amazon.com/exec/obidos/ASIN/0080407625/icongroupinterna

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Ending the Depression Cycle by Peter J. Bieling, et al (2003); ISBN: 1572243333; http://www.amazon.com/exec/obidos/ASIN/1572243333/icongroupinterna

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Essential Components of Cognitive-Behavior Therapy for Depression by Jacqueline B. Persons, et al; ISBN: 1557986975; http://www.amazon.com/exec/obidos/ASIN/1557986975/icongroupinterna

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Essential Psychopharmacology of Depression and Bipolar Disorder by Stephen M. Stahl (Author), Nancy Muntner (2000); ISBN: 0521786452; http://www.amazon.com/exec/obidos/ASIN/0521786452/icongroupinterna

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Exercising Your Way to Better Mental Health : Combat Stress, Fight Depression, and Improve Your Overall Mood and Self-Concept With These Simple Exercises by Larry M. Leith (Illustrator) (1998); ISBN: 1885693095; http://www.amazon.com/exec/obidos/ASIN/1885693095/icongroupinterna

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Facing Life's Challenges: Daily Meditations for Overcoming Depression, Grief, and "the Blues" by Amy E. Dean (1995); ISBN: 1561701459; http://www.amazon.com/exec/obidos/ASIN/1561701459/icongroupinterna

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From Sad to Glad: Kline on Depression by Nathan S. Kline; ISBN: 039911372X; http://www.amazon.com/exec/obidos/ASIN/039911372X/icongroupinterna

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Get Off the Menopause Roller Coaster: Natural Solutions for Mood Swings, Hot Flashes, Fatigue, Anxiety, Depression, and Other Symptons by Shari, Phd Lieberman; ISBN: 1583330003; http://www.amazon.com/exec/obidos/ASIN/1583330003/icongroupinterna

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Getting Your Life Back: The Complete Guide to Recovery from Depression by Jesse H. Wright, et al (2002); ISBN: 0743200500; http://www.amazon.com/exec/obidos/ASIN/0743200500/icongroupinterna

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Good Mood: The New Psychology of Overcoming Depression by Julian L. Simon, et al (1993); ISBN: 0812690982; http://www.amazon.com/exec/obidos/ASIN/0812690982/icongroupinterna

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Good Women Get Angry: A Woman's Guide to Handling Her Anger, Depression, Anxiety, and Stress by Gary J. Oliver, H. Norman Wright (1995); ISBN: 089283935X; http://www.amazon.com/exec/obidos/ASIN/089283935X/icongroupinterna

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Growing Up Sad: Childhood Depression and Its Treatment by Leon Cytryn, et al (1998); ISBN: 0393317889; http://www.amazon.com/exec/obidos/ASIN/0393317889/icongroupinterna

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Handbook of Depression by Ian H. Gotlib (Editor), Constance L. Hammen (Editor); ISBN: 1572307250; http://www.amazon.com/exec/obidos/ASIN/1572307250/icongroupinterna

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Handbook of Depression in Children and Adolescents (Issues in Clinical Child Psychology) by Hugh F. Johnston (Editor), William Michael Reynolds (1994); ISBN: 0306447428; http://www.amazon.com/exec/obidos/ASIN/0306447428/icongroupinterna

Books 515

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Hand-Me-Down Blues: How to Stop Depression from Spreading in Families by Michael D., Ph.D. Yapko (2000); ISBN: 0312263325; http://www.amazon.com/exec/obidos/ASIN/0312263325/icongroupinterna

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Happiness Is a Choice: Symptoms, Causes, and Cures of Depression by Frank, Md Minirth, Paul, MD Meier (2002); ISBN: 080078698X; http://www.amazon.com/exec/obidos/ASIN/080078698X/icongroupinterna

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Happiness Is a Choice: The Symptoms, Causes, and Cures of Depression by Frank Minirth, Paul Meier (1994); ISBN: 0801063140; http://www.amazon.com/exec/obidos/ASIN/0801063140/icongroupinterna

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Heal With Amino Acids and Nutrients: Survive Stress, Pain, Anxiety, Depression Without Drugs, What to Use and When by Billie J., Ph.D. Sahley, Katherine M. Birkner (2002); ISBN: 1889391204; http://www.amazon.com/exec/obidos/ASIN/1889391204/icongroupinterna

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Healing Anxiety and Depression: The Revolutionary Brain-Based Program That Allows You to See and Heal the 7 Types of Anxiety and Depression by Daniel G. Amen, Lisa C. Routh (2003); ISBN: 0399150366; http://www.amazon.com/exec/obidos/ASIN/0399150366/icongroupinterna

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Healing Depression: A Holistic Guide by Catherine Carrigan, William G. Crook; ISBN: 1569246564; http://www.amazon.com/exec/obidos/ASIN/1569246564/icongroupinterna

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Healing from Depression: 12 Weeks to a Better Mood: A Body, Mind, and Spirit Recovery Program by Douglas Bloch (2002); ISBN: 1587611384; http://www.amazon.com/exec/obidos/ASIN/1587611384/icongroupinterna

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Healing the Blues: Drug-Free Psychotherapy for Depression: An Account by Dorothea Nudelman, David Willingham (1994); ISBN: 0940168316; http://www.amazon.com/exec/obidos/ASIN/0940168316/icongroupinterna

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Health Journeys for People With Depression (Health Journeys) by Belleruth Naparstek (Reader), Steven Mark Kohn (2000); ISBN: 1570428131; http://www.amazon.com/exec/obidos/ASIN/1570428131/icongroupinterna

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Helping Students Overcome Depression and Anxiety: A Practical Guide by Kenneth W. Merrell; ISBN: 1572306173; http://www.amazon.com/exec/obidos/ASIN/1572306173/icongroupinterna

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Helping Your Child Cope with Depression and Suicidal Thoughts by Tonia K. Shamoo (Author), Philip G. Patros (Author) (1997); ISBN: 0787908444; http://www.amazon.com/exec/obidos/ASIN/0787908444/icongroupinterna

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Helping Your Depressed Child: A Reassuring Guide to the Causes and Treatments of Childhood and Adolescent Depression by Lawrence L. Kerns, Adrienne B. Lieberman; ISBN: 1559582758; http://www.amazon.com/exec/obidos/ASIN/1559582758/icongroupinterna

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Helplessness On Depression, Development and Death by Martin E. P. Seligman; ISBN: 0716707519; http://www.amazon.com/exec/obidos/ASIN/0716707519/icongroupinterna

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How to Good-Bye Depression: If You Constrict Anus 100 Times Everyday. Malarkey? or Effective Way? by Hiroyuki Nishigaki (2000); ISBN: 0595094724; http://www.amazon.com/exec/obidos/ASIN/0595094724/icongroupinterna

516 Depression

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How to Heal Depression by Harold H. Bloomfield, et al (1994); ISBN: 0931580390; http://www.amazon.com/exec/obidos/ASIN/0931580390/icongroupinterna

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How to Win Over Depression by Tim Lahaye; ISBN: 0310203260; http://www.amazon.com/exec/obidos/ASIN/0310203260/icongroupinterna

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How You Can Survive When They're Depressed: Living and Coping With Depression Fallout by Anne Sheffield (1999); ISBN: 0609804154; http://www.amazon.com/exec/obidos/ASIN/0609804154/icongroupinterna

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Hypericum (St. John's Wort) and Depression by Peter McWilliams, et al (1997); ISBN: 0931580366; http://www.amazon.com/exec/obidos/ASIN/0931580366/icongroupinterna

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I Dont Want To Talk About It: Overcoming The Secret Legacy Of Male Depression by Terrence Real (1998); ISBN: 0684835398; http://www.amazon.com/exec/obidos/ASIN/0684835398/icongroupinterna

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In the Jaws of the Black Dogs: A Memoir of Depression by John Bentley Mays (1999); ISBN: 0060192887; http://www.amazon.com/exec/obidos/ASIN/0060192887/icongroupinterna

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In the Shadow of God's Wings: Grace in the Midst of Depression by Susan GreggSchroeder (1997); ISBN: 0835808076; http://www.amazon.com/exec/obidos/ASIN/0835808076/icongroupinterna

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Interpersonal Psychotherapy of Depression (The Master Work Series) by Gerald L. Klerman (Editor), et al (1994); ISBN: 1568213506; http://www.amazon.com/exec/obidos/ASIN/1568213506/icongroupinterna

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Life Strategies: The Struggle Between Anorexia and Depression by Lauren Elizabeth Chyr (2003); ISBN: 1410745155; http://www.amazon.com/exec/obidos/ASIN/1410745155/icongroupinterna

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Living Without Depression and Manic Depression: A Workbook for Maintaining Mood Stability by Mary Ellen Copeland (1994); ISBN: 1879237741; http://www.amazon.com/exec/obidos/ASIN/1879237741/icongroupinterna

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Loss: Sadness and Depression (Attachment and Loss) by John Bowlby (2000); ISBN: 0465042384; http://www.amazon.com/exec/obidos/ASIN/0465042384/icongroupinterna

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Manic Depression and Creativity by D. Jablow Hershman, Julian Lieb (1998); ISBN: 1573922412; http://www.amazon.com/exec/obidos/ASIN/1573922412/icongroupinterna

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Mayo Clinic on Depression: Answers to Help You Understand, Recognize and Manage Depression by Keith, Md. Kramlinger (Editor), et al; ISBN: 1893005178; http://www.amazon.com/exec/obidos/ASIN/1893005178/icongroupinterna

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Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse by Zindel V. Segal, et al; ISBN: 1572307064; http://www.amazon.com/exec/obidos/ASIN/1572307064/icongroupinterna

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Mommy Stayed in Bed This Morning: Helping Children Understand Depression by Mary Wenger Weaver, Mary Chambers (Illustrator) (2002); ISBN: 0836191501; http://www.amazon.com/exec/obidos/ASIN/0836191501/icongroupinterna

Books 517

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Mood Genes: Hunting for Origins of Mania and Depression by Samuel H. Barondes (1998); ISBN: 0716729431; http://www.amazon.com/exec/obidos/ASIN/0716729431/icongroupinterna

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Moodswing: Dr Fieve on Depression (1997); ISBN: 0553279831; http://www.amazon.com/exec/obidos/ASIN/0553279831/icongroupinterna

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More Than Moody: Recognizing and Treating Adolescent Depression by Harold S. Koplewicz (2002); ISBN: 039914918X; http://www.amazon.com/exec/obidos/ASIN/039914918X/icongroupinterna

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My Naked Truth: Surviving Depression and Bulimia by Ximena Veliz (2003); ISBN: 159299010X; http://www.amazon.com/exec/obidos/ASIN/159299010X/icongroupinterna

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Natural Healing for Depression: Solutions from the World's Great Health Traditions and Practitioners by James Strohecker (Editor), et al (1999); ISBN: 0399525378; http://www.amazon.com/exec/obidos/ASIN/0399525378/icongroupinterna

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Nature's Prozac: Natural Therapies and Techniques to Rid Yourself of Anxiety, Depression, Panic Attacks & Stress by Judith Sachs, Lendon H. Smith; ISBN: 0138876541; http://www.amazon.com/exec/obidos/ASIN/0138876541/icongroupinterna

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New Hope for People with Depression: Your Friendly, Authoritative Guide to the Latest in Traditional and Complementary Solutions by Marian Broida, Francis Mark Mondimore (Preface) (2001); ISBN: 0761535063; http://www.amazon.com/exec/obidos/ASIN/0761535063/icongroupinterna

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On the Edge of Darkness: Conversations About Conquering Depression by Kathy Cronkite (1995); ISBN: 0385314264; http://www.amazon.com/exec/obidos/ASIN/0385314264/icongroupinterna

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One Time One Place: Mississippi in the Depression: A Snapshot Album by Eudora Welty (Photographer), William Maxwell (1996); ISBN: 0878058664; http://www.amazon.com/exec/obidos/ASIN/0878058664/icongroupinterna

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Out of the Blues: From Depression to Renewed Vitality: Strategies That Work to Get You Through the Down Times by Jay Cleve; ISBN: 0896381544; http://www.amazon.com/exec/obidos/ASIN/0896381544/icongroupinterna

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Overcoming Anxiety, Panic, and Depression: New Ways to Regain Your Confidence by James Gardner, et al (2000); ISBN: 1564144356; http://www.amazon.com/exec/obidos/ASIN/1564144356/icongroupinterna

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Overcoming Depression - Therapist Protocol by Gary Emery (1999); ISBN: 1572241608; http://www.amazon.com/exec/obidos/ASIN/1572241608/icongroupinterna

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Overcoming Depression, by Paul A. Hauck (1973); ISBN: 0664249698; http://www.amazon.com/exec/obidos/ASIN/0664249698/icongroupinterna

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Overcoming Depression, 3rd edition by Demitri Papolos (Author) (1997); ISBN: 0060927828; http://www.amazon.com/exec/obidos/ASIN/0060927828/icongroupinterna

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Overcoming Depression: A Step-By-Step Approach to Gaining Control over Depression by Paul Gilbert (2001); ISBN: 0195143116; http://www.amazon.com/exec/obidos/ASIN/0195143116/icongroupinterna

518 Depression

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Overcoming Depression: Client Manual by Gary Emery (2000); ISBN: 1572241616; http://www.amazon.com/exec/obidos/ASIN/1572241616/icongroupinterna

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Physical Illness and Depression in Older Adults - A Handbook of Theory, Research, and Practice (The Plenum Series In Social/Clinical Psychology) by Gail M. Williamson (Editor), et al; ISBN: 0306462699; http://www.amazon.com/exec/obidos/ASIN/0306462699/icongroupinterna

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Practitioner's Guide to Empirically Based Measures of Depression by Arthur M. Nezu (Editor), et al; ISBN: 030646246X; http://www.amazon.com/exec/obidos/ASIN/030646246X/icongroupinterna

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Psychodynamic Understanding of Depression: The Meaning of Despair by Wilard Gaylin, Willard Gaylin (1984); ISBN: 0876686730; http://www.amazon.com/exec/obidos/ASIN/0876686730/icongroupinterna

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Queer Blues: The Lesbian and Gay Guide to Overcoming Depression by Kimeron N. Hardin, et al; ISBN: 1572242442; http://www.amazon.com/exec/obidos/ASIN/1572242442/icongroupinterna

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Recovering from Depression: A Workbook for Teens by Mary Ellen Copeland (Editor), et al (2002); ISBN: 1557665923; http://www.amazon.com/exec/obidos/ASIN/1557665923/icongroupinterna

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Restoring Intimacy: The Patient's Guide to Maintaining Relationships During Depression by Drew Pinsky (Contributor), et al; ISBN: 0967389305; http://www.amazon.com/exec/obidos/ASIN/0967389305/icongroupinterna

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Rock-A-By Baby: Feminism, Self-Help and Postpartum Depression by Verta A. Taylor (1996); ISBN: 041591292X; http://www.amazon.com/exec/obidos/ASIN/041591292X/icongroupinterna

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Rose's Journal: The Story of a Girl in the Great Depression by Marissa Moss (Illustrator); ISBN: 0152024239; http://www.amazon.com/exec/obidos/ASIN/0152024239/icongroupinterna

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Sacred Sorrows: Embracing and Transforming Depression (New Consciousness Reader) by John E., M.D. Nelson (Editor), Andrea Nelson (Editor) (1996); ISBN: 0874778220; http://www.amazon.com/exec/obidos/ASIN/0874778220/icongroupinterna

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Sad Days, Glad Days: A Story About Depression by Dewitt Hamilton, et al; ISBN: 0807572004; http://www.amazon.com/exec/obidos/ASIN/0807572004/icongroupinterna

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Seeing Beyond Depression by Jean Vanier (2001); ISBN: 0809140578; http://www.amazon.com/exec/obidos/ASIN/0809140578/icongroupinterna

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Self-Coaching: How to Heal Anxiety and Depression by Joseph J. Luciani (Author); ISBN: 0471387371; http://www.amazon.com/exec/obidos/ASIN/0471387371/icongroupinterna

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Silencing The Self : Women and Depression by Dana C. Jack (Author) (1993); ISBN: 006097527X; http://www.amazon.com/exec/obidos/ASIN/006097527X/icongroupinterna

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Situating Sadness: Women and Depression in Social Context (Qualitative Studies in Psychology Series) by Janet M. Stoppard (Editor), Linda M. McMullen (Editor) (2003); ISBN: 0814798012; http://www.amazon.com/exec/obidos/ASIN/0814798012/icongroupinterna

Books 519

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Skills Training Manual for Diagnosing and Treating Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy by James P., Jr. McCullough, Jr. McCullough; ISBN: 1572306912; http://www.amazon.com/exec/obidos/ASIN/1572306912/icongroupinterna

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Sleepless Days: 1 Woman's Journey Through Postpartum Depression by Susan Kushner Resnick (2001); ISBN: 0312272278; http://www.amazon.com/exec/obidos/ASIN/0312272278/icongroupinterna

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Social Origins of Depression by George W. Brown, Tirril Harris (1978); ISBN: 0029048907; http://www.amazon.com/exec/obidos/ASIN/0029048907/icongroupinterna

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SOS Help For Emotions: Managing Anxiety, Anger, And Depression by Lynn Clark (2002); ISBN: 0935111522; http://www.amazon.com/exec/obidos/ASIN/0935111522/icongroupinterna

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Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness by David A. Karp (1997); ISBN: 0195113861; http://www.amazon.com/exec/obidos/ASIN/0195113861/icongroupinterna

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Spiritual Depression: Its Causes and Cure by David Martyn Lloyd-Jones (1965); ISBN: 0802813879; http://www.amazon.com/exec/obidos/ASIN/0802813879/icongroupinterna

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Stop Depression Now: Sam-E: The Breakthrough Supplement That Works As Well As Prescription Drugs, in Half the Time...With No Side Effects by Richard Brown, et al (2000); ISBN: 0425176436; http://www.amazon.com/exec/obidos/ASIN/0425176436/icongroupinterna

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Straight Talk on Depression: Overcoming Emotional Battles with the Power of God's Word! by Joyce Meyer (2003); ISBN: 0446691518; http://www.amazon.com/exec/obidos/ASIN/0446691518/icongroupinterna

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Survival Strategies for Parenting Your Add Child: Dealing With Obsessions Compulsions, Depression, Explosive Behavior, and Rage by George T. Lynn (1996); ISBN: 1887424199; http://www.amazon.com/exec/obidos/ASIN/1887424199/icongroupinterna

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Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families, and Providers by E. Fuller Torrey, Michael B. Knable (2002); ISBN: 0465086632; http://www.amazon.com/exec/obidos/ASIN/0465086632/icongroupinterna

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Ten Steps to Victory over Depression by Tim Lahaye; ISBN: 0310270022; http://www.amazon.com/exec/obidos/ASIN/0310270022/icongroupinterna

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The Beast: A Journey Through Depression by Tracy Thompson (1996); ISBN: 0452276950; http://www.amazon.com/exec/obidos/ASIN/0452276950/icongroupinterna

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The Bible Cure for Depression and Anxiety (Fitness and Health) by Don Colbert, Donald, Md. Colbert (1999); ISBN: 088419650X; http://www.amazon.com/exec/obidos/ASIN/088419650X/icongroupinterna

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The Bright Side of Depression by Jim Geddes; ISBN: 0805450165; http://www.amazon.com/exec/obidos/ASIN/0805450165/icongroupinterna

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The Childhood Depression Sourcebook by Jeffrey A. Miller; ISBN: 0737300019; http://www.amazon.com/exec/obidos/ASIN/0737300019/icongroupinterna

520 Depression

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The Depression Book: Depression As an Opportunity for Spiritual Growth by Cheri Huber, June Shiver (Illustrator) (1999); ISBN: 096362556X; http://www.amazon.com/exec/obidos/ASIN/096362556X/icongroupinterna

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The Depression Helpbook by Evette, Ph.D. Ludman, et al; ISBN: 0923521682; http://www.amazon.com/exec/obidos/ASIN/0923521682/icongroupinterna

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The Depression Sourcebook by Brian P. Quinn PhD, et al; ISBN: 0737303794; http://www.amazon.com/exec/obidos/ASIN/0737303794/icongroupinterna

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The Depression Workbook 2 Ed: A Guide for Living with Depression and Manic Depression by M. A. Copeland, et al; ISBN: 157224268X; http://www.amazon.com/exec/obidos/ASIN/157224268X/icongroupinterna

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The Food Allergy Cure: A New Solution to Food Cravings, Obesity, Depression, Headaches, Arthritis and Fatigue by Ellen Dr Cutler, Ellen W. Cutler (2003); ISBN: 0609809008; http://www.amazon.com/exec/obidos/ASIN/0609809008/icongroupinterna

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The Food and Mood Handbook: Find Relief at Last from Depression, Anxiety, Pms, Cravings and Mood Swings by Amanda Geary (2001); ISBN: 0007114230; http://www.amazon.com/exec/obidos/ASIN/0007114230/icongroupinterna

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The Freedom From Depression Workbook : by Les Carter (Author), Frank Minirth (Author) (1995); ISBN: 0840762070; http://www.amazon.com/exec/obidos/ASIN/0840762070/icongroupinterna

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The Johns Hopkins White Papers: Depression and Anxiety by Karen L. Swartz, Simeon Margolis (2002); ISBN: 0929661176; http://www.amazon.com/exec/obidos/ASIN/0929661176/icongroupinterna

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The Marriage of Heaven and Hell: Manic Depression and the Life of Virginia Woolf by Peter Dally (2001); ISBN: 0312272731; http://www.amazon.com/exec/obidos/ASIN/0312272731/icongroupinterna

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The Natural Medicine Guide to Depression (The Healthy Mind Guides) by Stephanie Marohn (2003); ISBN: 1571742921; http://www.amazon.com/exec/obidos/ASIN/1571742921/icongroupinterna

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The Noonday Demon: An Atlas of Depression by Andrew Solomon (2002); ISBN: 0684854678; http://www.amazon.com/exec/obidos/ASIN/0684854678/icongroupinterna

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The Omega-3 Connection: The Groundbreaking Anti-depression Diet and Brain Program by Andrew L. Stoll (2001); ISBN: 0684871386; http://www.amazon.com/exec/obidos/ASIN/0684871386/icongroupinterna

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The Optimistic Child : Proven Program to Safeguard Children from Depression & Build Lifelong Resistance by Martin E. Seligman (Author) (1996); ISBN: 0060977094; http://www.amazon.com/exec/obidos/ASIN/0060977094/icongroupinterna

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The Pain Behind the Mask: Overcoming Masculine Depression by John Lynch, Christopher T. Kilmartin (1999); ISBN: 0789005581; http://www.amazon.com/exec/obidos/ASIN/0789005581/icongroupinterna

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The Postpartum Effect: Deadly Depression in Mothers by Arlene M., Ph.D. Huysman, Paul J. Goodnick (2003); ISBN: 1583225552; http://www.amazon.com/exec/obidos/ASIN/1583225552/icongroupinterna

Books 521

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The Prozac Alternative: Natural Relief from Depression With St. John's Wort, Kava, Ginkgo, 5-Htp, Homeopathy, and Other Alternative Therapies by Ran Knishinsky (1998); ISBN: 0892817917; http://www.amazon.com/exec/obidos/ASIN/0892817917/icongroupinterna

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The Secret Strength of Depression (3rd Edition) by Frederic F. Flach; ISBN: 1578261147; http://www.amazon.com/exec/obidos/ASIN/1578261147/icongroupinterna

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The Sensitive Person's Survival Guide: An Alternative Health Answer to Emotional Sensitivity & Depression by Kyra Mesich, Carol L. Philpot (2000); ISBN: 0595098002; http://www.amazon.com/exec/obidos/ASIN/0595098002/icongroupinterna

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The Seven Beliefs : A Step-by-Step Guide to Help Latinas Recognize and Overcome Depression by Belisa Lozano-Vranich (Author), Jorge Petit (Author) (2003); ISBN: 006001265X; http://www.amazon.com/exec/obidos/ASIN/006001265X/icongroupinterna

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The Thyroid Solution: A Mind-Body Program for Beating Depression and Regaining Your Emotional and Physical Health by Arem Ridha (2000); ISBN: 0345429206; http://www.amazon.com/exec/obidos/ASIN/0345429206/icongroupinterna

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The Tortured Mind: The Many Faces of Manic Depression ((Encyclopedia of Psychological Disorders)) by Ann Holmes, et al (1998); ISBN: 0791049000; http://www.amazon.com/exec/obidos/ASIN/0791049000/icongroupinterna

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The Truth About Depression: Choices for Healing by Charles Whitfield (Author); ISBN: 0757300375; http://www.amazon.com/exec/obidos/ASIN/0757300375/icongroupinterna

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The Zen Path Through Depression by Philip Martin (Author) (2000); ISBN: 0060654465; http://www.amazon.com/exec/obidos/ASIN/0060654465/icongroupinterna

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This Isn't What I Expected: Overcoming Postpartum Depression by Karen Kleiman, Valerie Davis Raskin (1994); ISBN: 0553370758; http://www.amazon.com/exec/obidos/ASIN/0553370758/icongroupinterna

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Treating Anger, Anxiety, And Depression In Children And Adolescents: A CognitiveBehavioral Perspective by Jerry Wilde; ISBN: 1560324821; http://www.amazon.com/exec/obidos/ASIN/1560324821/icongroupinterna

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Treating Postnatal Depression : A Psychological Approach for Health Care Practitioners by Jeannette Milgrom (Author), et al (2000); ISBN: 0471986453; http://www.amazon.com/exec/obidos/ASIN/0471986453/icongroupinterna

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Treatment for Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy (CBASP) by James P. McCullough, et al; ISBN: 1572305274; http://www.amazon.com/exec/obidos/ASIN/1572305274/icongroupinterna

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Treatment Plans and Interventions for Depression and Anxiety Disorders by Robert L. Leahy, Stephen J. Holland; ISBN: 1572305142; http://www.amazon.com/exec/obidos/ASIN/1572305142/icongroupinterna

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Undercurrents: A Therapist's Reckoning With Her Own Depression by Martha Manning; ISBN: 0694515655; http://www.amazon.com/exec/obidos/ASIN/0694515655/icongroupinterna

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Understanding Depression: A Complete Guide to Its Diagnosis and Treatment by Donald F., M.D. Klein, Paul H. Wender (Contributor) (1994); ISBN: 0195086694; http://www.amazon.com/exec/obidos/ASIN/0195086694/icongroupinterna

522 Depression

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Understanding Depression: What We Know and What You Can Do About It by J. Raymond DePaulo (Author), et al; ISBN: 0471395528; http://www.amazon.com/exec/obidos/ASIN/0471395528/icongroupinterna

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Understanding Teenage Depression: A Guide to Diagnosis, Treatment, and Management by Maureen Empfield, et al (2001); ISBN: 0805067612; http://www.amazon.com/exec/obidos/ASIN/0805067612/icongroupinterna

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Undoing Depression: What Therapy Doesn't Teach You and Medication Can't Give You by Richard O'Connor, Richard O'Conner (1999); ISBN: 0425166791; http://www.amazon.com/exec/obidos/ASIN/0425166791/icongroupinterna

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Unholy Ghost: Writers on Depression by Nell Casey (Author) (2002); ISBN: 0060007826; http://www.amazon.com/exec/obidos/ASIN/0060007826/icongroupinterna

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Unmasking Male Depression by Archibald D. Hart (Author); ISBN: 0849940702; http://www.amazon.com/exec/obidos/ASIN/0849940702/icongroupinterna

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Unveiling Depression in Women: A Practical Guide to Understanding and Overcoming Depression by Archibald, Phd Hart, Catherine Hart, Phd Weber (2002); ISBN: 0800757491; http://www.amazon.com/exec/obidos/ASIN/0800757491/icongroupinterna

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Up from Depression by Leonard Cammer; ISBN: 0671458280; http://www.amazon.com/exec/obidos/ASIN/0671458280/icongroupinterna

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Ups & Downs: How to Beat the Blues and Teen Depression (Plugged in) by Susan Klebanoff, et al (1999); ISBN: 0843174501; http://www.amazon.com/exec/obidos/ASIN/0843174501/icongroupinterna

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Victory over Depression by Bob George (2001); ISBN: 0736904913; http://www.amazon.com/exec/obidos/ASIN/0736904913/icongroupinterna

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When Going Through Hell Don't Stop: A Survivor's Guide to Overcoming Anxiety and Clinical Depression by Douglas Bloch, Douglas G. Bloch; ISBN: 0929671023; http://www.amazon.com/exec/obidos/ASIN/0929671023/icongroupinterna

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When Words Are Not Enough: The Women's Prescription for Depression and Anxiety by Valerie Davis Raskin (1997); ISBN: 0553067133; http://www.amazon.com/exec/obidos/ASIN/0553067133/icongroupinterna

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Why Are You So Sad?: A Child's Book About Parental Depression by Beth Andrews, et al (2002); ISBN: 1557988366; http://www.amazon.com/exec/obidos/ASIN/1557988366/icongroupinterna

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Why Do I Feel This Way: What Every Woman Needs to Know about Depression by Brenda Poinsett (1999); ISBN: 1576832090; http://www.amazon.com/exec/obidos/ASIN/1576832090/icongroupinterna

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Willow Weep for Me: A Black Woman's Journey Through Depression by Meri NanaAma Danquah (1999); ISBN: 0345432134; http://www.amazon.com/exec/obidos/ASIN/0345432134/icongroupinterna

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Win The Battle, The 3-Step Lifesaving Formula to Conquer Depression and Bipolar Disorder by Bob Olson, Melissa Olson (Contributor) (1999); ISBN: 1886284318; http://www.amazon.com/exec/obidos/ASIN/1886284318/icongroupinterna

Books 523

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Women and Anxiety: A Step-By-Step Program for Managing Anxiety and Depression by Helen De Rosis, Helen A. Derosis (1998); ISBN: 1886330999; http://www.amazon.com/exec/obidos/ASIN/1886330999/icongroupinterna

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Working in the Dark: Keeping Your Job While Dealing With Depression by Fawn Fitter, et al (2002); ISBN: 1568387903; http://www.amazon.com/exec/obidos/ASIN/1568387903/icongroupinterna

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Wrestling With Depression: A Spiritual Guide to Reclaiming Life by William Hulme, Lucy Hulme (Contributor) (1995); ISBN: 0806626992; http://www.amazon.com/exec/obidos/ASIN/0806626992/icongroupinterna

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Yoga and Depression: A Compassionate Guide to Relieving Suffering Through Yoga by Amy Weintraub (2004); ISBN: 0767914503; http://www.amazon.com/exec/obidos/ASIN/0767914503/icongroupinterna

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You Are What You Say: The Proven Program That Uses the Power of Language to Combat Stress, Anger, and Depression by Matthew, Md Budd, Larry Rothstein (2001); ISBN: 0812929624; http://www.amazon.com/exec/obidos/ASIN/0812929624/icongroupinterna

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You Can Beat Depression: A Guide to Prevention & Recovery (Third Edition) by John Preston Psy.D., John D. Preston; ISBN: 1886230404; http://www.amazon.com/exec/obidos/ASIN/1886230404/icongroupinterna

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You Can Choose to Be Happy: "Rise Above" Anxiety, Anger, and Depression by Tom G. Stevens (1998); ISBN: 0965337715; http://www.amazon.com/exec/obidos/ASIN/0965337715/icongroupinterna

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You Can Feel Good Again: Common-Sense Therapy for Releasing Depression and Changing Your Life by Richard Carlson (1994); ISBN: 0452272424; http://www.amazon.com/exec/obidos/ASIN/0452272424/icongroupinterna

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You Mean I Don't Have to Feel This Way?: New Help for Depression, Anxiety, and Addiction by Colette Dowling, et al (1993); ISBN: 055337169X; http://www.amazon.com/exec/obidos/ASIN/055337169X/icongroupinterna

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Your Depression Map: Find the Source of Your Depression and Chart Your Own Recovery by Randy J., Ph.D. Paterson (2002); ISBN: 1572243007; http://www.amazon.com/exec/obidos/ASIN/1572243007/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “depression” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 11 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created

524 Depression

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Anxiety, nervousness & depression. Author: Casson, Frederick Ronald Christopher.; Year: 1964; [London] British Medical Assn. [1966]

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Aspects of depression, edited by Edwin S. Shneidman [and] Magno J. Ortega. Author: Ortega, Magno J.; Year: 1968; Boston, Little, Brown [c1969]

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Concepts of depression. Author: Mendels, Joseph.; Year: 1969; New York, Wiley [c1970]; ISBN: 0471593508 http://www.amazon.com/exec/obidos/ASIN/0471593508/icongroupinterna

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Depression and its treatment. Author: Pollitt, John.; Year: 1965; London, Heinemann [1965]

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Depression: its diagnosis and treatment. Lithium: the history of its use in psychiatry. Author: Kline, Nathan Schellenberg,; Year: 1965; Basel, New York, Karger, 1969

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Depression: mood, symptom, syndrome [by] R. A. Cleghorn and G. C. Curtis. Author: Cleghorn, Robert Allen,; Year: 1962; [Basle, J. R. Geigy, 1959]

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Depression; comparative studies of normal, neurotic, and psychotic conditions. Author: Jacobson, Edith,; Year: 1966; New York, International Universities Press [c1971]; ISBN: 0823611957 http://www.amazon.com/exec/obidos/ASIN/0823611957/icongroupinterna

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Depression; proceedings of the symposium held at Cambridge 22 to 26 Sept. 1959. Author: Davies, Edward Beresford.; Year: 1965; Cambridge, University Press, 1964

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Depressive disorders in the community. Author: Watts, C. A. H. (Cuthbert Arthur Harry); Year: 1966; Bristol, Wright [1966]

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Depressive states in childhood and adolescence. Depressionszustände bei Kindern und Jugendlichen. Etats dépressifs chez l'enfant et l'adolescent. Edited by Anna-Lisa Annell. Author: Union of European Pedopsychiatrists.; Year: 1967; Stockholm, Almqvist; Wiksell [1972]

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How to handle feelings of depression. Author: Narramore, Clyde M. (Clyde Maurice),; Year: 1969; London] Oliphants [1970, c1969]; ISBN: 55100147X

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McGill University conference on depression and allied states, Montreal, March 19-21, 1959. Author: McGill University, Montreal. Dept. of Psychiatry.; Year: 1964; [Ottawa, Canadian Psychiatric Assn. journal] 1959

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Patterns of self-destruction: depression and suicide; proceedings. Edited by Kurt Wolff. Author: Wolff, Kurt,; Year: 1959; Springfield, Ill., Thomas [c1970]

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Pharmacotherapy of depression; comp. and ed. by Jonathan O. Cole and J. R. Wittenborn. Author: Cole, Jonathan O.; Year: 1966; Springfield, Ill., Thomas [c1966]

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The epidemiology of depression. Author: Silverman, Charlotte.; Year: 1964; Baltimore, Johns Hopkins Press [c1968]

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The meaning of despair; psychoanalytic contributions to the understanding of depression. Author: Gaylin, Willard.; Year: 1964; New York, Science House [c1968]

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The structure of depression, by factoring Q-data, in relation to general personality source traits, in normal and pathological subjects [by] Cattell, R. B. & Bjerstedt, A. Author: Cattell, Raymond B. (Raymond Bernard),; Year: 1967; Malmö, 1966

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Up from depression; an eminent psychiatrist tells you what depression is, how to recognize its symptoms, and what to do when depression strikes at a member of your family. Author: Cammer, Leonard,; Year: 1963; New York, Simon and Schuster [c1969]

between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

Books 525

Chapters on Depression In order to find chapters that specifically relate to depression, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and depression using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “depression” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on depression: •

Differential Assessment of Dementia and Depression in Elderly People (Chapter 5) Source: in Safford, F. Krell, G.I., eds. Gerontology for Health Professionals: A Practice Guide. Annapolis JCT, MD: National Association for Social Workers Press. 1992. p. 5167. Contact: Available from National Association for Social Workers Press. P.O. Box 431, Annapolis JCT, MD 20701. (800) 227-3590 or FAX (301) 206-7989. PRICE: $20.95 plus $3.00 shipping and handling. Summary: This book chapter examines the differential assessment of dementia and depression in elderly people. The first section highlights some of the obstacles to an accurate diagnosis in older people and provides a differential definition of three syndromes of mental impairment: dementia, delirium, and depression. The second section describes the cognitive, psychological, and behavioral symptoms that may appear in persons with mental impairment and that may help to identify the problem. The third section describes the individualized assessment to establish an accurate diagnosis of dementia or depression and to distinguish between the two disorders. This section discusses commonly used mental status examinations, distinguishing features of dementia versus depression, symptoms that are characteristic of depression in older people, diagnostic criteria for major depression, the classification of primary versus secondary depressive disorders, and medical problems and medications that may cause depression. The final section discusses the treatment of dementia and depression in older people. 31 references.

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Caring for Residents With Dementia or Depression Source: in Anderson, M.A. Beaver, K.W. Wheeler, R.E., eds. Long-Term Care Nursing Assistant Training Manual. Baltimore, MD: Health Professional Press. 1991. p. 239-250. Contact: Available from Health Professions Press. Box 10624, Baltimore, MD 21285. (410) 337-9585 or FAX (410) 337-8539. PRICE: $25.00. ISBN: 1878812009. Summary: Chapter 35 in this training manual for nursing assistants and licensed vocational nurses who care for geriatric clients in long term care settings provides guidelines for caring for residents who have dementia or depression. Topics discussed in the chapter include identifying and coping with violent or potentially violent behaviors and disoriented, inappropriate, and anxious behaviors in residents; communicating with residents who exhibit the preceding behaviors; proper application of restraints for residents who require them and necessary safety measures for restraint use; and basic behavior modification techniques. The chapter lists several learning activities for the caregiver and outlines specific suggestions for dealing with problems.

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Epidemiology of Late-Life Depression and Dementia: A Comparative Study Source: in Tasman, A. Goldfinger, S.M. Kaufmann, C.A., eds. Review of Psychiatry, Volume 9. Washington, DC: American Psychiatric Press. 1990. p. 210-219. Contact: Available from American Psychiatric Press. 1400 K Street, NW, Washington, DC 20005. (202) 682-6262 or (800) 368-5777. PRICE: $54.95 plus $5.00 shipping and handling. Summary: This chapter discusses how depression and dementia reflect different patterns of prevalence and distribution among the elderly. Depression is not associated with increased age, whereas dementia is correlated with age after about the age of 55.The causes of depressive disorders and dementing illness are multiple, yet the epidemiologic evidence suggests that primary degenerative disease of the Alzheimer's type is an age-related disorder with primarily psychobiological etiology. In contrast, the prevalence of major depression is not associated with age, and psychosocial factors are important in the etiology. Major depression presents much as it does at other ages and requires a similar approach to diagnostics and therapeutics across the life cycle. Both disorders lead to an increased use of health services, yet dementia accounts for the major portion of the sizable long-term care cases in the United States. 42 references.

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Depression and Dementia Source: in Byyny, R.L. Speroff, L. Clinical Guide for the Care of Older Women. Baltimore, MD: Williams and Wilkins. 1990. p. 299-306. Contact: Available from Williams and Wilkins. 428 East Preston Street, Baltimore, MD 21202. (800) 882-0483. PRICE: $65.00; please call for shipping information. Summary: This chapter in a book about the health care of older women provides a general overview of the symptoms and treatment of depression and dementia in the older woman, and differentiates between the two. Discussion of the treatment of depression focuses on antidepressant medications and on the physician's role in providing sympathy and respect. Dementia is explained in the context of normal brain function in aging, and the symptoms of Alzheimer's disease and vascular dementia are described. Treatment is discussed briefly. 11 references.

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Cholinergic Drug Studies in Dementia and Depression Source: in Zandi, T. Ham, R.J., eds. New Directions in Understanding Dementia and Alzheimer's Disease. New York: Plenum Press. 1990. p. 65-76. Contact: Available from Plenum Press. 233 Spring Street, New York, NY 10013. (800) 221-9369 or (212) 620-8000. PRICE: $59.50. Summary: This chapter describes three studies to evaluate the functional significance of the observed cholinergic system lesions in Alzheimer's disease. A variety of pharmacological probes are used to test the function, responsiveness, and sensitivity of central cholinergic neurons in Alzheimer's disease and in the elderly in general. These studies have a number of limitations, such as the limited numbers of control subjects in the two agonist studies and the lack of a similar antagonist study with a nicotinic blocker. Further, the adverse behavioral effects of the two agonists drugs preclude firm conclusions being made about the therapeutic potential of cholinergic augmentation. In addition, chronic nicotine administration may produce desensitization of central nicotinic receptors and up-regulate receptor numbers, probably secondary to this desensitization. The scopolamine studies established that muscarinic cholinergic

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systems clearly must be involved in the cognitive disorder of Alzheimer's disease although it is not entirely clear exactly what types of cognitive operations these systems modulate. Implications for therapy from these studies indicate the difficulty in using the cholinergic agonists that are currently available.37 references. •

Depression and Other Negative Affects in Family Caregivers Source: in Light, E. Lebowitz, B.D. Alzheimer's Disease Treatment and Family Stress: Directions for Research. Rockville, MD: National Institute of Mental Health. 1989. p. 218244. Contact: This publication may be available from your State depository library. Call for information. Publication Number: ADM891569. Summary: This book chapter discusses the negative emotions experienced by family caregivers of persons with Alzheimer's disease. A review of the literature indicates that caregivers experience a high frequency of negative emotions such as depression, anger, anxiety, resentment, and frustration. Clinical depression, in particular, is quite common. A systematic study of the frequency and intensity of some of these negative emotions has been undertaken. To date, 190 family caregivers have participated; 112 were caring for a relative with Alzheimer's disease or a related disorder with significant cognitive impairment, and 78 were caring for a relative with other conditions but no cognitive impairment. In both groups, a comparable number of caregivers were clinically depressed (46 percent and 47 percent for the cognitively impaired and noncognitively impaired groups, respectively). Angry feelings, depressed feelings, worrying, discouragement, expression of anger, lack of energy, sleep disturbance, guilt feelings, and anxiety feelings were the most frequently experienced negative emotions and depressive symptoms. Ranking of the affects between the two groups was virtually identical. The implications for treatment and future research are discussed. 70 references.

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Assessing the Effects of Depression Source: in Poon, L.W., ed. Handbook for Clinical Memory Assessment of Older Adults. Washington, DC: American Psychological Association. 1986. Section IV. p. 197-268. Contact: Available from American Psychological Association. Order Department, P.O. Box 2710, Hyattsville, MD 20784. (202) 336-5510. ISBN: 091270442X. PRICE: $45.00 (nonmembers); $35.00 (members and affiliates). Summary: This textbook provides directions to psychologists, psychiatrists, neurologists, and other health care professionals for making informed decisions about clinical memory assessment (see AZBK02304). Section IV consists of eight chapters that evaluate instruments for detecting depression and for differentiating depression from observed aging effects in performance.A major purpose of this section is to highlight a number of the methodologic problems and controversial issues embedded in the literature. The authors have presented data from their research that illustrate the discrepancies.

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Depression Source: in Green, W.F. First Year: Hepatitis B. New York, NY: Marlowe and Company. 2002. p. 209-218. Contact: Available from Marlowe and Company. 161 William Street, 16th Floor, New York, NY 10038. PRICE: $15.95 plus shipping and handling. ISBN: 1569245339.

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Summary: Viral hepatitis B (liver infection) is one of the most preventable medical conditions due to the availability of a hepatitis B vaccine, yet an estimated 100,000 people in the United States are infected each year, and 6,000 die from complications. When the author of this book was diagnosed in 1993, he decided to be proactive in his quest to understand and manage his illness. In this chapter, the author focuses on what readers might be learning about by the tenth month after they receive their diagnosis of hepatitis B virus (HBV) infection, discussing depression. In nontechnical language, the author discusses the high incidence of chronic depression in people with HBV (and other chronic diseases), the causes and symptoms of depression, seasonal affective disorder (SAD), drug therapy for depression (including concerns about the hepatotoxicity of such drugs), and how to find information about resources and diagnostic tests for depression. A second section of the chapter reviews common misconceptions about HBV. •

Recognizing and Managing Depression in Patients With Diabetes Source: in Anderson, B.J. and Rubin, R.R., eds. Practical Psychology for Diabetes Clinicians: How to Deal with the Key Behavioral Issues Faced by Patients and Health Care Teams. Alexandria, VA: American Diabetes Association. 1996. p. 143-152. Contact: Available from American Diabetes Association. Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (404) 442-9742. PRICE: $19.95 (members); $24.95 (nonmembers). ISBN: 0945448732. Summary: This chapter, from a guidebook on behavioral issues for diabetes clinicians, provides a framework for recognizing and managing depression in patients with diabetes. Topics include the frequency, causes, and consequences of depression in diabetes; identification of depression in diabetes; and the course and management of depression in diabetes. The authors stress that depression will actually complicate the medical disease of diabetes by influencing the reporting of diabetes symptoms, reducing compliance, promoting poor glycemic control, and increasing the risk of progressive end-organ damage. 1 figure. 2 tables. 7 references.

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Toolkit for Assessing or Documenting Decision-Making Capacity, Depression, Mental Status, Advance Directives, Prognosis, and Quality of Life Source: in Renal Physicians Association. American Society of Nephrology. Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis. Washington, DC: Renal Physicians Association. 2000. p. 39-65. Contact: Available from Renal Physicians Association (RPA). 4701 Randolph Road, Suite 102, Rockville, MD 20852. (301) 468-3515. Fax (301) 468-3511. E-mail: [email protected]. Website: www.renalmd.org. PRICE: $35.00 for members; $50.00 for nonmembers. Summary: This chapter is from a document that presents recommendations concerning withholding or withdrawing dialysis in adult patients with either acute renal (kidney) failure (ARF) or end stage renal disease (ESRD). In this section, the authors present a toolkit of materials and checklists to support the implementation of the guideline recommendations. The recommendations cover nine areas: shared decisionmaking, informed consent or refusal, estimating prognosis (life expectancy and quality of life issues), conflict resolution, advance directives, withholding or withdrawing dialysis, special patient groups, time limited trials of dialysis, and palliative care. The toolkit offers materials to assist with each of these areas, including a checklist documenting shared decision making capacity, depression screening instruments, cognitive impairment screening instruments, assessment of decisionmaking capacity, advance

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directives, prognostic tables, assessment of quality of life or functional status, dealing with difficult patients, patient education, National Kidney Foundation checklists for initiation or withdrawal of dialysis, and preparation for dying checklist. •

Depression in Epilepsy Source: in Women and Epilepsy. Trimble, M.R. ed. Chichester, England, John Wiley and Sons Ltd., pp. 223-242, 1991. Contact: John Wiley and Sons Ltd., Baffins Lane, Chichester, West Sussex PO19 1UD, England. Summary: Depression in Epilepsy, a chapter in Women and Epilepsy, provides a brief overview of the subject, addressing in particular the topic of studies noting gender differences, and offering some suggestions as to the etiology of depression. A relationship between depression and epilepsy has been documented since the earliest medical writings. It is well known that epilepsy may compromise a person's quality of life, rendering some individuals susceptible to psychiatric illness. Depression is a serious and probably the most common psychiatric illness associated with epilepsy, but there have been no epidemiological studies to determine the exact frequency of its occurrence. Only one study has set out to inquire as to whether depression occurs more frequently in individuals with epilepsy compared with other disabling conditions. More properlycontrolled studies should be performed to determine more precisely the prevalence of inter-ictal depression in populations with epilepsy compared with those with other chronic diseases. The majority of studies to date are remarkably consistent in highlighting the fact that depressive symptomatology is common in patients with epilepsy. Depressed patients with epilepsy often have a significant past history of depressive illness, deliberate drug overdosage, and self-harm, but no more so than a depressed group without epilepsy. Genetic predisposition appears to be well recognized in bipolar illness and recurrent unipolar depressions. The temporal relationship between seizures and mood has been known for some time. When considering inter-ictal depression, several authors have noted a decrease in seizure frequency prior to the onset of the lowered mood. Others have found that depression was associated with an increase in seizures. Many investigators have found depressive symptomatology not to be intimately related to neuroepilepsy variables such as age of onset of epilepsy, the presence of an intracranial lesion, seizure frequency, type, site, or side of lesion. Various psychosocial models of depression have been suggested and many of these models may apply to people with epilepsy. Carbamazepine was first noted to have a psychotropic effect in patients with epilepsy in 1971. Others reported that patients receiving phenobarbitone were more depressed than those not receiving this drug, while patients on carbamazepine were less depressed and had lower trait anxiety. The effect of gender is not clear, but the predominance of females, noted in primary affective disorder, is not clear in populations with epilepsy. The risk of suicide is increased in people with epilepsy and in people with depression.

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to depression have been published that consolidate information across

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various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 •

Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians Source: New York, NY: Oxford University Press. 2000. 377 p. Contact: Available from Oxford University Press. 2001 Evans Road, Cary, NC 27513. (800) 445-9715; Fax: (919)677-1303. E-mail: custserv@oup- usa.org. Website: www.oupusa.org. PRICE: $55.00. ISBN: 0195116615. Summary: This book is designed to help healthcare professionals and families improve care for patients during the last stages of life, including persons with Alzheimer's disease and related disorders. The examples are taken from a year-long collaborative involving more than four dozen healthcare organizations committed to improving endof-life palliative care. Each chapter provides step-by-step stories of their successful efforts to provide good end-of-life care. Part 1 suggests quality improvement projects most organizations can implement right away. Part 2 focuses on changes patients and families often demand or would most benefit from. Part 3 describes environments that encourage better practice. Part 4 discusses opportunities for change in caring for patients with specific diseases, including Alzheimer's disease and other dementias. The last chapter gives specific tips on getting started. Content-specific resources are listed at the end of each chapter. Issues covered throughout the book related to patients with Alzheimer's disease and other dementias include advance care planning, ethical issues, family caregiver support, nursing facility improvement, palliative care, terminal stage determination, depression, pain management, and final phases of care. An appendix provides instruments used by organizations to assess various aspects of end-of-life care. The book includes a glossary, a list of references, and an index.

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California women's health directory Source: Los Angeles, CA: KCET; San Francisco, CA: KQED. 1994. 34 pp. Contact: Available from Cayleen Nakamura, Associate Director, KCET Community Television of Southern California, KCET Community Outreach, 4401 Sunset Boulevard, Los Angeles, CA 90027. Telephone: (213) 953-5245 / fax: (213) 953-5331. Summary: This directory of women's health resources is designed to help women in California locate resources and information in their community, allowing them to become active and educated consumers in the health care arena. It first looks briefly at six issues of concern all women face: osteoporosis, breast cancer, cardiovascular disease, violence, depression, and smoking: then the body of the directory lists the various health centers arranged alphabetically by topic. The directory also provides a list of women's organizations, libraries and publications, and other resources.

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You will need to limit your search to “Directory” and “depression” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “depression” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.

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CHAPTER 8. MULTIMEDIA ON DEPRESSION Overview In this chapter, we show you how to keep current on multimedia sources of information on depression. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on depression is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “depression” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “depression” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on depression: •

Fighting back: Teenage depression Source: Pleasantville, NY: Sunburst Communications. 1991. 1 videotape (44 minutes, VHS 1/2 inch). Contact: Available from Sunburst Communications, 101 Castleton Street, P.O. Box 40, Pleasantville, NY 10570-9971. Telephone: (800) 431-1934 / fax: (914) 747-4109. $199.00 plus 6 percent shipping and handling. Summary: This videotape was designed to help adolescents understand the causes and symptoms of depression while focusing their attention on the many sources of help within the community. The videotape is a first person account of three high school students who suffer from depression to varying degrees. It discusses how the symptoms as well as the severity of depression can vary from one individual to the next. The learning objectives include: provide information on the symptoms, causes, and consequences of depression; demonstrate the difference between a less serious situational depression and a chronic, clinical neurotic depression; encourage adolescents

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to seek outside help for chronic depression and suggest possible sources of help; and help students see that it is possible to make positive change in their lives through a variety of active methods.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “depression” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on depression: •

Gotta Lotta Livin' to Do Source: Peter Alsop "Pluggin' Away". Contact: Moose School Productions, Moose School Records, PO Box 960, Topanga, CA, 90290, (310) 455-2318. Summary: The song on this sound recording track tells listeners they should be friends to persons with Human immunodeficiency virus (HIV) infection or Acquired immunodeficiency syndrome (AIDS). The vocalist sings about his friend with AIDS, who needs to be treated just like anyone else. The song talks of overcoming depression about the illness, and dismisses fears about contracting AIDS through friendly contact. It explains that HIV lives in blood, and that contact with infected blood could result in HIV transmission.

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HIV in a Holistic Perspective Contact: Alternative Healing Modalities, PO Box 946 Planetarium Sta, New York, NY, 10024, (212) 222-4349. Summary: This sound recording presents a program of autogenic meditation aimed at reducing stress and depression associated with a positive result on the test for Human immunodeficiency virus (HIV) antibodies. Using soft piano music and the alternating voices of a man and a woman, the sound recording stresses that a positive result does not mean an automatic diagnosis of Acquired immunodeficiency syndrome (AIDS). The speakers emphasize that not all scientists believe that HIV solely causes AIDS; a healthy immune system and a healthy lifestyle can do much to promote overall health and a strong chance of survival in spite of test results. Using the meditative phrases, I avoid disease by being at ease, and I am at peace with HIV, the sound recording presents a self-hypnotic program designed to induce a healing state of mind in the listener.

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Working Effectively with Your Dialysis Team Source: Madison, WI: Life Options Rehabilitation Program. 2000. (audiocassette). Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email: [email protected]. PRICE: Single copy free. Summary: This audiocassette is part of a free educational program for people with kidney disease. Narrated by a dialysis social worker who is on the Life Options staff, the

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program focuses on helping kidney patients to live active productive lives, despite the fact that they are on dialysis. The program notes that end stage renal disease (ESRD) is a life threatening illness that, for most people, means living with dialysis. The program features interviews with three patients (Harold, Jim, and Kelly), Dr. Brian Becker (a nephrologist), and Janet Shu (a dialysis clinic nurse). The narrator notes that many people feel overwhelmed by how much they have to learn and do not try because they know the dialysis team will be there to take care of the patient. But the program emphasizes that the patient is the most important member of the team and that patients who take an active part in their own care usually get better results from dialysis. The program consists of five chapters: becoming a member of the team; the other members of the health care team and what each person does; the patient's role on the health care team; communication from patients to staff; and staff communication with patients. Specific strategies are provided on how to participate in one's own health care, recordkeeping, how to counteract depression and feeling overwhelmed by kidney disease, questions to ask the dialysis team (including those seemingly not related to dialysis, such as sexuality, rehabilitation, psychosocial issues), and how best to work within the framework of the dialysis unit. The program concludes with the contact information for the Life Options Rehabilitation Program (800-468-7777 or www.lifeoptions.org).

Bibliography: Multimedia on Depression The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in depression (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on depression: •

Crisis intervention: depression and anxiety [sound recording] Source: Career Aids, Inc; Year: 1973; Format: Sound recording; Glendale, Calif.: Career Aids, p1973

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Depression: coping with loss [videorecording] Source: Departments of Neurology and Psychiatry, Columbia University College of Physicians and Surgeons; [made by] New York State Psychiatric Institute; Year: 1972; Format: Videorecording; New York: New York State Psychiatric Institute, [1972]

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Depression: recognizing it, treating it [slide] Source: Ibis Media; Year: 1979; Format: Slide; Pleasantville, N. Y.: Human Relations Media: [for loan or sale by Ibis Media], c1979

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Depression: retarded and agitated forms [videorecording] Source: Departments of Neurology and Psychiatry, Columbia University College of Physicians and Surgeons; [made by] New York State Psychiatric Institute; Year: 1972; Format: Videorecording; New York: New York State Psychiatric Institute [1972]

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Depression [filmstrip] Source: Trainex Corporation; Year: 1973; Format: Filmstrip; [Garden Grove, Calif.]: Trainex, c1973

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Depression [filmstrip] Source: Medical Electronic Educational Services; Year: 1977; Format: Filmstrip; Tucson: The Services, c1977

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Depression [filmstrip] Source: Concept Media; Year: 1980; Format: Filmstrip; Irvine, CA: Concept Media, c1980

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Depression [motion picture] Source: Lakeside Laboratories, inc. produced by Medcom, inc; Year: 1970; Format: Motion picture; Milwaukee, Wis.: The Laboratories, c1970

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Feelings of depression [motion picture] Source: produced for the Mental Health Division of the Department of National Health and Welfare by the National Film Board of Canada; Year: 1950; Format: Motion picture; [Canada?]: McGraw-Hill Book Co., 1950

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Post partum depression [videorecording] Source: National Film Board of Canada; Year: 1979; Format: Videorecording; [Montreal]: The Board, c1979

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Psychoanalysis of depression [videorecording] Source: Social Psychiatry Research Institute; Year: 1978; Format: Videorecording; New York: SPRI, c1978

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Review of depression [videorecording] Source: South Carolina Health Communications Network; produced by Dept. of Psychiatry and Behavioral Sciences and Division of Continuing Education of the Medical University of South Carolina; Year: 1976; Format: Videorecording; Charleston: The Network, 1976

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The measurement of depression [motion picture] Source: Lakeside Laboratories, inc. produced by Sturgis Grant Productions, inc; Year: 1969; Format: Motion picture; Milwaukee, Wisc.,: Lakeside Laboratories, [196-?]

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Understanding post-coronary depression [sound recording] Source: Thomas McGee; Year: 1976; Format: Sound recording; La Jolla, Calif.: Health Care Educational Systems: [for sale by Delores Evers], c1976

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CHAPTER 9. PERIODICALS AND NEWS ON DEPRESSION Overview In this chapter, we suggest a number of news sources and present various periodicals that cover depression.

News Services and Press Releases One of the simplest ways of tracking press releases on depression is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “depression” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to depression. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “depression” (or synonyms). The following was recently listed in this archive for depression: •

Forest says its depression drug matches Wyeth's Source: Reuters Industry Breifing Date: September 19, 2003 http://www.reutershealth.com/archive/2003/09/19/business/links/20030919drgd002 .html

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Sertraline less effective when depression involves psychosis Source: Reuters Industry Breifing Date: September 09, 2003

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More evidence links statins and decreased risk of depression Source: Reuters Industry Breifing Date: September 08, 2003

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Cholesterol drugs seem to lower depression risk Source: Reuters Health eLine Date: September 08, 2003

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Study shows drug lifts children's depression Source: Reuters Health eLine Date: August 27, 2003

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Sertraline effective short-term treatment for children with depression Source: Reuters Industry Breifing Date: August 26, 2003

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Estrogen may help depression at menopause Source: Reuters Health eLine Date: August 25, 2003

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Depression doubles risk of dying after heart bypass Source: Reuters Health eLine Date: August 22, 2003

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Depression doubles mortality risk after CABG Source: Reuters Medical News Date: August 21, 2003

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Artery stiffening related to depression in elderly Source: Reuters Health eLine Date: August 20, 2003

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Arterial stiffness is related to depression in the elderly Source: Reuters Medical News Date: August 20, 2003

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Long-term statin use may reduce risk of depression Source: Reuters Industry Breifing Date: August 19, 2003

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Cholesterol drug may also prevent depression Source: Reuters Health eLine Date: August 19, 2003

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Antidepressants may prevent depression-related loss of hippocampal volume Source: Reuters Industry Breifing Date: August 01, 2003

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Andrx signs deal on depression, smoking drugs Source: Reuters Industry Breifing Date: July 31, 2003

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Zoloft improves depression in Alzheimer's patients Source: Reuters Health eLine Date: July 25, 2003

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Sertraline appears useful for Alzheimer's patients with major depression Source: Reuters Industry Breifing Date: July 25, 2003

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Electrical stimulator helps depression Source: Reuters Health eLine Date: July 23, 2003

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Cyberonics study shows device helps treat depression Source: Reuters Industry Breifing Date: July 23, 2003

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Cyberonics says electrical stimulator helps treat depression Source: Reuters Medical News Date: July 23, 2003

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Depression tied to myocardial ischemia in patients with ischemic heart disease Source: Reuters Medical News Date: July 22, 2003

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Gene increases risk of depression after stress Source: Reuters Health eLine Date: July 18, 2003

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Hyperactive stress response to interferon-alpha predicts development of depression Source: Reuters Industry Breifing Date: July 10, 2003

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Treating cancer-related fatigue may reduce anxiety and depression Source: Reuters Medical News Date: July 09, 2003

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NY HMOs fall short on treating depression: report Source: Reuters Health eLine Date: July 09, 2003

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Depression predicts QOL better than cardiac function in patients with CAD Source: Reuters Medical News Date: July 09, 2003

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Sertraline effective for late-life depression Source: Reuters Industry Breifing Date: July 08, 2003

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Glaxo faces new rival to depression drug Paxil Source: Reuters Industry Breifing Date: July 07, 2003

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B-vitamin problems may cause depression in some Source: Reuters Health eLine Date: July 04, 2003

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Genome survey finds depression genes Source: Reuters Health eLine Date: July 02, 2003

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Triiodothyronine does not improve SSRI therapy for major depression Source: Reuters Industry Breifing Date: June 20, 2003

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FDA advises against Glaxo's Paxil for major depression in children Source: Reuters Industry Breifing Date: June 19, 2003

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Depression common in doctors, getting help is not Source: Reuters Health eLine Date: June 18, 2003

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Millions of US adults experience major depression, relatively few treated well Source: Reuters Medical News Date: June 17, 2003

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High homocysteine, MTHFR polymorphism linked to depression Source: Reuters Medical News Date: June 09, 2003

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Vernalis seeks new partner for depression, Parkinson's drug candidates Source: Reuters Industry Breifing Date: June 05, 2003

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Chronic complications of diabetes linked to depression Source: Reuters Medical News Date: May 28, 2003 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “depression” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “depression” (or synonyms). If you know the name of a company that is relevant to depression, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “depression” (or synonyms).

Newsletters on Depression Find newsletters on depression using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “depression.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “depression” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Brown University Geriatric Research Application Digest: GRAD. [Newsletter] Source: Providence, RI: Manisses Communications Group, Inc. 1993-. [8 p. Average]. Contact: Available from Manisses Communications Group, Inc. 205 Governor Street, Providence, RI 02906. (401) 831-6020 or (800) 333-7771. PRICE: $127.00 per year. Summary: This newsletter is produced monthly by the Brown University Center for Gerontology and Health Care Research. The newsletter reviews selected scientific and research articles on clinical geriatrics and policy analysis that have been recently published in professional journals. Some of the articles are specifically concerned with Alzheimer's disease and related dementias, some are about topics that are relevant but not specific to Alzheimer's disease, and some are concerned with other areas of geriatric practice and policy. The April 1993 issue includes reviews of research on such topics as the efficacy of a multidisciplinary approach to diagnosing dementia, the prevalence and causes of dementia in Sweden, treatment decisions for terminally ill patients, the treatment of depression in older patients, the use of age as a criterion for rationing health care, and the Medicare waiver program for home and community based care.

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Health Benefits of Physical Activity Source: Physical Activity and Fitness Research Digest. 1(1):1-8, February 1993. Summary: The Health Benefits of Physical Activity is a newsletter issue that provides a simple summary of the benefits of physical activity. Section one, Disease Prevention and Treatment, lists the diseases for which regular physical activity can reduce risk, either of getting the disease or of dying from it, and describes how exercise reduces risk for these diseases. Diseases that can be prevented through physical activity include (1) heart disease, (2) stroke, (3) vascular disease, (4) high blood pressure, (5) diabetes, (6) colon cancer, (7) obesity, (8) depression, (9) back pain, and (10) osteoporosis. Physical activity has been shown to have a significant beneficial health effect on individuals suffering from depression. Section two, Health Promotion, discusses the Healthy People 2000 report and its health goals. While physical activity's contribution to quality of life and a personal sense of well-being is more difficult to document than its contribution to prevention and treatment of disease, evidence suggests that humans were designed to be physically active and that physical activity has great potential for enhancing quality of life. Section three, Physical Fitness, examines the relationship between physical

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activity and physical fitness. Physical fitness has been linked to injury prevention and is often an important factor in the level of body fat, which can affect disease risk. Regular physical activity has positive benefits for both good health and adequate physical fitness.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “depression” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on depression: •

Depression in Alzheimer's Disease Patients and Caregivers Source: Alzheimer's Association, San Diego Chapter Newsletter. 9(1): 3. Winter 1991. Contact: Available from Alzheimer's Association, San Diego Chapter. P.O. Box 23877, San Diego, CA 92193. (619) 541-1776. PRICE: Call for information. Summary: This newsletter article examines the problem of undiagnosed treatable depression among patients with Alzheimer's disease. In a controlled study of the treatment of Alzheimer's disease patients with depression, it was found that depressed patients improved when given anti-depressant medications or other forms of treatment. Not only are Alzheimer's disease patients subject to depression, but a significant number of their caregivers also are affected by depression. Depression is noted as more disabling than arthritis, ulcers, diabetes, or high blood pressure. Depression can be caused by a physical illness or medication. A list of 'telltale signs' of depression is provided in the article.

•

PXE and Depression Source: PXE Awareness. 9(3): 8-11. 2002. Contact: Available from National Association for Pseudoxanthoma Elasticum (NAPE, Inc.). 3500 East 12th Avenue, Denver, CO 80206. (303) 355-3866. Fax (303) 355-3859. Email: [email protected]. Website: www.napxe.org. Summary: This newsletter article provides people who have pseudoxanthoma elasticum (PXE) with information on depression. Some of the more common symptoms of depression, such as sadness, tears, and hopelessness, may not be present in people who have PXE. Instead, lethargy, loss of interest in activities, inability to concentrate, memory impairment, and impaired ability to care for one's self are more prevalent. Heredity may be a factor in the transmission of depression. The severity of a person's illness may not necessarily predict the presence or seriousness of depression. The article lists the symptoms for major depression as provided by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, of the American Psychiatric Association. Five or more of the symptoms must be present during the same two week period to meet the diagnostic criteria of major depression. In addition, the article discusses the

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treatments that are available, including antidepressants such as Prozac, cognitive behavioral therapy, and interpersonal therapy. •

Depression in the Patient With Lupus: Is It Primary Depression or Is It Lupus Involving the Brain? Source: Happenings. 24(4):1; April 1997. Contact: Lupus Foundation of America, Connecticut Chapter, Inc., 45 South Main Street, Room 111, West Hartford, CT 06107. Summary: This newsletter article for health professionals offers advice for the treatment and management of depression in the lupus patient. Depression can result from the stress of dealing with lupus, but it can also be caused by the affect of lupus on the neurologic system. Subtle and obvious signs of depression are identified. The article identifies blood and other medical tests that may help the rheumatologist determine if the patient is having a lupus flare so that he or she may decide if the patient's depression is the result of a lupus flare. In addition, medications that may be helpful in treating a flare and depression are highlighted.

•

Treatment and Support: A Sunny Forecast for Depression and Behcet's Disease Source: American Behcet's Disease Association. 9(3):4-9. Contact: American Behcet's Disease Association, P.O. Box 6663, Minneapolis, MN 554060663. (800) 7BEHCETS. Summary: This newsletter article for individuals with Behcet's Disease (BD) focuses on the treatment of and support for individuals who develop depression along with BD. It presents reasons why individuals with BD may develop depression and explains why BD patients need to be more alert to the symptoms of depression. The article also discusses available treatments for depression, including the use of antidepressants. These include monoamine oxidase inhibitors, the tricyclic antidepressants, the serotonin selective re-uptake inhibitors, a miscellaneous class of antidepressants, and a new class of antidepressants known as the alpha 2-receptor antagonists. In addition, the article presents alternative treatment options for milder cases of depression such as exercising, initiating contact with others, and taking St. John's wart, and it identifies resources to help cope with BD and depression.

•

Acoustic Neuroma and Depression: An Update Source: ANA Notes. Number 67: 1, 6. September 1998. Contact: Available from Acoustic Neuroma Association (ANA). 600 Peachtree Parkway, Suite 108, Cumming, GA 30041-8211. (770) 205-8211. Fax (770 www.ANAUSA.org. Summary: Acoustic neuroma is a serious illness that, even after surgery, can leave multiple disabling symptoms and depression. This review focuses on depression after surgery for acoustic neuroma. The author notes that a 1993 article reviewed the available information on acoustic neuroma and depression and showed that up to 37 percent of acoustic neuroma patients experienced depression. The author of this 1998 article reports on research published in the past five years. The author also reviews the definitions of depressive disorders as they are outlined in the American Psychiatric Association's diagnostic manual. All of the depressive disorders can be helped by appropriate intervention. This intervention can include peer support, individual counseling, and anti-depressant medication. The author concludes by encouraging

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readers to use the support services offered by the Acoustic Neuroma Association (ANA). 8 references. •

Depression and Incontinence Source: Quality Care. 19(3): 1, 5. Summer 2001. Contact: Available from National Association for Continence. P.O. Box 8310, Spartanburg, SC 29305-8310. (800) 252-3337 or (864) 579-7900. Fax (864) 579-7902. Summary: This newsletter article helps people with urinary incontinence (UI) understand the link between depression and UI. The author notes that the literature suggests that there is an association between a variety of psychiatric disorders and incontinence. Most notably, depression is found in a significant percentage of patients with UI. Depression also occurs in other conditions associated with urinary urge incontinence (involuntary loss of urine associated with urgency), such as aging, dementia, and neurologic disorders. The author considers the possibility that there is a common link in the central nervous system (CNS) between the two conditions (depression and UI). It seems obvious that the unexpected, involuntary loss of urine produces emotional distress, embarrassment, and feelings of loss of control, which can lead to depression. A more interesting explanation is that the imbalances in the chemical messengers that may lead to depression could also make the same patients more prone to involuntary bladder contractions that can cause urge incontinence and enuresis (bedwetting). The author explores this hypothesis, including the role of abnormalities in serotonin function. The author concludes that the search for the cause of various emotional disorders is intensifying.

•

Weights Lift Depression Source: Nutrition Action Healthletter. 29(1):11. January/February 2002. Contact: Center for Science in the Public Interest. 1875 Connecticut Ave., NW, Suite 300, Washington, DC 20009-5728. www.cspinet.org. Summary: A study from the Harvard Medical School and the Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston found that lifting weights may help reduce clinical depression. Symptoms of depression receded in three-quarters of men and women aged 60 to 84 who followed a 20-week strength training program. The benefit was greatest for those with the 'more severe depression,' and continued even when the 'exercisers were on their own and no one was directly supervising them'.

Academic Periodicals covering Depression Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to depression. In addition to these sources, you can search for articles covering depression that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the

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name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

13

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

14

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “depression” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “depression” (or synonyms) into the “For these words:” box. The following is a sample result: •

Predictors of Depression in the Primary Caregivers of HIV Infected Children Contact: Rutgers University, Department of Psychology, Busch Campus, New Brunswick, NJ, 08903. Summary: This paper presents the results of a study conducted to determine the relationships between depression and several possible moderators of depressive reaction among caregivers of children with HIV. Subjects were 46 primary caregivers of 55 HIV-antibody positive children receiving medical treatment in northern and central New Jersey. The information was collected via structured interview with the primary caregiver. Depression was substantially elevated in the biological parents group as compared to the foster caregiver group. Depression was also greater when the caregiver had less availability of social support. Among biological mothers, self-blame for the child's infection as significantly associated with depression. It is imperative that psychosocial support be available to the primary caregivers of HIV infected children, particularly to those who are themselves infected.

•

Psychological Evaluation in Dementia and Depression Source: Danish Medical Bulletin. 32(Supplement 1): 60-61. February 1985. Summary: Patients with organic dementia (28 subjects) and patients with heavy depression (14 subjects) were evaluated on level of cognitive functioning and behavior characteristics. In patients with organic dementia, a general cognitive reduction was found. Severely depressed persons showed some reduction in verbal ability, but performance reached normal level following antidepressant treatment. Patients with Alzheimer's disease have generally systemic solutions on test; brain dysfunctions such as rotations and perseverations are often absent from the tests of depressed persons. Psychometric investigations are obviously valuable for the differentiation of various kinds of organic dementia and nonorganic mental disorders such as depression. 13 references.

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•

Promoting resilience: Helping young children and parents affected by substance abuse, domestic violence, and depression in the context of welfare reform Source: New York, NY: National Center for Children in Poverty. 2000. 23 pp. Contact: Available from National Center for Children in Poverty, Columbia University, 154 Haven Avenue, New York, NY 10032. Telephone: (212) 304- 7100 / fax: (212) 5444200 / e-mail: [email protected] / Web site: http://www.nccp.org. Available from the Web site at no charge. Summary: This report addresses the needs of vulnerable young children and families affected by welfare reform, those in which the adults, particularly mothers, experience substance abuse, domestic violence, and/or serious mental health problems. Section topics include the dimensions of the challenges in policy, families, and services; responses, strategies, policy opportunities, and a discussion f welfare reform action steps. The appendices provide information on the Starting Early Starting Smart program, a list of national organizations and agencies, and contact information for selected state and local organizations. Endnotes conclude the report.

•

Depression in children and adolescents Source: Newark, NJ: Gordon and Breach Publishers. 1993. 254 pp. Contact: Available from Gordon and Breach Publishers, P.O. Box 32160, Newark, NJ 07102. Telephone: (800) 545-8398 / e-mail: [email protected] / Web site: http://www.gbhap.com. $38.00 plus shipping. Summary: This book spans current research in the etiology, biology, phenomenology and treatment of depression in children and adolescents. It is divided into four sections. The first section includes five papers on the development and etiology of depression. The second section has three papers about the relationship between physical illnesses and depression. The third section is about depression and other psychiatric illnesses, and the final section discusses treatment approaches.

The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “depression” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category.

16 17

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 146123 2584 965 1253 307 151232

HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.20 Simply search by “depression” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

18

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

19

The HSTAT URL is http://hstat.nlm.nih.gov/.

20 Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Depression In the following section, we will discuss databases and references which relate to the Genome Project and depression. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).24 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “depression” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for depression: •

Parkinsonism with Alveolar Hypoventilation and Mental Depression Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?168605 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: 24 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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•

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

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•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “depression” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database25 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html.

25

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.

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The Genome Database26 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “depression” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

26

Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on depression can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to depression. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to depression. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “depression”:

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Other Guides Bereavement http://www.nlm.nih.gov/medlineplus/bereavement.html Bipolar Disorder http://www.nlm.nih.gov/medlineplus/bipolardisorder.html Disasters and Emergency Preparedness http://www.nlm.nih.gov/medlineplus/disastersandemergencypreparedness.html Mental Health http://www.nlm.nih.gov/medlineplus/mentalhealth.html Panic Disorder http://www.nlm.nih.gov/medlineplus/panicdisorder.html Postpartum Depression http://www.nlm.nih.gov/medlineplus/postpartumdepression.html Schizophrenia http://www.nlm.nih.gov/medlineplus/schizophrenia.html Seasonal Affective Disorder http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html Suicide http://www.nlm.nih.gov/medlineplus/suicide.html

Within the health topic page dedicated to depression, the following was listed: •

General/Overviews Postpartum Depression Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZSLRXO97C& sub_cat=4 Postpartum Depression Source: National Women's Health Information Center http://www.4woman.gov/faq/postpartum.htm Postpartum Depression and Caring for Your Baby Source: Nemours Foundation http://kidshealth.org/parent/pregnancy_newborn/home/ppd_baby.html

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Diagnosis/Symptoms Recognizing Postpartum Depression Source: National Mental Health Association http://www.nmha.org/children/ppd.pdf

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Treatment Interpersonal Psychotherapy Effective for Treatment of Postpartum Depression Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZ4LE2OEFC &sub_cat=638 Medications Source: National Institute of Mental Health http://www.nimh.nih.gov/publicat/medicate.cfm

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Coping Postpartum Coping: The Blues and Depression Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01243 Tips on Healthy Parenting for Mothers with Depression http://www.nmha.org/infoctr/factsheets/HealthyParentingTips.pdf

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Specific Conditions/Aspects Answers to Common Questions About Postpartum Depression Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ125JYAWC& sub_cat=2001

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Organizations National Institute of Mental Health http://www.nimh.nih.gov/ National Mental Health Association http://www.nmha.org/

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Research Depressed Mothers' Speech Affects Learning In Babies Source: National Institute of Mental Health http://www.nimh.nih.gov/sciadvances/17.cfm

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Statistics Depression in Women Source: National Mental Health Association http://www.nmha.org/infoctr/factsheets/23.cfm

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search.

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The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on depression. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Age Page- Depression: A Serious but Treatable Illness Source: Gaithersburg, MD: National Institute on Aging. 1998. Contact: Alzheimer's Disease Education and Referral (ADEAR) Center. P.O. Box 8250, Silver Spring, MD 20907-8250. (800) 438- 4380; (301) 495-3311; FAX (301) 495-3334. Internet access: www.alzheimers.org. Summary: This pamphlet defines and describes depression in older adults. It points out how depression is often missed, untreated, or misdiagnosed. A list of common signs of depression highlights some symptoms to look for, including ongoing sadness, fatigue, and problems with eating or sleeping. The pamphlet discusses causes of depression and outlines ways it can be treated and prevented. Information about getting help for depression and a list of helpful organizations are provided.

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Depression and the Elderly Source: Los Angeles, CA: Los Angeles County Department of Mental Health, Older Adults Task Force. 1990. [4 p.]. Contact: Available from University of Southern California Alzheimer's Disease Research Center. Andrus Gerontology Center, University Park, MC 0191, Los Angeles, CA 900890191. (213) 740-1709. PRICE: Free. Summary: This brochure describes one elderly woman's experience with depression, a condition that affects approximately ten percent of the elderly population, including people with Alzheimer's disease or dementia and their caregivers. The personal narrative describes her experiences with poor health and daily stresses, her symptoms of depression, the physical and emotional changes it caused, and the frustration she experienced in her search for help. The woman recounts how she eventually dealt with her depression through the help of her psychiatrist and therapist and her own acceptance of the disease. The latter part of the brochure provides information about the prevalence of depression, its causes, including emotional and mental stress, and its symptoms. Treatment may include individual or group counseling, medication, and therapeutic activities designed to alleviate stress. This brochure is available in Spanish (AZBR03242).

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La Depresion En Las Personas Mayores. [Depression and the Elderly] Source: Los Angeles, CA: Los Angeles County Department of Mental Health, Older Adults Task Force. 1989. [4 p.]. Contact: Available from University of Southern California Alzheimer's Disease Research Center. Andrus Gerontology Center, University Park, MC 0191, Los Angeles, CA 900890191. (213) 740-1709. PRICE: Free.

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Summary: This brochure, written in Spanish, describes one elderly woman's experience with depression, a condition that affects approximately ten percent of the elderly population, including people with Alzheimer's disease or dementia and their caregivers. The personal narrative describes her experiences with poor health and daily stresses, her symptoms of depression, the physical and emotional changes it caused, and the frustration she experienced in her search for help. The woman recounts how she eventually dealt with her depression through the help of her psychiatrist and therapist and her own acceptance of the disease. The latter part of the brochure provides information about the prevalence of depression, its causes, including emotional and mental stress, and its symptoms. Treatment may include individual or group counseling, medication, and therapeutic activities designed to alleviate stress. This brochure is available in English (AZBR03241). •

Depression in Lupus Source: Rockville, MD: Lupus Foundation of America, Inc. 1998. 6 p. Contact: Available from Lupus Foundation of America, Inc. 1300 Piccard Drive, Suite 200, Rockville, MD 20850-4303. (800) 558-0121 or (301) 670-9292. Website: www.lupus.org/lupus. PRICE: Available as part of a package of 21 different lupusrelated brochures for $3.95 plus shipping and handling. Summary: This pamphlet for people with lupus uses a question and answer format to examine the occurrence of depression during the course of lupus. It presents the physical and psychological symptoms of clinical depression, identifies the symptoms that indicate the depth and degree of depression, and highlights the most common psychological signs of clinical depression. The pamphlet discusses the occurrence and underdiagnosis of clinical depression in people with a chronic medical illness such as lupus. Other topics include the causes of depression in lupus, the treatment of depression with psychotropic medication or psychotherapy, the prognosis for depression in lupus, and cognitive changes in lupus. The pamphlet also provides information on the Lupus Foundation of America.

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Postpartum depression: Incidence, risk factors, diagnosis, treatment, and resources Source: Baltimore, MD: Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene. 2001. 6 pp. Contact: Available from Maryland Department of Health and Mental Hygiene, 201 West Preston Street, Baltimore, MD 21201. Telephone: (410) 767-6500 or (877) 463-3464 / Web site: http://www.dhmh.state.md.us. Available at no charge; also available from the Web site at no charge. Summary: This booklet for pregnant women and new mothers discusses postpartum depression, reality versus myth, incidence, making the diagnosis, risk factors, screening for hyperthyroidism, and treatments for postpartum depression and psychosis. Two organizational resources are provided.

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Depression in primary care: Detection, diagnosis, and treatment Source: Rockville, MD: Agency for Health Care Policy and Research, U.S. Department of Health and Human Services. 1993. 20 pp. Contact: Available from AHCPR Clearinghouse, U.S. Agency for Healthcare Research and Quality , 2101 East Jefferson Street, Suite 501, Rockville, MD 20852. Telephone: (800)

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358-9295 clearinghouse or (301) 594-1364 AHCPR public affairs / Web site: http://www.ahcpr.gov. Available at no charge. Summary: This pamphlet summarizes for health care practitioners the information contained in the guideline from the Agency for Health Care Policy and Research on depressive disorders, entitled 'Depression in Primary Care, Volumes 1 and 2.' It covers briefly the same issues of detection, diagnosis and treatment regimens, including psychotherapy, medication, and the combination of both. Algorithms for diagnosis and treatment are included. •

Depression is a treatable illness: A patient's guide Source: Rockville, MD: Agency for Health Care Policy and Research, U.S. Department of Health and Human Services. 1993. 33 pp. Contact: Available from AHCPR Clearinghouse, U.S. Agency for Healthcare Research and Quality , 2101 East Jefferson Street, Suite 501, Rockville, MD 20852. Telephone: (800) 358-9295 clearinghouse or (301) 594-1364 AHCPR public affairs / Web site: http://www.ahcpr.gov. Available at no charge. Summary: This pamphlet summarizes for patients with depressive disorders the information contained in the guideline from the Agency for Health Care Policy and Research, entitled 'Depression in Primary Care, Volumes 1 and 2.' It covers briefly the same issues of detection, diagnosis and treatment, including medication, psychotherapy or a combination of both. A list of organizations that can provide help is included, as is a glossary.

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Downtime: A worksite guide to understanding clinical depression Source: Omaha, NE: Wellness Councils of America. 1993. 1 videotape, 1 manual (34 pp.), 1 brochure (2 pp.). Contact: Available from Wellness Councils of America, Community Health Plaza, 7101 Newport Avenue, Suite 311, Omaha, NE 68152-2175. Telephone: (402) 572-3590 / fax: (402) 572-3594 / e-mail: [email protected] / Web site: http://www.welcoa.org. $65.00. Summary: This videotape and accompanying materials educates employers to recognize and respond to depression in the workplace. In addition to the videotape, there is a training manual that gives information and action steps for managers to take in dealing with depression among their employees. A brochure from the National Institute of Mental Health gives additional guidance for supervisors.

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Lets talk about depression Source: Washington, DC: U.S. Government Printing Office. 1991. 2 pp. Contact: Available from Superintendent of Documents, U.S. Government Printing Office, P.O. Box 371954, Pittsburgh, PA 15250-7954. Telephone: (202) 512-1991 for public information (D.C. office) or (202) 512-1800 for ordering and publication information (D.C. office) / fax: (202) 512-1293 (public information); (202) 512-2250 (ordering) / Web site: http://www.access.gpo.gov. $22.00 per 50 copies. Make checks payable to to Superintendent of Documents. Summary: This pamphlet provides information on depression and was developed for inner city youth, particularly African-Americans. Its colorful design, use of celebrity photographs (Whitney Houston, recording artist and Charles A. Mann, Washington

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Redskin football player), and language was designed to attract and hold the attention of young adolescents. •

Guidelines for parents: Surviving: Coping with adolescent depression and suicide Source: Elk Grove Village, IL: American Academy of Pediatrics. 1990. 1 p. Contact: Available from Publications Department, American Academy of Pediatrics, 141 Northwest Point Boulevard, P.O. Box 927, Elk Grove Village, IL 60009-0927. Telephone: (847) 228-5005 or (800) 433-9016 / fax: (847) 228-5097 / e-mail: [email protected] / Web site: http://www.aap.org. $23.50 for 100 copies, members; $28.50, nonmembers. Minimum order: 100 copies. Summary: This brochure provides information for parents to better understand the cause of adolescent suicide. It provides warning signs and guidelines for parents and friends to help a depressed adolescent. Additional national organizations are listed for referral.

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Clinical depression and African Americans Source: Arlington, VA: National Alliance for the Mentally Ill. 1995. 17 items. Contact: Available from National Alliance for the Mentally Ill, 200 North Glebe Road, Suite 1015, Arlington, VA 22203-3754. Telephone: (703) 524-7600 or (800) 950-6264 or (703) 526-7991 TDD / fax: (703) 524-9094 / e-mail: [email protected] / Web site: http://www.nami.org. Summary: This information package contains fact sheets, consumer pamphlets, articles, and other information about depression in African Americans.

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Clinical depression and college students Source: Arlington, VA: National Alliance for the Mentally Ill. 1995. 17 items. Contact: Available from National Alliance for the Mentally Ill, 200 North Glebe Road, Suite 1015, Arlington, VA 22203-3754. Telephone: (703) 524-7600 or (800) 950-6264 or (703) 526-7991 TDD / fax: (703) 524-9094 / e-mail: [email protected] / Web site: http://www.nami.org. Summary: This information package contains fact sheets, consumer pamphlets, articles, and other information about depression in college students.

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Clinical depression and older Americans Source: Arlington, VA: National Alliance for the Mentally Ill. 1995. 17 items. Contact: Available from National Alliance for the Mentally Ill, 200 North Glebe Road, Suite 1015, Arlington, VA 22203-3754. Telephone: (703) 524-7600 or (800) 950-6264 or (703) 526-7991 TDD / fax: (703) 524-9094 / e-mail: [email protected] / Web site: http://www.nami.org. Summary: This information package contains fact sheets, consumer pamphlets, articles, and other information about depression in older people.

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Clinical depression and young professional women Source: Arlington, VA: National Alliance for the Mentally Ill. 1995. 17 items.

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Contact: Available from National Alliance for the Mentally Ill, 200 North Glebe Road, Suite 1015, Arlington, VA 22203-3754. Telephone: (703) 524-7600 or (800) 950-6264 or (703) 526-7991 TDD / fax: (703) 524-9094 / e-mail: [email protected] / Web site: http://www.nami.org. Summary: This information package contains fact sheets, consumer pamphlets, articles, and other information about depression in young women. •

Depression: It's an illness, not a weakness Source: Alexandria, VA: National Mental Health Association. 1995. 11 items. Contact: Available from National Mental Health Association, 1021 Prince Street, Alexandria, VA 22314-2971. Telephone: (703) 684-7722 or (800) 969-NMHA / fax: (703) 684-5968 / Web site: http://www.nmha.org. Summary: This information package contains information about clinical depression in women, including fact sheets, resource lists, newsletters, and pamphlets for consumers.

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Depression and women: Dispelling the myths Source: Staten Island, NY: Freedom from Fear. 1994. 30 pp., 1 videotape (14 minutes, VHS 1/2 inch). Contact: Available from Freedom from Fear, 308 Seaview Avenue, Staten Island, NY 10305. Telephone: (718) 351-1717 / fax: (718) 667-8893. $59.95. Summary: This notebook includes materials to use in organizing a health promotion program about women and depression. It contains a program planning and promotion manual, a depression questionnaire, fact sheets, and an educational videotape.

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Depression and HIV : Assessment and Treatment Contact: Project Inform, HIV Treatment Hotline, 205 13th St Ste 2001, San Francisco, CA, 94103, (415) 558-8669, http://www.projectinform.org. Summary: This fact sheet discusses the treatment of persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) who also suffer from depression. The fact sheet defines depression and explains how it affects persons with HIV/AIDS and their medical treatments. It identifies the symptoms of depression and outlines the various options that can be used to treat depression in conjunction with HIV/AIDS treatment. The treatment options discussed include psychotherapy, which consists of counseling, peer support, and/or group counseling, as well as pharmacotherapy. The fact sheet makes recommendations concerning the safe administration of pharmacotherapy to persons with HIV/AIDS.

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St. John's Wort and the Treatment for Depression Source: Gaithersburg, MD: National Center for Complementary and Alternative Medicine. 2002. 8 p. Contact: Available from National Center for Complementary and Alternative Medicine Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898. (888) 644-6226; INTERNATIONAL PHONE: (301) 519-3153; TTY: (866) 464-3615; FAX: (866) 464-3616; EMAIL: [email protected]. PRICE: Free. Publication Number: D005. Summary: This fact sheet discusses the use of St. John's wort for depression to help consumers make informed decisions about whether to use this complementary and

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alternative medicine (CAM) therapy. It includes a section on key facts about St. John's wort, a section on safety in using this therapy, and a questions and answers section. Information is provided about what St. John's wort is and the purposes for which it is used, what depression is, why St. John's wort is used as a CAM for depression, whether St. John's wort works, how widely it is used, how it is sold, and the risks and possible problems of this therapy. It also lists contacts where consumers can go for more information. 7 references. •

Questions and Answers: A Trial of St. John's Wort (Hypericum perforatum) for the Treatment of Major Depression Source: Gaithersburg, MD: National Center for Complementary and Alternative Medicine. 2002. 8 p. Contact: Available from National Center for Complementary and Alternative Medicine Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898. (888) 644-6226; INTERNATIONAL PHONE: (301) 519-3153; TTY: (866) 464-3615; FAX: (866) 464-3616; EMAIL: [email protected]. PRICE: Free. Publication Number: D145. Summary: This fact sheet, written in a question and answer format, provides information about a clinical trial on St. John's wort for the treatment of major depression. The questions are categorized into three sections: background on St. John's wort and depression, about the trial, and conclusions and future research. It includes information about the specifics of the trial, such as the characteristics of the trial participants, the types of drugs and doses used, and the main results. 6 references.

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Just the Facts: Dealing with Depression Source: Madison, WI: Life Options Rehabilitation Program. 2000. [2 p.]. Contact: Available from Life Options Rehabilitation Program. Medical Education Institute, Inc, 414 D'Onofrid Drive., Suite 200, Madison, WI 53719. (608) 833-8033. Email: [email protected]. PRICE: Single copy free to health professionals only. Summary: This fact sheet offers tips for readers on how to deal with depression. Designed primarily for readers with kidney disease, the fact sheet notes that depression is very common after receiving a diagnosis of kidney disease. Depression is not just a rare day of sadness but includes symptoms of feeling hopeless and helpless for a few weeks, sleeping or eating more or less than usual, or missing dialysis. Depression can sometimes be prevented and can always be treated. The fact sheet stresses that getting help for depression is vital to dealing with a chronic illness. The second page of the fact sheet consists of a chart that summarizes specific problems that may arise in depression, how to prevent them, and questions that readers could ask of the health care team to alleviate those problems. The fact sheet concludes with a listing of three information resources (including websites) for readers who wish additional assistance. 1 table.

The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “depression” (or synonyms). The following was recently posted:

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Depression Source: University of Michigan Health System - Academic Institution; 1998 June http://www.guideline.gov/summary/summary.aspx?doc_id=1782&nbr=1008&a mp;string=depression

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Depression following spinal cord injury. A clinical practice guideline for primary care physicians Source: Consortium for Spinal Cord Medicine - Private Nonprofit Organization; 1998; 35 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1677&nbr=903&am p;string=depression

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Depression. A guide to diagnosis and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2001; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3432&nbr=2658&a mp;string=depression

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Detection of depression in the cognitively intact older adult Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1998; 25 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1503&nbr=729&am p;string=depression

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Major depression in adults for mental health care providers Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 February (revised 2002 May); 43 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3354&nbr=2580&a mp;string=depression

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Major depression, panic disorder and generalized anxiety disorder in adults in primary care Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 January (revised 2002 May); 55 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3350&nbr=2576&a mp;string=depression

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Pharmacologic treatment of acute major depression and dysthymia Source: American College of Physicians - Medical Specialty Society; 2000; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2547&nbr=1773&a mp;string=depression

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Pharmacotherapy companion to the depression clinical practice guideline Source: American Health Care Association - Professional Association; 1998; 26 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1807&nbr=1033&a mp;string=depression

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Postnatal depression and puerperal psychosis. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2002 June; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3360&nbr=2586&a mp;string=depression

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Practice guideline for the treatment of patients with major depressive disorder Source: American Psychiatric Association - Medical Specialty Society; 1993 (revised 2000); 45 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2605&nbr=1831&a mp;string=depression

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Practice parameters for the assessment and treatment of children and adolescents with depressive disorders Source: American Academy of Child and Adolescent Psychiatry - Medical Specialty Society; 1998; 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1531&nbr=757&am p;string=depression

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Screening for depression: recommendations and rationale Source: United States Preventive Services Task Force - Independent Expert Panel; 1996 (revised 2002 May); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3176&nbr=2402&a mp;string=depression

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VHA/DOD clinical practice guideline for the management of major depressive disorder in adults Source: Department of Defense - Federal Government Agency [U.S.]; 1997 (updated 2000); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2585&nbr=1811&a mp;string=depression

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Wheelchair biking for the treatment of depression Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2003 February; 53 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3682&nbr=2908&a mp;string=depression Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Age Page - Depression: Don't Let the Blues Hang Around Summary: This fact sheet addresses depression in the elderly. Topics covered include causes, symptoms, treatment, prevention and tips on getting help. Source: National Institute on Aging, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5192

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Bupropion (Wellbutrin) Summary: Bupropion (byoo-PROE-pee-on) is used to relieve mental depression and is used as part of a support program to help you stop smoking. Source: National Library of Medicine, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6997

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Caring for the Caregiver Summary: Caring for a child with a disability can create stress, depression, and physical problems. Source: American Occupational Therapy Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7294

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Clinical Depression in Women Summary: A discussion on clinical depression in women. Topics covered include episodes in a woman's life that trigger depressive illnesses. Source: National Mental Health Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4294

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Dealing with the Depths of Depression Summary: This consumer health information article discusses depression, diagnosis and the effectiveness of various treatments, including alternative therapy. Source: U.S. Food and Drug Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3589

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Depression Summary: Also available In: Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=151

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Depression (PDQ®) Summary: This patient summary on depression is adapted from a summary written for health professionals by cancer experts. Source: National Cancer Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4462

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Depression and Alzheimer's Disease Summary: A fact sheet that discusses depression and Alzheimer's disease and how a caregiver can recognize depression in a family member or patient with Alzheimer's disease. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6084

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Depression and Cancer Summary: Research has enabled many men, women, and young people with cancer to survive and to lead fuller, more productive lives, both while they are undergoing treatment, and afterwards. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6901

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Depression and Diabetes Summary: Depression can strike anyone, but people with diabetes, a serious disorder that afflicts an estimated 16 million Americans, may be at greater risk. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6902

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Depression and Heart Disease Summary: Depression can strike anyone. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6900

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Depression and HIV/AIDS Summary: Research has enabled many men and women, and young people living with human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), to lead fuller, more Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6899

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Depression and Parkinson's Disease Summary: Depression can strike anyone, but people with Parkinson's disease, a progressive brain disorder affecting more than 500,000 Americans, may be at greater risk. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6898

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Depression and Stroke Summary: Depression can strike anyone, but people with serious illnesses such as stroke may be at greater risk. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6903

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Depression Can Break Your Heart Summary: Research over the past two decades has shown that depression and heart disease are common companions and, what is worse, each can lead to the other. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6614

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Depression in Children and Adolescents: A Fact Sheet for Physicians Summary: This fact sheet, prepared by the National Institute of Mental Health (NIMH), the lead Federal agency for research on mental disorders, summarizes some of the latest scientific findings on child and Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6623

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Depression in Men Before and After the Birth of a Child Summary: A brief review of a study of the prevalence of depressive symptoms in men before and after the birth of a child and any relationship between depression and family structure. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4296

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Depression: Electroconvulsive Therapy Summary: This fact sheet provides a general overview of electroconvulsive therapy (ECT) and the types of depressive conditions for which ECT is favored as a treatment. Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5636

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Depression: What Every Woman Should Know Summary: Also available In: Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2378

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Depression-Screening Test Summary: If you think you are experiencing symptoms of clinical depression the depression-screening test on this site may help you to decide if you need to seek professional help. Source: National Mental Health Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5190

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Do You Have Postnatal Depression? Symptom-Feeling Checklist Summary: This checklist is not intended to be used to diagnose antenatal or postnatal depression. It is intended to help women express the way they have been feeling over the past two weeks. Source: Postpartum Support International http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7442

•

Fluoxetine and Counseling for Postpartum Depression Summary: An from the American Family Physician discusses postpartum depression and its treatment, abstracted from a controlled study of fluoxetine and cognitivebehavioral counseling in the treatment of Source: American Academy of Family Physicians http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4295

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•

Holiday Blues or Depression? Summary: This article discusses some major factors that contribute to holiday Source: American Association for Geriatric Psychiatry http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6146

•

If You're Over 65 and Feeling Depressed Summary: This booklet discusses causes, symptoms, and treatment of depression and bipolar disorder (also called manic-depression), especially as it relates to older adults. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=123

•

Information about Depression and Bipolar Disorder (Manic-Depressive Illness) in Adolescents Summary: This on-line pamphlet for teens with depression and bipolar disorder discusses depression symptoms and treatment. Links for additional resources are included. Source: Depression and Related Affective Disorders Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5793

•

Late Life Depression Summary: A general overview of late-life depression, a serious illness affecting adults over age 65. Source: American Association for Geriatric Psychiatry http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6148

•

Let's Talk About Depression Summary: Most people with depression can be helped with treatment. But a majority of depressed people never get the help they need. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6641

•

Major Depression in Children and Adolescents Summary: Major depression is one of the mental, emotional, and behavior disorders that can appear during childhood and adolescence. Source: SAMHSA's National Mental Health Information Center, Center for Mental Health Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5168

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•

Mental Health Publications & Education Programs Summary: Conference proceedings, consumer publications, and public education program materials on anxiety, attention deficit hyperactivity disorder, depression, panic disorder, learning disabilities, bipolar Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=358

•

NIMH Depression Summary: Links to fact sheets, summaries, and booklets about depression for the public and to conference and workshop summaries for researchers. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=698

•

Older Adults: Depression and Suicide Facts Summary: Major depression, a significant predictor of suicide in older adults, is a widely underrecognized and undertreated medical illness. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6647

•

Online Depression Screening Test Summary: ODST is a preliminary screening test for depressive symptoms that does not replace in any way a formal psychiatric evaluation. Source: Educational Institution--Follow the Resource URL for More Information http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1124

•

Real Men. Real Depression. Summary: The National Institute of Mental Health (NIMH) is reaching out to educate the public about depression in men through its Real Men. Real Depression. campaign. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7424

•

S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease Summary: The objective of this report was to conduct a search of the published literature on the use of S-adenosyl- L-methionine (SAMe) for the treatment of osteoarthritis, depression, and liver disease; and, Source: Agency for Healthcare Research and Quality http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7461

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•

St. John's Wort Summary: This fact sheet provides a description of St. John's Wort and discusses its current use as a treatment for depression, anxiety, seasonal affective disorder, and sleep disorders. Source: National Center for Complementary and Alternative Medicine, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6048

•

St. John's Wort and the Treatment of Depression Summary: The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet on the use of St. John's wort for depression. Source: National Center for Complementary and Alternative Medicine, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7356

•

The Invisible Disease: Depression Summary: Depression is a serious medical condition. Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6656

•

Why Am I So Sad? Summary: This fact sheet discusses sadness in children and teenagers, the difference between sadness and depression and where to get help when sadness becomes depression. Source: Nemours Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5533 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to depression. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Additional Web Sources

A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Associations and Depression The following is a list of associations that provide information on and resources relating to depression: •

American Institute of Stress Telephone: (914) 963-1200 Fax: (914) 965-6267 Email: [email protected] Web Site: http://www.stress.org Background: The American Institute of Stress (AIS), established in 1978, is a nonprofit organization dedicated to advancing knowledge of mind-body relationships and the role of stress in health and illness. Its Board of Trustees consists of physicians, health care professionals and lay individuals with expertise in various stress-related areas as well as interest in the role of stress in disease and promoting health. Eligibiity for Fellowship s granted to those whose can demonstrate expertise by virtue of training, publications or practical experience. Updated files are maintained on all stress-related topics from which informational packets can be ordered. A monthly Newsletter is available to subscribers, Members and Fellows. AIS also organizes and participates in conferences dealing with relevant issues. Relevant area(s) of interest: Depression

•

Bazelon Center for Mental Health Law Telephone: (202) 467-5730 Fax: (202) 223-0409 Email: [email protected] Web Site: http://www.bazelon.org Background: The Bazelon Center for Mental Health Law is a national not-for-profit organization that uses litigation and federal policy reform to define and uphold the legal rights of children, adults, and elderly individuals with mental disabilities and to create

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approaches to meeting their needs that will assure them choice and dignity. Staff attorneys provide training and technical assistance to legal services, protection and advocacy, state ombudsman programs, and other advocates for low income individuals and families. The Center was formed in 1972 as the Mental Health Law Project; however, its name was changed in 1993 to honor the late Chief Justice of the U.S. Court of Appeals of the District of Columbia Circuit, David L. Bazelon. The Center publishes issue papers, booklets, manuals, and periodic newsletters explaining and interpreting major federal laws and regulations that protect the rights of and make resources available to children and adults with disabilities. •

Child and Adolescent Bipolar Foundation (CABF) Telephone: (847) 256-8525 Fax: (847) 920-9498 Email: [email protected] Web Site: http://www.bpkids.org Background: The Child and Adolescent Bipolar Foundation (CABF) is a not-for-profit organization dedicated to educate families, professionals, and the public about earlyonset bipolar disorder; support families to maximize the well-being of the child while minimizing the adverse impact of bipolar disorders on the family; and advocate for increased services to families and research on the nature, causes, and treatment of bipolar disorders in the young. CABF was established in 1999, and currently consists of more than 12,500 members. Relevant area(s) of interest: Depression

•

Dana Alliance for Brain Initiatives Telephone: (212) 223-4040 Fax: (212) 593-7623 Email: [email protected] Web Site: http://www.dana.org Background: The Dana Alliance for Brain Initiatives, a nonprofit organization supported by the Charles A. Dana Foundation, was established as an alliance of neuroscientists dedicated to providing information and promoting understanding concerning the personal and public benefits of brain research. (The Charles A. Dana Foundation is a private philanthropic foundation with grant programs in health and education.) According to the Alliance, approximately one in five Americans is affected by a brain disease or disorder, ranging from learning disabilities to Parkinson s Disease from epilepsy to spinal cord injuries. The Dana Alliance for Brain Initiatives is dedicated to answering questions concerning brain-related research and providing information concerning new developments. The Alliance offers a variety of periodicals, newsletters, reports, reference works, and books. Relevant area(s) of interest: Depression

•

Delta Society Telephone: (425) 226-7357 Toll-free: (800) 869-6898 Fax: (425) 235-1076

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Email: [email protected] Web Site: http://www.deltasociety.org Background: The Delta Society is a not-for-profit, voluntary organization dedicated to bringing pets into the lives of people who are ill in an effort to improve healing and to helping individuals with disabilities overcome barriers and lead healthier lifestyles. The Society s Pet Partners Program was established in 1977 to train volunteers and screen their pets for visiting animal programs in hospitals, nursing homes, rehabilitation centers, and schools. The organization currently consists of 5,000 members with 2,000 pet partners teams operating in 45 states. Animal assisted therapy is incorporated as part of the treatment program for depression, attention deficit hyperactivity disorder, head injuries, and speech disorders as well as many other conditions. Training is provided through Delta certified instructors, a home study course and videotape, and a continuing education newsletter. In addition, the Society offers an 800 Action Line, which provides immediate and comprehensive assistance to people with service dogs who are denied access to places of public accommodation, housing, and employment. Relevant area(s) of interest: Depression •

Depression Alliance (UK) Telephone: 020 7633 0557 Fax: 020 7633 0559 Email: [email protected] Web Site: www.depressionalliance.org Background: The Depression Alliance is a not-for-profit organization in the United Kingdom that is run by and for individuals affected by depression and their caregivers. Depression is characterized by persistent sadness with feelings of helplessness and hopelessness. The Depression Alliance was established in 1974 and currently consists of over 3,000 members and approximately 100 self-help groups. The Alliance is dedicated to providing information about the nature of depression and how it may be overcome, offering networking opportunities to affected individuals, enabling relatives and friends to understand and cope with the problems that arise when a family member or friend is depressed, and helping members form self-help groups that provide mutual support. In addition, the Depression Alliance works to raise awareness to increase public understanding, cooperates with professionals who care for affected individuals, and promotes and encourages research into the causes and treatment of depression. The Alliance's programs and services include conducting seminars, lectures, workshops, discussions, annual general meetings, and 'Open Days' for members or other interested individuals; offering a variety of educational materials including leaflets, booklets, videotapes, and a quarterly newsletter entitled 'A Single Step'; and maintaining a web site on the Internet. The Alliance's web site discusses the organization's mission, goals, and services; provides a FAQ ('frequently asked questions') area; and offers access to extracts of several educational leaflets.

•

Depression and Related Affective Disorders Association Telephone: (410) 955-4647 Fax: (410) 614-3241 Email: [email protected] Web Site: www.drada.org

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Background: The Depression and Related Affective Disorders Association (DRADA) is a nonprofit organization uniting the efforts of persons with affective disorders, family members, and mental health professionals. The mission of the organization is to provide information, assistance, and support to those with depression and manic depression by assisting self-help groups. In addition, the Association lends support to research programs. Educational materials produced by the Depression and Related Affective Disorders Association include a variety of pamphlets, books, and videos. Relevant area(s) of interest: Depression •

Emotions Anonymous Telephone: (651) 647-9712 Fax: (651) 647-1593 Email: [email protected] Web Site: http://www.EmotionsAnonymous.org Background: Emotions Anonymous (EA) is an international not-for-profit self-help group that follows a twelve step program (similar to Alcoholics Anonymous) for individuals seeking emotional health and wellness. EA sponsors support group meetings for the purpose of facilitating mutual help by the sharing of experiences, strength, and hope and working toward recovery from emotional difficulties. Individuals for whom EA has proved beneficial include those experiencing problems such as anger, depression, panic or anxiety, phobias, grief, broken or strained relationships, difficulty expressing emotions, low self-esteem, obsessive or compulsive behavior, worry, tension, and a variety of other emotional problems. Founded in 1971, EA has grown to encompass approximately 1,300 chapters in 39 countries. EA is an anonymous program that protects the confidentiality of its members at all times. Relevant area(s) of interest: Depression

•

Harvard Brain Tissue Resource Center Telephone: (617) 855-2400 Toll-free: (800) 272-4622 Fax: (617) 855-3199 Email: [email protected] Web Site: http://www.brainbank.mclean.org:8080 Background: The Harvard Brain Tissue Resource Center is a federally funded, not-forprofit organization, dedicated to serving as a national resource for the collection and distribution of postmortem brain tissues for medical research into the causes of neurological and psychiatric disorders. The Brain Bank is interested in the study of Huntington s, Alzheimer s, and Parkinson s diseases, progressive supranuclear palsy (PSP), amyotrophic lateral sclerosis (ALS), Tourette and Rett syndromes, and autism, as well as schizophrenia and manic depressive illnesses. The Center distributes brain tissue samples, at no charge, to qualified investigators in the United States who are involved in studying the neurobiology of these disorders.

•

Lithium Information Center/Obsessive Compulsive Information Center Telephone: (608) 827-2470 Fax: (608) 827-2479

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Email: [email protected] Web Site: http://www.miminc.org Background: The Lithium Information Center and Obsessive Compulsive Information Center are affiliated with the Madison Institute of Medicine, a not-for-profit organization committed to conceptualizing, developing, and disseminating innovative approaches to the education of professionals, consumers, and the general public about psychiatric disorders and their treatment. An additional focus of the Institute is clinical research as a vehicle to advance the frontiers of medicine and improve quality of life. At the core of the Institute's educational efforts are the Lithium Information Center (LIC) and the Obsessive Compulsive Information Center (OCIC). The LIC acquires, catalogs, and disseminates information on the biomedical uses of lithium and other medications for the treatment of bipolar (manic-depressive) disorder, a psychiatric disorder in which affected individuals experience recurrent mood swings including episodes of depression and episodes characterized by overactivity, elation, irritability, and other symptoms (mania). The Center currently has more than 28,000 references on such topic areas as lithium treatment in bipolar disorder or related psychiatric disorders, use of lithium during pregnancy, interactions with other medications, and appropriate monitoring procedures. The Obsessive Compulsive Center obtains, catalogs, and distributes biomedical information concerning obsessive compulsive disorder (OCD) and related disorders. OCD is an anxiety disorder characterized by repetitive actions or rituals (compulsions) performed in response to recurrent obsessive thoughts, according to certain rules. The OCIC currently has more than 12,000 references on file on such topics as OCD, related disorders including trichotillomania and body dysmorphic disorder, diagnosis and classification, behavior therapy, and pharmacologic therapy. The LIC's and OCIC's references include medical journal articles, books, book chapters, government documents, meeting proceedings, pamphlets, magazine articles, and other documents. Reference files may be searched by author, title word, key word (subject), publication name, and year of publication. In response to requests, the Centers provide computer-printed bibliographies and single photocopies of articles (subject to copyright law) on any topic relating to lithium or OCD. The Centers also maintain physician and support group referral lists. The Madison Institute of Medicine also hosts semiannual Continuing Medical Education (CME) conferences concerning mental health and health care issues. Such programs are endorsed and certified by the University of Wisconsin Medical School Continuing Medical Education. •

March of Dimes Birth Defects Foundation Telephone: (914) 428-7100 Toll-free: (888) 663-4637 Fax: (914) 997-4763 Email: [email protected] Web Site: http://www.marchofdimes.com Background: The March of Dimes Birth Defects Foundation is a national not-for-profit organization that was established in 1938. The mission of the Foundation is to improve the health of babies by preventing birth defects and infant mortality. The March of Dimes funds programs of research, community services, education, and advocacy. Educational programs that seek to prevent birth defects are important to the Foundation and to that end it also produces a wide variety of printed informational materials and videos. The Pregnancy and Newborn Health Education Center staffs trained health information specialists who provide researched information on pregnancy issues,

580 Depression

complications and risks, newborn care, birth defects, genetic diseases and related topics as well as referrals to relevant organizations and support groups. •

Mental Health Foundation (UK) Telephone: 0207 802 0300 Fax: 0207 802 0301 Email: [email protected] Web Site: http://www.mentalhealth.org.uk Background: The Mental Health Foundation is a not-for-profit organization in the United Kingdom that is concerned with all aspects of mental health, including mental illness and learning disabilities. Established in 1949, the Foundation is committed to pioneering new approaches to delivering services, treatment, and care that will help meet the needs of affected individuals and increase understanding of mental illness and learning disabilities. The Foundation works to fulfill its mission and objectives by regularly identifying and implementing major initiatives and working closely with health, housing, and social services agencies across the UK, professional bodies, research centers, the voluntary sector, and the government. Current programs include providing biomedical research grants that focus on bridging research knowledge of effective intervention and its use in practice, funding projects to work with parents affected by depression, and working in partnership with schools to promote a whole school approach to the mental health of children and young people. The Foundation also provides community health services including implementing a crisis services development initiative to develop alternatives to hospitals for people in a mental health crisis, conducting an annual crisis services conference, developing community mental health teams, and funding projects focusing on supported employment in non-mental health settings for people with a mental illness. The Mental Health Foundation has also established the Foundation for People with Learning Disabilities. This Foundation provides the 'Choice Initiative,' which is dedicated to providing assistance to people affected by severe, profound, and multiple learning disabilities. The Choice Initiative funds projects that help young people in the transition process and enable affected individuals to access employment opportunities. The Foundation for People with Learning Disabilities also offers a program that is dedicated to extending choice and opportunities for older people with learning disabilities. In addition, the Mental Health Foundation maintains a web site on the Internet and offers a variety of educational materials including information sheets, leaflets, and a directory.

•

National Alliance for the Mentally Ill Telephone: (703) 524-7600 Toll-free: (800) 950-6264 Fax: (703) 524-9094 Email: [email protected] Web Site: http://www.nami.org Background: The National Alliance for the Mentally Ill (NAMI) is a not-for-profit voluntary health organization dedicated to providing mutual support, education, advocacy, and research funding for people affected by mental illness, their families, and friends. The organization also serves those who have been diagnosed with schizophrenic depression and other related disorders. Established in 1979, this self-help organization refers individuals to nationwide support groups, services, and outreach

Patient Resources 581

programs. Educational materials produced by the organization include a database, directories, annual reports, informational brochures, pamphlets, a bimonthly newsletter entitled 'The Advocate,' and 'The Decade of the Brain,' NAMI's quarterly publication for presenting research, clinical practices and advances, and policy updates relevant to serious brain disorders. Relevant area(s) of interest: Depression •

National Depressive and Manic-Depressive Association (DMDA) Address: Telephone: (312) 642-0049 Toll-free: (800) 826-3632 Fax: (312) 642-7243 Web Site: http://www.ndmda.org Background: The National Depressive and Manic-Depressive Associatino (National DMDA) is the nation's largest patient-directed, illness-specific organization. Incorporated in 1986 and based in Chicago, it represents the voices of more than 23 million American adults living with depression and an additional 2.5 million adults living with manic-depression, also known as bipolar disorder. It is a not-for-profit organization that educates the public concerning the nature of depressioin and manicdepressive illnesses as treatable medical diseases. National DMDA has a grassroots network of mroe than 800 patient-run support groups that hold regular meetings across the United States and Canada. Relevant area(s) of interest: Depression

•

National Mental Health Association Telephone: (703) 684-7722 Toll-free: (800) 969-6642 Fax: (703) 684-5968 Email: [email protected] Web Site: http://www.nmha.org Background: Established in 1909, the National Mental Health Association (NMHA) is a not-for-profit voluntary organization that addresses the mental health needs of individuals throughout the United States. The Association, which has over 300 affiliates in 35 states, has a network of volunteers across the country that work to meet the mental health needs of their communities. Activities include support groups, community outreach and education, information and referral programs, patient advocacy, and a wide array of other services. Nationally, the Association works with the media to keep the public informed about mental health and mental illness and with the Federal government to promote research and services for people with mental health problems. The Association also works with other major organizations to ensure that the nation s mental health needs are understood and addressed. Services include fact sheet and pamphlet distribution; buddy and companion programs; client services and case management; education and training programs; referral services; and social and recreational programs, workshops, and seminars. Educational materials distributed by the Association include quarterly newsletters entitled 'Prevention Update' and 'The Bell.'. Relevant area(s) of interest: Depression

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National Mental Health Consumer Self-Help Clearinghouse Telephone: Toll-free: (800) 553-4539 Fax: (215) 636-6312 Email: [email protected] Web Site: http://www.mhselfhelp.org Background: The National Mental Health Consumers' Self-Help Clearinghouse is a selfhelp technical assistance organization that was established in 1985. The Clearinghouse handles thousands of inquiries annually from people who are concerned with mental health issues. Clients include mental health care consumers, family members, professionals, and other interested people who request information and technical assistance about starting and developing self-help projects, self-advocacy projects, and consumer-run mental health services. The Clearinghouse also provides on-site consultations to individuals and groups interested in self-help group and consumer-run service development. In addition, the Clearinghouse sponsors conferences and training events and has developed a wide variety of printed pamphlets and manuals on issues related to developing self-help and self-advocacy projects. A national quarterly newsletter entitled 'The Key' provides assistance to consumers, their families, advocates, and physicians.

•

SANE Australia Telephone: 61 3 9682 5933 Toll-free: 1800 688 382 Fax: 61 3 9682 5944 Email: [email protected] Web Site: http://www.sane.org Background: SANE Australia is a national voluntary organization dedicated to improving the well-being of Australians affected by mental illness. Established in 1986, the organization is committed to promoting and conducting research, developing innovative resources for affected individuals and families, and campaigning for improved awareness, attitudes, and services. SANE Australia works to fulfill its mission and objectives by offering an information and referral helpline for Australian callers who are concerned about mental illness; conducting research into the effects of mental illness; promoting public awareness through media campaigns, sponsorships, and other activities; and having an informational network of over 100 community organizations across Australia that are dedicated to working with people affected by mental illness. The organization also develops a wide range of print and multimedia resources that explain mental illness and related issues in understandable language, including fact sheets, booklets, educational software, videotapes, audiotapes, a magazine entitled 'SANE News,' and a series entitled 'SANE Blueprints' that focuses on helping individuals affected by mental illness live in the community.

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to depression. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with depression.

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The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about depression. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “depression” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “depression”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “depression” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “depression” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.27

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

27

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)28: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

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California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

28

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

588 Depression

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries 589

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

590 Depression

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

591

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on depression: •

Basic Guidelines for Depression Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Depression - elderly Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001521.htm Depression - resources Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002177.htm Depression signs in teenagers Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001996.htm Major depressive disorder Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm

592 Depression

•

Signs & Symptoms for Depression Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Change in appetite Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003121.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Difficulty falling asleep Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Difficulty sleeping Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Discouragement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm High blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Hypersomnia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Insomnia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Irritability Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003214.htm Lethargy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Loss of appetite Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003121.htm Memory loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003257.htm Sadness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Sleepiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm

Online Glossaries 593

Sleeping difficulties Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Tiredness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Weariness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Weight gain (unintentional) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003084.htm Weight loss (unintentional) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for Depression Differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm Dopamine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003561.htm Electroconvulsive therapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003324.htm MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003335.htm Norepinephrine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003561.htm Serotonin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003562.htm

•

Background Topics for Depression Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Physical activity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm

594 Depression

Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

595

DEPRESSION DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 2-Propanol: An isomer of 1-propanol. It is a colorless liquid having disinfectant properties. It is used in the manufacture of acetone and its derivatives and as a solvent. Topically, it is used as an antiseptic. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Absenteeism: Chronic absence from work or other duty. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH] ACE Inhibitor: A type of drug used to lower blood pressure. Studies indicate that it may also help prevent or slow the progression of kidney disease in people with diabetes. [NIH] Acetone: A colorless liquid used as a solvent and an antiseptic. It is one of the ketone bodies produced during ketoacidosis. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH]

596 Depression

Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjustment Disorders: Maladaptive reactions to identifiable psychosocial stressors occurring within a short time after onset of the stressor. They are manifested by either impairment in social or occupational functioning or by symptoms (depression, anxiety, etc.) that are in excess of a normal and expected reaction to the stressor. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH]

Dictionary 597

Adrenaline: A hormone. Also called epinephrine. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic Agents: Drugs that act on adrenergic receptors or affect the life cycle of adrenergic transmitters. Included here are adrenergic agonists and antagonists and agents that affect the synthesis, storage, uptake, metabolism, or release of adrenergic transmitters. [NIH]

Adrenergic Uptake Inhibitors: Drugs that block the transport of adrenergic transmitters into axon terminals or into storage vesicles within terminals. The tricyclic antidepressants (antidepressive agents, tricyclic) and amphetamines are among the therapeutically important drugs that may act via inhibition of adrenergic transport. Many of these drugs also block transport of serotonin. [NIH] Adrenolytic: Inhibiting the action of adrenergic nerves; inhibiting the response to epinephrine. [EU] Adrenoreceptor: Receptors specifically sensitive to and operated by adrenaline and/or noradrenaline and related sympathomimetic drugs. Adrenoreceptor is an alternative name. [NIH]

Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosols: Colloids with a gaseous dispersing phase and either liquid (fog) or solid (smoke) dispersed phase; used in fumigation or in inhalation therapy; may contain propellent agents. [NIH]

Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring

598 Depression

substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Alanine: A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases immunity, and provides energy for muscle tissue, brain, and the central nervous system. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH]

Dictionary 599

Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (-COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (-COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amnesia: Lack or loss of memory; inability to remember past experiences. [EU] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amoxapine: The N-demethylated derivative of the antipsychotic agent loxapine that works by blocking the reuptake of norepinephrine, serotonin, or both. It also blocks dopamine receptors. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]

Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH]

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Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Angioid Streaks: Small breaks in the elastin-filled tissue of the retina. [NIH] Angiotensin converting enzyme inhibitor: A drug used to decrease pressure inside blood vessels. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Annual Reports: Annual statements concerning the administrative and operational functions of an institution or organization. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anosognosia: Inability to recognize loss of function, disease, or defect in a part of one's own body. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery. Branches of the anterior cerebral artery supply the caudate nucleus, internal capsule, putamen, septal nuclei, gyrus cinguli, and surfaces of the frontal lobe and parietal lobe. [NIH] Anthropometry: The technique that deals with the measurement of the size, weight, and proportions of the human or other primate body. [NIH] Anti-Anxiety Agents:

Agents that alleviate anxiety, tension, and neurotic symptoms,

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promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Anticonvulsive: An agent that prevents or relieves convulsions. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antidepressive Agents, Second-Generation: A structurally and mechanistically diverse group of drugs that are not tricyclics or monoamine oxidase inhibitors. The most clinically important appear to act selectively on serotonergic systems, especially by inhibiting serotonin reuptake. [NIH] Antidiuretic: Suppressing the rate of urine formation. [EU] Antidopaminergic: Preventing or counteracting (the effects of) dopamine. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU]

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Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Anti-Obesity Agents: Agents that increase energy expenditure and weight loss by neural and chemical regulation. Beta-adrenergic agents and serotoninergic drugs have been experimentally used in patients with non-insulin dependent diabetes mellitus (NIDDM) to treat obesity. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antispasmodic: An agent that relieves spasm. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Apnea: A transient absence of spontaneous respiration. [NIH] Apnoea: Cessation of breathing. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH]

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Aptitude: The ability to acquire general or special types of knowledge or skill. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Articular: Of or pertaining to a joint. [EU] Aspartate: A synthetic amino acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-aminoacids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atenolol: A cardioselective beta-adrenergic blocker possessing properties and potency similar to propranolol, but without a negative inotropic effect. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] ATP: ATP an abbreviation for adenosine triphosphate, a compound which serves as a carrier of energy for cells. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the

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heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autogenic: A type of succession when the developing vegetation itself is the cause for the succession. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autopsy: Postmortem examination of the body. [NIH] Autoreceptors: Transmitter receptors on or near presynaptic terminals (or varicosities) which are sensitive to the transmitter(s) released by the terminal itself. Receptors for the hormones released by hormone-releasing cells are also included. [NIH] Axilla: The underarm or armpit. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH]

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Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Behavioral Medicine: The interdisciplinary field concerned with the development and integration of behavioral and biomedical science, knowledge, and techniques relevant to health and illness and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation. [NIH] Behavioral Symptoms: Observable manifestions of impaired psychological functioning. [NIH]

Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Benchmarking: Method of measuring performance against established standards of best practice. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Bereavement: Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bicarbonates: Inorganic salts that contain the -HCO3 radical. They are an important factor in determining the pH of the blood and the concentration of bicarbonate ions is regulated by the kidney. Levels in the blood are an index of the alkali reserve or buffering capacity. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH]

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Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding agent: A substance that makes a loose mixture stick together. For example, binding agents can be used to make solid pills from loose powders. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biodegradation: The series of processes by which living organisms degrade pollutant chemicals, organic wastes, pesticides, and implantable materials. [NIH] Biogenic Amines: A group of naturally occurring amines derived by enzymatic decarboxylation of the natural amino acids. Many have powerful physiological effects (e.g., histamine, serotonin, epinephrine, tyramine). Those derived from aromatic amino acids, and also their synthetic analogs (e.g., amphetamine), are of use in pharmacology. [NIH] Biogenic Monoamines: Biogenic amines having only one amine moiety. Included in this group are all natural monoamines formed by the enzymatic decarboxylation of natural amino acids. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH]

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Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bone Remodeling: The continuous turnover of bone matrix and mineral that involves first, an increase in resorption (osteoclastic activity) and later, reactive bone formation (osteoblastic activity). The process of bone remodeling takes place in the adult skeleton at discrete foci. The process ensures the mechanical integrity of the skeleton throughout life and plays an important role in calcium homeostasis. An imbalance in the regulation of bone remodeling's two contrasting events, bone resorption and bone formation, results in many of the metabolic bone diseases, such as osteoporosis. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Hypoxia: Lack of oxygen leading to unconsciousness. [NIH] Brain Infarction: The formation of an area of necrosis in the brain, including the cerebral

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hemispheres (cerebral infarction), thalami, basal ganglia, brain stem (brain stem infarctions), or cerebellum secondary to an insufficiency of arterial or venous blood flow. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bromine: A halogen with the atomic symbol Br, atomic number 36, and atomic weight 79.904. It is a volatile reddish-brown liquid that gives off suffocating vapors, is corrosive to the skin, and may cause severe gastroenteritis if ingested. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [NIH] Butyric Acid: A four carbon acid, CH3CH2CH2COOH, with an unpleasant odor that occurs in butter and animal fat as the glycerol ester. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic

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weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Hydroxide: Ca(OH)2. A white powder that has many therapeutic uses. Because of its ability to stimulate mineralization, it is found in many dental formulations. [NIH] Calcium Isotopes: Stable calcium atoms that have the same atomic number as the element calcium, but differ in atomic weight. Ca-42-44, 46, and 48 are stable calcium isotopes. [NIH] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbidopa: A peripheral inhibitor of dopa decarboxylase. It is given in parkinsonism along with levodopa to inhibit the conversion of levodopa to dopamine in the periphery, thereby reducing the peripheral adverse effects, increasing the amount of levodopa that reaches the central nervous system, and reducing the dose needed. It has no antiparkinson actions when given alone. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

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Cardiac: Having to do with the heart. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group. [NIH] Catalogs: Ordered compilations of item descriptions and sufficient information to afford access to them. [NIH] Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Division: The fission of a cell. [NIH]

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Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Diseases: Diseases of any component of the brain (including the cerebral hemispheres, diencephalon, brain stem, and cerebellum) or the spinal cord. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]

Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and

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vagina. [NIH] Chaos: Complex behavior that seems random but actually has some hidden order. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Child Behavior: Any observable response or action of a child from 24 months through 12 years of age. For neonates or children younger than 24 months, infant behavior is available. [NIH]

Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]

Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Cholinergic Agonists: Drugs that bind to and activate cholinergic receptors. [NIH] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromans: Benzopyrans saturated in the 2 and 3 positions. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been

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listed as known carcinogens. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: emphysema. [NIH]

Collective term for chronic bronchitis and

Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [NIH]

Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomipramine: A tricyclic antidepressant similar to imipramine that selectively inhibits the uptake of serotonin in the brain. It is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine. [NIH]

Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of gaba receptor responses. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU] Cloning:

The production of a number of genetically identical individuals; in genetic

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engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the

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high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH]

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Compulsions: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Compulsive Behavior: The behavior of performing an act persistently and repetitively without it leading to reward or pleasure. The act is usually a small, circumscribed behavior, almost ritualistic, yet not pathologically disturbing. Examples of compulsive behavior include twirling of hair, checking something constantly, not wanting pennies in change, straightening tilted pictures, etc. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]

Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]

Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or

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treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: group. [NIH]

An experiment or clinical trial that includes a comparison (control)

Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] Convulsive Therapy: The use of convulsive agents to influence favorably the course of a mental disorder. It is used primarily in the treatment of severe affective disorders and schizophrenia. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Disease: Disorder of cardiac function due to an imbalance between myocardial function and the capacity of the coronary vessels to supply sufficient flow for normal function. It is a form of myocardial ischemia (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. [NIH] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or

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clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coronary Vessels: The veins and arteries of the heart. [NIH] Corpus: The body of the uterus. [NIH] Corpus Callosum: Broad plate of dense myelinated fibers that reciprocally interconnect regions of the cortex in all lobes with corresponding regions of the opposite hemisphere. The corpus callosum is located deep in the longitudinal fissure. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Corpus Striatum: Striped gray and white matter consisting of the neostriatum and paleostriatum (globus pallidus). It is located in front of and lateral to the thalamus in each cerebral hemisphere. The gray substance is made up of the caudate nucleus and the lentiform nucleus (the latter consisting of the globus pallidus and putamen). The white matter is the internal capsule. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortices: The outer layer of an organ; used especially of the cerebrum and cerebellum. [NIH] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Corticotropin-Releasing Hormone: A neuropeptide released by the hypothalamus that stimulates the release of corticotropin by the anterior pituitary gland. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Criterion: A standard by which something may be judged. [EU] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclohexanones: Cyclohexane ring substituted by one or more ketones in any position.

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[NIH]

Cystitis: Inflammation of the urinary bladder. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Dehydroepiandrosterone: DHEA. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Delusion: A false belief, not susceptible to argument or reason, and determined, pathologically, by some form of mental disorder. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is

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multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Deprenyl: Substance that blocks the breakdown of dopamine, thus preserving its availability in the striatum. [NIH] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Dexamethasone:

(11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4-

Dictionary 621

diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Dextrorotatory: Turning towards the right hand. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Foot: Ulcers of the foot as a complication of diabetes. Diabetic foot, often with infection, is a common serious complication of diabetes and may require hospitalization and disfiguring surgery. The foot ulcers are probably secondary to neuropathies and vascular problems. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diathesis: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the person more than usually susceptible to certain diseases. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH] Dilatation: The act of dilating. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH]

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Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dispenser: Glass, metal or plastic shell fitted with valve from which a pressurized formulation is dispensed; an instrument for atomizing. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuretic: A drug that increases the production of urine. [NIH] Diurnal: Occurring during the day. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] DNA Topoisomerase: An enzyme catalyzing ATP-independent breakage of singlestranded DNA, followed by passage and rejoining of another single-stranded DNA. This enzyme class brings about the conversion of one topological isomer of DNA into another, e.g., the relaxation of superhelical turns in DNA, the interconversion of simple and knotted rings of single-stranded DNA, and the intertwisting of single-stranded rings of complementary sequences. (From Enzyme Nomenclature, 1992) EC 5.99.1.2. [NIH] Domestic Violence: Deliberate, often repetitive, physical abuse by one family member against another: marital partners, parents, children, siblings, or any other member of a household. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopa Decarboxylase: One of the aromatic-l-amino-acid decarboxylases, this enzyme is responsible for the conversion of dopa to dopamine. It is of clinical importance in the treatment of Parkinson's disease. EC 4.1.1.28. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH]

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Doping: The action of administering a drug to someone before a sports event (originally to a horse before a race); the substance thus administered. [EU] Doxepin: A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism of histamine H(1)- and H(2)-receptors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU]

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Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electroconvulsive Therapy: Electrically induced convulsions primarily used in the treatment of severe affective disorders and schizophrenia. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electroplating: Coating with a metal or alloy by electrolysis. [NIH] Electroshock: Induction of a stress reaction in experimental subjects by means of an electrical shock; applies to either convulsive or non-convulsive states. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat hypertension. [NIH]

Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH]

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Encephalomyelitis: A general term indicating inflammation of the brain and spinal cord, often used to indicate an infectious process, but also applicable to a variety of autoimmune and toxic-metabolic conditions. There is significant overlap regarding the usage of this term and encephalitis in the literature. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]

Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energetic: Exhibiting energy : strenuous; operating with force, vigour, or effect. [EU] Enhancers: Transcriptional element in the virus genome. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Enuresis: Involuntary discharge of urine after the age at which urinary control should have been achieved; often used alone with specific reference to involuntary discharge of urine occurring during sleep at night (bed-wetting, nocturnal enuresis). [EU] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH] Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ependymal: It lines the cavities of the brain's ventricles and the spinal cord and slowly divides to create a stem cell. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control

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studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU]

Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithalamus: The dorsal posterior subdivision of the diencephalon. The epithalamus is generally considered to include the habenular nuclei (habenula) and associated fiber bundles, the pineal body, and the epithelial roof of the third ventricle. The anterior and posterior paraventricular nuclei of the thalamus are included with the thalamic nuclei although they develop from the same pronuclear mass as the epithalamic nuclei and are sometimes considered part of the epithalamus. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrina: A genus of leguminous shrubs or trees, mainly tropical, yielding certain alkaloids, lectins, and other useful compounds. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH]

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Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acid Agonists: Drugs that bind to and activate excitatory amino acid receptors. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

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Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Finasteride: An orally active testosterone 5-alpha-reductase inhibitor. It is used as a surgical alternative for treatment of benign prostatic hyperplasia. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flatus: Gas passed through the rectum. [NIH] Flexor: Muscles which flex a joint. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Foot Ulcer: Lesion on the surface of the skin of the foot, usually accompanied by inflammation. The lesion may become infected or necrotic and is frequently associated with diabetes or leprosy. [NIH] Forearm: The part between the elbow and the wrist. [NIH]

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Fosinopril: A phosphinic acid-containing angiotensin-converting enzyme inhibitor that is effective in the treatment of hypertension. It is a prodrug that is converted to its active metabolite fosinoprilat. [NIH] Fourth Ventricle: An irregularly shaped cavity in the rhombencephalon, between the medulla oblongata, the pons, and the isthmus in front, and the cerebellum behind. It is continuous with the central canal of the cord below and with the cerebral aqueduct above, and through its lateral and median apertures it communicates with the subarachnoid space. [NIH]

Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Fumigation: The application of smoke, vapor, or gas for the purpose of disinfecting or destroying pests or microorganisms. [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] GABA: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallium: A rare, metallic element designated by the symbol, Ga, atomic number 31, and atomic weight 69.72. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating

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food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genistein: An isoflavonoid derived from soy products. It inhibits protein-tyrosine kinase and topoisomerase-ii (dna topoisomerase (atp-hydrolysing)) activity and is used as an antineoplastic and antitumor agent. Experimentally, it has been shown to induce G2 phase arrest in human and murine cell lines. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Geriatric Assessment: Evaluation of the level of physical, physiological, or mental functioning in the older population group. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gifted: As used in child psychiatry, this term is meant to refer to a child whose intelligence is in the upper 2 per cent of the total population of his age. [NIH] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH]

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Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH] Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granule: A small pill made from sucrose. [EU]

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Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanabenz: An alpha-2 selective adrenergic agonist used as an antihypertensive agent. [NIH]

Guanidine: A strong organic base existing primarily as guanidium ions at physiological pH. It is found in the urine as a normal product of protein metabolism. It is also used in laboratory research as a protein denaturant. (From Martindale, the Extra Pharmacopoeia, 30th ed and Merck Index, 12th ed) It is also used in the treatment of myasthenia and as a fluorescent probe in HPLC. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Gyrus Cinguli: One of the convolutions on the medial surface of the cerebral hemisphere. It surrounds the rostral part of the brain and interhemispheric commissure and forms part of the limbic system. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haematemesis: The vomiting of blood. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Happiness: Highly pleasant emotion characterized by outward manifestations of gratification; joy. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH]

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Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic

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alterations of hepatocytes. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocyte: A liver cell. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heritability: The proportion of observed variation in a particular trait that can be attributed to inherited genetic factors in contrast to environmental ones. [NIH] Heroin Dependence: Strong dependence, both physiological and emotional, upon heroin. [NIH]

Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Hexanes: Six-carbon saturated hydrocarbon group of the methane series. Include isomers and derivatives. Various polyneuropathies are caused by hexane poisoning. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homicide: The killing of one person by another. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hospice: Institution dedicated to caring for the terminally ill. [NIH] Humidifier: A machine that puts moisture in the air. [NIH]

Dictionary 635

Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxides: Inorganic compounds that contain the OH- group. [NIH] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hypericum: Genus of perennial plants in the family Clusiaceae (Hypericaceae). Herbal and homeopathic preparations are used for depression, neuralgias, and a variety of other conditions. Contains flavonoids, glycosides, mucilage, tannins, and volatile oils (oils, essential). [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]

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Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypomania: An abnormality of mood resembling mania (persistent elevated or expansive mood, hyperactivity, inflated self-esteem, etc.) but of lesser intensity. [EU] Hypophyseal: Hypophysial. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idazoxan: An alpha(2)-adrenoceptor antagonist. It has been used experimentally to test the binding activity of other chemicals. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileum: The lower end of the small intestine. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]

Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: (antigens). [NIH]

The activity of the immune system against foreign substances

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic effects of foreign microorganisms or to the toxic effect of antigenic substances. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH]

Dictionary 637

Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantable pump: A small device installed under the skin to administer a steady dose of drugs. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Inbreeding: The mating of plants or non-human animals which are closely related genetically. [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU]

Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Inertia: Inactivity, inability to move spontaneously. [EU] Infant Behavior: Any observable response or action of a neonate or infant up through the age of 23 months. [NIH] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

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Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infuse: To pour (a liquid) into something. [EU] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Institutionalization: The caring for individuals in institutions and their adaptation to routines characteristic of the institutional environment, and/or their loss of adaptation to life outside the institution. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH]

Dictionary 639

Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Intermediate Filaments: Cytoplasmic filaments intermediate in diameter (about 10 nanometers) between the microfilaments and the microtubules. They may be composed of any of a number of different proteins and form a ring around the cell nucleus. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction

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of a blood vessel. [EU] Isopropyl: A gene mutation inducer. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kainate: Glutamate receptor. [NIH] Kainic Acid: (2S-(2 alpha,3 beta,4 beta))-2-Carboxy-4-(1-methylethenyl)-3-pyrrolidineacetic acid. Ascaricide obtained from the red alga Digenea simplex. It is a potent excitatory amino acid agonist at some types of excitatory amino acid receptors and has been used to discriminate among receptor types. Like many excitatory amino acid agonists it can cause neurotoxicity and has been used experimentally for that purpose. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Killer Cells: Lymphocyte-like effector cells which mediate antibody-dependent cell cytotoxicity. They kill antibody-coated target cells which they bind with their Fc receptors. [NIH]

Kinetic: Pertaining to or producing motion. [EU] Lactates: Salts or esters of lactic acid containing the general formula CH3CHOHCOOR. [NIH]

Lactation: The period of the secretion of milk. [EU] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laterality: Behavioral manifestations of cerebral dominance in which there is preferential use and superior functioning of either the left or the right side, as in the preferred use of the right hand or right foot. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Lectins: Protein or glycoprotein substances, usually of plant origin, that bind to sugar moieties in cell walls or membranes and thereby change the physiology of the membrane to

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cause agglutination, mitosis, or other biochemical changes in the cell. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukemia: Cancer of blood-forming tissue. [NIH] Leukocyte Count: A count of the number of white blood cells per unit volume in venous blood. A differential leukocyte count measures the relative numbers of the different types of white cells. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Levothyroxine: Levo isomer of the thyroid hormone thyroxine. It is used for replacement therapy in reduced or absent thyroid function. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: circulation. [NIH]

Services offered to the library user. They include reference and

Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model

642 Depression

parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

Lithium Carbonate: A lithium salt, classified as a mood-stabilizing agent. Lithium ion alters the metabolism of biogenic monoamines in the central nervous system, and affects multiple neurotransmission systems. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Local Government: Smallest political subdivisions within a country at which general governmental functions are carried-out. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locus Coeruleus:

Bluish region in the superior angle of the fourth ventricle floor,

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corresponding to melanin-like pigmented nerve cells which lie lateral to the pontomesencephalic central gray (griseum centrale). It is also known as nucleus pigmentosus pontis. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Long-Term Potentiation: A persistent increase in synaptic efficacy, usually induced by appropriate activation of the same synapses. The phenomenological properties of long-term potentiation suggest that it may be a cellular mechanism of learning and memory. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Loxapine: An antipsychotic agent used in schizophrenia. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH]

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Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Maprotiline: A bridged-ring tetracyclic antidepressant that is both mechanistically and functionally similar to the tricyclic antidepressants, including side effects associated with its use. [NIH] Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc. [NIH] Marital Therapy: A form of psychotherapy involving the husband and wife and directed to improving the marital relationship. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Median Eminence: Raised area on the infundibular hypothalamus at the floor of the third ventricle of the brain which contains the primary capillary network of the hypophyseal portal system. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of

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the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: illnesses. [NIH]

Recording of pertinent information concerning patient's illness or

Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator. [NIH] Medroxyprogesterone Acetate: An injectable contraceptive, generally marketed under the name Depo-Provera. [NIH] Megaloblastic: anaemia. [EU]

A large abnormal red blood cell appearing in the blood in pernicious

Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Memory Disorders: Disturbances in registering an impression, in the retention of an acquired impression, or in the recall of an impression. Memory impairments are associated with dementia; craniocerebraltrauma; encephalitis; alcoholism (see also alcohol amnestic disorder); schizophrenia; and other conditions. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH]

646 Depression

Mental Health Services: Organized services to provide mental health care. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH] Mesencephalic: Ipsilateral oculomotor paralysis and contralateral tremor, spasm. or choreic movements of the face and limbs. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metabotropic: A glutamate receptor which triggers an increase in production of 2 intracellular messengers: diacylglycerol and inositol 1, 4, 5-triphosphate. [NIH] Methanol: A colorless, flammable liquid used in the manufacture of formaldehyde and acetic acid, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microtubule-Associated Proteins: High molecular weight proteins found in the microtubules of the cytoskeletal system. Under certain conditions they are required for tubulin assembly into the microtubules and stabilize the assembled microtubules. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Microwaves: That portion of the electromagnetic spectrum lying between UHF (ultrahigh frequency) radio waves and heat (infrared) waves. Microwaves are used to generate heat,

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especially in some types of diathermy. They may cause heat damage to tissues. [NIH] Midwifery: The practice of assisting women in childbirth. [NIH] Mifepristone: A progestational and glucocorticoid hormone antagonist. Its inhibition of progesterone induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. As a glucocorticoid receptor antagonist, the drug has been used to treat hypercortisolism in patients with nonpituitary Cushing syndrome. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH]

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Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mother-Child Relations: Interaction between the mother and the child. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter Studies: Controlled studies which are planned and carried out by several cooperating institutions to assess certain variables and outcomes in specific patient populations, for example, a multicenter study of congenital anomalies in children. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary

Dictionary 649

thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neocortex: The largest portion of the cerebral cortex. It is composed of neurons arranged in six layers. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree

650 Depression

of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Neostriatum: The phylogenetically newer part of the corpus striatum consisting of the caudate nucleus and putamen. It is often called simply the striatum. [NIH] Nephrologist: A doctor who treats patients with kidney problems or hypertension. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [EU] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]

Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroendocrinology: The study of the anatomical and functional relationships between the nervous system and the endocrine system. [NIH] Neurofibrillary Tangles: Abnormal structures located in various parts of the brain and composed of dense arrays of paired helical filaments (neurofilaments and microtubules). These double helical stacks of transverse subunits are twisted into left-handed ribbon-like filaments that likely incorporate the following proteins: (1) the intermediate filaments: medium- and high-molecular-weight neurofilaments; (2) the microtubule-associated proteins map-2 and tau; (3) actin; and (4) ubiquitin. As one of the hallmarks of Alzheimer disease, the neurofibrillary tangles eventually occupy the whole of the cytoplasm in certain classes of cell in the neocortex, hippocampus, brain stem, and diencephalon. The number of

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these tangles, as seen in post mortem histology, correlates with the degree of dementia during life. Some studies suggest that tangle antigens leak into the systemic circulation both in the course of normal aging and in cases of Alzheimer disease. [NIH] Neurofilaments: Bundle of neuronal fibers. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurogenic Inflammation: Inflammation caused by an injurious stimulus of peripheral neurons and resulting in release of neuropeptides which affect vascular permeability and help initiate proinflammatory and immune reactions at the site of injury. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU]

Neuronal Plasticity: The capacity of the nervous system to change its reactivity as the result of successive activations. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]

Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neurotrophins: A nerve growth factor. [NIH] Neutralization: An act or process of neutralizing. [EU] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH]

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Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Obsession:

A recurrent, persistent thought, image, or impulse that is unwanted and

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distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it. Common obsessions involve thoughts of violence, contamination, and selfdoubt. [EU] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Occipital Lobe: Posterior part of the cerebral hemisphere. [NIH] Occupational Therapy: The field concerned with utilizing craft or work activities in the rehabilitation of patients. Occupational therapy can also refer to the activities themselves. [NIH]

Octanes: Eight-carbon saturated hydrocarbon group of the methane series. Include isomers and derivatives. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Omega-3 fatty acid: A type of fat obtained in the diet and involved in immunity. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncology: The study of cancer. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmolality: The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per kilogram of solvent. The osmolality is directly proportional to the colligative properties of solutions; osmotic pressure, boiling point elevation, freezing point depression, and vapour pressure lowering. [EU] Osmoles: The standard unit of osmotic pressure. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH]

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Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxazolidinones: Derivatives of oxazolidin-2-one. They represent an important class of synthetic antibiotic agents. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxides: Binary compounds of oxygen containing the anion O(2-). The anion combines with metals to form alkaline oxides and non-metals to form acidic oxides. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Juice:

The fluid containing digestive enzymes secreted by the pancreas in

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response to food in the duodenum. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Pargyline: A monoamine oxidase inhibitor with antihypertensive properties. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]

Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Partial response: A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment. [NIH] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH]

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Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perennial: Lasting through the year of for several years. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Personality Inventory:

Check list, usually to be filled out by a person about himself,

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consisting of many statements about personal characteristics which the subject checks. [NIH] Perylene: Dibenz(de, kl)anthracene. Polycyclic hydrocarbon soil and water pollutant; also used as fluorescent lipid probe in cytochemistry of membranes and other lipid structures; derivatives may be carcinogenic. Synonyms: peri-dinaphthalene. [NIH] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phosphates: Inorganic salts of phosphoric acid. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH]

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Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylates: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Phototransduction: The transducing of light energy to afferent nerve impulses, such as takes place in the retinal rods and cones. After light photons are absorbed by the photopigments, the signal is transmitted to the outer segment membrane by the cyclic GMP second messenger system, where it closes the sodium channels. This channel gating ultimately generates an action potential in the inner retina. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors,

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precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polyneuropathies: Diseases of multiple peripheral nerves. The various forms are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Portal System: A system of vessels in which blood, after passing through one capillary bed, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system. [NIH] Post partum: After childbirth, or after delivery. [EU] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's

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life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-synaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH]

Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [NIH] Potassium hydroxide: A toxic and highly corrosive chemical used to make soap, in bleaching, and as a paint remover. It is used in small amounts as a food additive and in the preparatrion of some drugs. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precordial: Pertaining to the precordium (= region over the heart and lower part of the thorax). [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH]

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Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Premenstrual: Occurring before menstruation. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Preventive Health Services: Services designed for promotion of health and prevention of disease. [NIH] Primula: An allergic contact dermatitis caused by exposure to the primrose, primula obconica; occurs as an occupational skin disease in gardeners. [NIH] Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Professional Impairment: The inability of a health professional to provide proper professional care of patients due to his or her physical and/or mental disability. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH]

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Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Propofol: A widely used anesthetic. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostaglandins F: (9 alpha,11 alpha,13E,15S)-9,11,15-Trihydroxyprost-13-en-1-oic acid (PGF(1 alpha)); (5Z,9 alpha,11,alpha,13E,15S)-9,11,15-trihydroxyprosta-5,13-dien-1-oic acid (PGF(2 alpha)); (5Z,9 alpha,11 alpha,13E,15S,17Z)-9,11,15-trihydroxyprosta-5,13,17-trien-1oic acid (PGF(3 alpha)). A family of prostaglandins that includes three of the six naturally occurring prostaglandins. All naturally occurring PGF have an alpha configuration at the 9carbon position. They stimulate uterine and bronchial smooth muscle and are often used as oxytocics. [NIH]

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Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protein-Tyrosine Kinase: An enzyme that catalyzes the phosphorylation of tyrosine residues in proteins with ATP or other nucleotides as phosphate donors. EC 2.7.1.112. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protriptyline: Tricyclic antidepressant similar in action and side effects to imipramine. It may produce excitation. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Pseudoxanthoma Elasticum: A rare, progressive inherited disorder resulting from extensive basophilic degeneration of elastic tissue, usually presenting after puberty and involving the skin, eye, and cardiovascular system. Characteristic manifestations are small, circumscribed yellowish patches at sites of considerable movement of the skin, angioid streaks in the retina, and a tendency towards hemorrhage and arterial insufficiency. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU]

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Psychological Adaptation: The alteration of the selective response of a neural unit due to the received signals. [NIH] Psychological Tests: Standardized tests designed to measure abilities, as in intelligence, aptitude, and achievement tests, or to evaluate personality traits. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs,

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may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Putamen: The largest and most lateral of the basal ganglia lying between the lateral medullary lamina of the globus pallidus and the external capsule. It is part of the neostriatum and forms part of the lentiform nucleus along with the globus pallidus. [NIH] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Quiescent: Marked by a state of inactivity or repose. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects

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are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]

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Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rehabilitation Centers: Facilities which provide programs for rehabilitating the mentally or physically disabled individuals. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxin: Hormone produced by the ovaries during pregnancy that loosens ligaments that hold the hip bones together. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Reserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH]

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Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Right to Die: The right of the patient or the patient's representative to make decisions with regard to the patient's dying. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Rural Health: The status of health in rural populations. [NIH] Rural Population: The inhabitants of rural areas or of small towns classified as rural. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH]

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Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scopolamine: An alkaloid from Solanaceae, especially Datura metel L. and Scopola carniolica. Scopolamine and its quaternary derivatives act as antimuscarinics like atropine, but may have more central nervous system effects. Among the many uses are as an anesthetic premedication, in urinary incontinence, in motion sickness, as an antispasmodic, and as a mydriatic and cycloplegic. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seasonal Affective Disorder: A syndrome characterized by depressions that recur annually at the same time each year, usually during the winter months. Other symptoms include anxiety, irritability, decreased energy, increased appetite (carbohydrate cravings), increased duration of sleep, and weight gain. SAD (seasonal affective disorder) can be treated by daily exposure to bright artificial lights (phototherapy), during the season of recurrence. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sedatives, Barbiturate: Those derivatives of barbituric or thiobarbituric acid that are used as hypnotics or sedatives. The structural class of all such derivatives, regardless of use, is barbiturates. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight

670 Depression

78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semantic Differential: Analysis of word concepts by the association of polar adjectives, e.g., good-bad, with the concept, father. The adjectives are usually scaled in 7 steps. The subject's placement of the concept on the adjectival scale indicates the connotative meaning of the concept. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory Deprivation: The absence or restriction of the usual external sensory stimuli to which the individual responds. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septal Nuclei: Neural nuclei situated in the septal region. They have afferent and cholinergic efferent connections with a variety of forebrain and brainstem areas including the hippocampus, the lateral hypothalamus, the tegmentum, and the amygdala. Included are the dorsal, lateral, medial, and triangular septal nuclei, septofimbrial nucleus, nucleus of diagonal band, nucleus of anterior commissure, and the nucleus of stria terminalis. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Uptake Inhibitors: Compounds that specifically inhibit the reuptake of serotonin in the brain. This increases the serotonin concentration in the synaptic cleft which then activates serotonin receptors to a greater extent. These agents have been used in treatment of depression, panic disorder, obsessive-compulsive behavior, and alcoholism, as analgesics, and to treat obesity and bulimia. Many of the adrenergic uptake inhibitors also inhibit serotonin uptake; they are not included here. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]

Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH]

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Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: female or male. [NIH]

The biological characteristics which distinguish human beings as

Ships: Large vessels propelled by power or sail used for transportation on rivers, seas, oceans, or other navigable waters. Boats are smaller vessels propelled by oars, paddles, sail, or power; they may or may not have a deck. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Sleep Deprivation: The state of being deprived of sleep under experimental conditions, due to life events, or from a wide variety of pathophysiologic causes such as medication effect, chronic illness, psychiatric illness, or sleep disorder. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and

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processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Socialism: A system of government in which means of production and distribution of goods are controlled by the state. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU]

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Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Speech Disorders: Acquired or developmental conditions marked by an impaired ability to comprehend or generate spoken forms of language. [NIH] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sprayer: A device for converting a medicated liquid into a vapor for inhalation; an instrument for applying a spray which is a jet of fine medicated vapor used either as an application to a diseased part or to charge the air of a room with a disinfectant. [NIH] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Steady state: Dynamic equilibrium. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strained: A stretched condition of a ligament. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH]

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Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH]

Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Sublingual: Located beneath the tongue. [EU] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic:

1. Mimicking the effects of impulses conveyed by adrenergic

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postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tacrine: A cholinesterase inhibitor that crosses the blood-brain barrier. Tacrine has been used to counter the effects of muscle relaxants, as a respiratory stimulant, and in the treatment of Alzheimer's disease and other central nervous system disorders. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU]

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Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]

Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutic Community: Psychotherapeutic technique which emphasizes socioenvironmental and interpersonal influences in the resocialization and rehabilitation of the patient. The setting is usually a hospital unit or ward in which professional and nonprofessional staff interact with the patients. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh:

A leg; in anatomy, any elongated process or part of a structure more or less

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comparable to a leg. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH]

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Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Trail Making Test: The subject's ability to connect 25 numbered and lettered circles in sequence in a specific length of time. A score of 12 or below is suggestive of organic brain damage. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma:

Any injury, wound, or shock, must frequently physical or structural shock,

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producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Trichotillomania: Compulsion to pull out one's hair. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trimipramine: Tricyclic antidepressant similar to imipramine, but with more antihistaminic and sedative properties. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is

680 Depression

also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ubiquitin: A highly conserved 76 amino acid-protein found in all eukaryotic cells. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU]

Dictionary 681

Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventral Tegmental Area: A region in the mesencephalon which is dorsomedial to the substantia nigra and ventral to the red nucleus. The mesocortical and mesolimbic dopaminergic systems originate here, including an important projection to the nucleus accumbens. Overactivity of the cells in this area has been suspected to contribute to the positive symptoms of schizophrenia. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Video Recording: The storing or preserving of video signals for television to be played back later via a transmitter or receiver. Recordings may be made on magnetic tape or discs (videodisc recording). [NIH] Videodisc Recording: The storing of visual and usually sound signals on discs for later reproduction on a television screen or monitor. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH]

682 Depression

Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] War: Hostile conflict between organized groups of people. [NIH] Wart: A raised growth on the surface of the skin or other organ. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Word Processing: Automated production of typewritten documents with text editing and storage functions using computer software. [NIH] Wounds, Gunshot: Disruption of structural continuity of the body as a result of the discharge of firearms. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yohimbine: A plant alkaloid with alpha-2-adrenergic blocking activity. Yohimbine has been used as a mydriatic and in the treatment of impotence. It is also alleged to be an aphrodisiac. [NIH]

683

INDEX 2 2-Propanol, 433, 595 A Abdomen, 595, 606, 607, 639, 642, 654, 656, 663, 668, 673, 677, 680, 681 Abdominal, 595, 621, 629, 639, 654, 655, 656, 668, 680 Abdominal Pain, 595, 629, 639, 680 Aberrant, 595, 614 Absenteeism, 595 Acceptor, 595, 654 Accommodation, 577, 595 ACE, 445, 595 ACE Inhibitor, 445, 595 Acetone, 595 Acetylcholine, 467, 595, 612, 652 Acne, 595, 640 Acne Vulgaris, 595, 640 Acoustic, 542, 595, 681 Acquired Immunodeficiency Syndrome, 570, 595 Acrylonitrile, 595, 668 Actin, 596, 648, 649, 650 Activities of Daily Living, 7, 8, 18, 596 Acute lymphoblastic leukemia, 596 Acute lymphocytic leukemia, 596 Acute renal, 528, 596 Acyl, 596 Adaptation, 403, 505, 596, 638, 659 Adenine, 596, 665 Adenocarcinoma, 596, 634 Adenosine, 484, 485, 596, 603, 608, 657, 676 Adenylate Cyclase, 463, 596 Adipose Tissue, 432, 596 Adjunctive Therapy, 489, 596 Adjustment, 8, 371, 376, 387, 392, 408, 410, 595, 596 Adjustment Disorders, 596 Adolescence, 377, 379, 391, 395, 524, 572, 596 Adrenal Cortex, 596, 618, 626, 661, 667 Adrenal Glands, 475, 596 Adrenal Medulla, 596, 610, 626, 652 Adrenaline, 475, 597 Adrenergic Agents, 597, 602 Adrenergic Uptake Inhibitors, 597, 670 Adrenolytic, 7, 597

Adrenoreceptor, 497, 597 Adverse Effect, 5, 7, 597, 609, 614, 640, 667, 671 Aerosols, 597 Aetiology, 597 Afferent, 447, 455, 597, 658, 660, 670 Affinity, 597, 603, 614, 620, 672 Agar, 597, 658 Age Groups, 339, 597 Age of Onset, 501, 529, 597, 679 Aged, 80 and Over, 597 Agoraphobia, 598, 636, 655, 657 Airway, 598, 671 Akathisia, 598, 602 Alanine, 436, 598 Albumin, 598, 658 Algorithms, 332, 562, 598, 606 Alimentary, 598, 655, 656 Alkaline, 444, 598, 599, 608, 654 Alkaloid, 598, 604, 614, 648, 652, 667, 669, 676, 682 Alleles, 16, 598, 634 Allergen, 598, 620 Allylamine, 598, 599 Alopecia, 598 Alpha-1, 476, 598, 599 Alternative medicine, 338, 539, 598 Aluminum, 318, 444, 598 Alveolar Process, 598, 667 Amebiasis, 599, 646 Amine, 459, 460, 461, 481, 483, 489, 599, 606, 634 Amino Acid Sequence, 599, 601, 627 Amitriptyline, 438, 439, 457, 460, 461, 511, 599 Ammonia, 444, 599, 631 Amnesia, 468, 599 Amnestic, 599, 628, 645 Amoxapine, 438, 439, 599 Amphetamine, 386, 599, 606, 621 Ampulla, 599, 612 Amputation, 599 Amygdala, 599, 605, 642, 670, 676 Anaesthesia, 599, 637 Anal, 380, 599, 625, 643 Analgesic, 443, 454, 457, 464, 599, 625, 641, 648, 653 Analog, 449, 456, 496, 599

684 Depression

Analogous, 439, 483, 600, 678 Anatomical, 600, 603, 637, 642, 650, 669 Anemia, 554, 600, 628 Anesthesia, 332, 598, 600, 601, 624 Anesthetics, 600, 604, 626 Angina, 600, 662 Angina Pectoris, 600, 662 Anginal, 600, 652 Angioid Streaks, 600, 663 Angiotensin converting enzyme inhibitor, 446, 600 Animal model, 481, 600 Anions, 450, 477, 598, 600, 639 Annual Reports, 581, 600 Anode, 600 Anomalies, 600, 648, 676 Anorexia, 341, 343, 437, 482, 493, 497, 516, 600, 629 Anosognosia, 600 Antagonism, 600, 608, 614, 623, 676 Anterior Cerebral Artery, 600, 611 Anthropometry, 600 Anti-Anxiety Agents, 600, 661, 664, 678 Antibacterial, 601, 673 Antibiotic, 354, 458, 600, 601, 654, 661, 673 Antibodies, 532, 601, 635, 643, 658, 665 Antibody, 550, 597, 601, 615, 634, 636, 637, 640, 645, 665, 673 Anticholinergic, 7, 459, 599, 601, 623 Anticonvulsant, 487, 489, 601, 609, 613 Anticonvulsive, 487, 601 Antidepressive Agents, 433, 459, 597, 601, 664 Antidepressive Agents, SecondGeneration, 601 Antidiuretic, 483, 601 Antidopaminergic, 487, 601 Antiemetic, 601, 602, 646 Antiepileptic, 438, 439, 489, 601 Antigen, 597, 601, 615, 634, 635, 636, 637, 645 Antihistamine, 457, 601 Antihypertensive, 469, 602, 632, 655, 667 Anti-infective, 441, 602, 639 Anti-inflammatory, 487, 602, 621, 631 Antineoplastic, 602, 630 Anti-Obesity Agents, 432, 602 Antioxidant, 602 Antipsychotic, 453, 599, 602, 614, 643, 651, 667, 668, 678 Antipyretic, 457, 602 Antiseptic, 595, 602

Antispasmodic, 602, 653, 669 Antiviral, 441, 602, 638 Anus, 515, 599, 602, 607 Anxiety Disorders, 182, 417, 521, 602, 655 Anxiolytic, 454, 464, 481, 482, 487, 497, 602, 608 Aorta, 602, 617, 681 Apathy, 11, 12, 602, 651 Apnea, 602 Apnoea, 602 Apolipoproteins, 602, 642 Aptitude, 603, 664 Aqueous, 441, 603, 605, 619, 641, 642 Arachidonic Acid, 603, 662 Arginine, 446, 603, 652 Aromatic, 447, 455, 475, 476, 603, 606, 609, 622, 657, 674 Arterial, 326, 536, 598, 603, 608, 609, 611, 612, 617, 635, 663, 675 Arteries, 602, 603, 607, 617, 618, 643, 646, 648, 665 Arterioles, 603, 607, 609, 649 Articular, 603, 654 Aspartate, 177, 313, 492, 603 Aspartic, 181, 603, 627 Aspartic Acid, 181, 603 Asthenia, 603 Astrocytes, 603, 647 Ataxia, 554, 603, 611, 676 Atenolol, 603 Atmospheric Pressure, 603 ATP, 596, 603, 622, 630, 657, 663 Atrial, 603, 617, 679 Atrioventricular, 603, 617 Atrium, 603, 617, 679, 681 Atrophy, 176, 554, 604, 650 Atropine, 314, 449, 457, 604, 605, 669 Attenuation, 604 Atypical, 178, 484, 604, 614, 652, 668 Auditory, 409, 604, 627, 644, 660, 680 Autogenic, 532, 604 Autoimmune disease, 604, 648 Autonomic, 480, 595, 602, 604, 605, 652, 656, 659, 672, 674 Autonomic Nervous System, 604, 605, 656, 672, 674 Autopsy, 509, 604 Autoreceptors, 462, 473, 491, 604 Axilla, 604, 607 B Back Pain, 341, 344, 540, 604

Index 685

Bacteria, 596, 601, 604, 620, 624, 626, 629, 646, 670, 673, 680 Bacterial Physiology, 596, 604 Bactericidal, 604, 626 Bacteriophage, 604, 658 Bacterium, 604, 615 Barbiturates, 354, 604, 669 Basal Ganglia, 480, 484, 602, 603, 604, 605, 608, 612, 636, 642, 652, 665 Basal Ganglia Diseases, 603, 605, 612, 636 Base, 450, 477, 596, 605, 619, 620, 632, 640, 676 Basophils, 605, 641 Behavior Therapy, 401, 514, 579, 605 Behavioral Medicine, 605 Behavioral Symptoms, 12, 508, 525, 605 Belladonna, 604, 605 Benchmarking, 605 Benign, 7, 605, 628, 632, 650, 665 Benzene, 605 Benzodiazepines, 438, 439, 496, 497, 605, 608 Benzoic Acid, 447, 455, 605 Bereavement, 374, 392, 398, 425, 426, 558, 605 Bewilderment, 605, 616 Bicarbonates, 444, 605 Bilateral, 13, 329, 338, 485, 605 Bile, 605, 606, 629, 630, 642, 673 Bile Acids, 605, 630, 673 Biliary, 606, 612 Bilirubin, 598, 606 Binding agent, 471, 606 Binding Sites, 606 Biochemical, 326, 412, 429, 598, 606, 641, 654, 670 Biodegradation, 448, 606 Biogenic Amines, 467, 606 Biogenic Monoamines, 448, 606, 642 Biological response modifier, 606, 638 Biological Transport, 606, 621 Biopsy, 429, 606 Biosynthesis, 454, 475, 603, 606 Biotechnology, 173, 523, 539, 549, 553, 554, 555, 606 Biotransformation, 606 Bladder, 543, 606, 619, 637, 648, 651, 663, 680 Bloating, 606, 639 Blood Coagulation, 606, 609 Blood Glucose, 606, 633, 635, 638 Blood Platelets, 606, 670

Blood vessel, 595, 600, 607, 610, 611, 617, 625, 640, 671, 672, 674, 676, 677, 680 Blood-Brain Barrier, 607, 641, 675 Body Fluids, 607, 608, 623, 672 Body Mass Index, 607 Bone Density, 411, 429, 607 Bone Marrow, 336, 429, 596, 605, 607, 643, 647 Bone Marrow Transplantation, 336, 607 Bone Remodeling, 429, 607 Bone Resorption, 607 Bowel, 344, 599, 607, 621, 637, 639, 656, 673, 680 Bowel Movement, 607, 621, 673 Brachial, 607 Brachial Plexus, 607 Bradykinin, 175, 607, 652, 659 Brain Hypoxia, 607, 608, 676 Brain Infarction, 607, 608 Brain Ischemia, 181, 608 Brain Stem, 608, 611, 650 Branch, 589, 608, 630, 644, 655, 664, 673, 675, 676 Breakdown, 429, 432, 469, 608, 620, 621, 629 Bromine, 433, 608 Bronchi, 608, 626, 676, 678 Bronchial, 608, 634, 662, 676 Bronchitis, 608, 613 Buccal, 608, 643 Bulimia, 334, 342, 343, 517, 608, 670 Bupropion, 355, 437, 443, 452, 471, 486, 493, 495, 498, 568, 608 Burns, 342, 397, 608 Burns, Electric, 608 Buspirone, 454, 608 Butyric Acid, 357, 440, 608 Bypass, 536, 608 C Caffeine, 608, 665 Calcium Hydroxide, 444, 609 Calcium Isotopes, 412, 609 Cannabidiol, 609 Cannabinoids, 176, 609 Cannabinol, 609 Capillary, 607, 609, 644, 659 Capsules, 469, 609, 630 Captopril, 445, 446, 609 Carbamazepine, 438, 439, 529, 609 Carbidopa, 361, 475, 609 Carbohydrate, 452, 609, 631, 669 Carbon Dioxide, 609, 619, 658, 667, 681

686 Depression

Carboxy, 609, 640 Carboxylic Acids, 444, 609 Carcinogen, 609, 646 Carcinogenic, 605, 609, 638, 657, 662, 673 Carcinoma, 609 Cardioselective, 603, 610, 662 Cardiovascular disease, 441, 482, 530, 610 Cardiovascular System, 480, 610, 663 Carnitine, 310, 318, 474, 610 Case report, 179, 312, 334, 610, 613 Case series, 610, 613 Case-Control Studies, 6, 610, 626 Catalogs, 579, 610 Cataract, 5, 610 Catecholamine, 475, 601, 610, 622, 657 Cathode, 600, 610, 624 Cations, 610, 639 Caudal, 610, 621, 636, 652, 659 Caudate Nucleus, 600, 605, 610, 618, 650, 652 Causal, 6, 370, 388, 395, 397, 484, 610, 625 Cell Cycle, 610, 680 Cell Division, 554, 604, 610, 645, 658, 662, 669 Cell membrane, 492, 606, 611, 629, 657, 660 Cell Respiration, 611, 667 Cellulose, 611, 658 Central Nervous System Diseases, 494, 611 Central Nervous System Infections, 611, 632 Cerebellar, 174, 177, 179, 311, 314, 603, 611, 666, 679 Cerebellar Diseases, 603, 611, 679 Cerebellum, 178, 608, 611, 618, 629, 666 Cerebral hemispheres, 604, 608, 611, 676 Cerebral Infarction, 608, 611 Cerebrospinal, 177, 611 Cerebrospinal fluid, 177, 611 Cerebrovascular, 441, 472, 605, 610, 611, 676 Cerebrum, 611, 618, 676, 679 Cervical, 607, 611, 649 Cervix, 611 Chaos, 612 Character, 600, 612, 619 Chemoreceptor, 602, 612 Chemotherapy, 612 Chest Pain, 612 Child Behavior, 396, 612 Child Psychiatry, 612, 630

Chlorine, 433, 612 Cholecystokinin, 436, 612 Cholestasis, 323, 612 Cholesterol, 311, 342, 343, 536, 537, 605, 612, 613, 618, 623, 635, 642, 643, 673 Cholesterol Esters, 612, 642 Choline, 319, 458, 612 Cholinergic, 468, 491, 526, 599, 602, 612, 652, 670 Cholinergic Agonists, 527, 612 Chorea, 602, 612 Chromans, 448, 612 Chromium, 318, 461, 462, 464, 465, 612 Chromosome, 442, 613, 632, 642, 669 Chronic Disease, 178, 509, 528, 529, 613 Chronic Obstructive Pulmonary Disease, 342, 613 Chronic renal, 613, 659 Chylomicrons, 613, 642 Circadian, 437, 454, 482, 493, 497, 613 Circadian Rhythm, 437, 454, 482, 493, 497, 613 CIS, 434, 577, 613, 668 Citalopram, 7, 325, 356, 443, 486, 495, 613 Clamp, 613 Clinical Medicine, 613, 660 Clinical study, 423, 424, 425, 613, 617 Clomipramine, 314, 404, 438, 439, 613 Clonazepam, 613 Clonic, 613 Cloning, 606, 613 Clozapine, 356, 614 Coagulation, 606, 614, 633, 658, 677 Coca, 614 Cocaine, 484, 486, 502, 614 Cochlear, 614, 677, 681 Cochlear Diseases, 614, 677 Cofactor, 614, 663 Cognition, 5, 7, 8, 9, 15, 331, 471, 480, 491, 614, 651 Cognitive Therapy, 17, 373, 388, 402, 512, 516, 614 Cohort Studies, 614, 626 Colitis, 347, 614, 639 Collagen, 614, 628, 630, 659, 662 Collapse, 390, 608, 615, 671 Colloidal, 598, 615 Combination Therapy, 414, 489, 494, 615 Community Health Services, 580, 615 Comorbidity, 5, 389, 615 Competency, 509, 615 Complement, 615, 658

Index 687

Complementary and alternative medicine, 323, 324, 368, 565, 615 Complementary medicine, 324, 615 Complete remission, 615, 667 Compulsions, 519, 579, 616 Compulsive Behavior, 578, 616, 670 Computational Biology, 549, 553, 616 Conception, 616, 628 Concomitant, 400, 438, 439, 616 Conduction, 616 Cone, 390, 616 Confounding, 14, 616 Confusion, 471, 616, 622, 635, 651 Congestion, 602, 616, 626 Congestive heart failure, 616 Conjugated, 605, 616 Connective Tissue, 607, 614, 616, 628, 629, 630, 668, 675 Consciousness, 405, 518, 599, 601, 616, 619, 620, 622 Constipation, 342, 602, 616, 639 Constriction, 616, 639, 680 Consumption, 379, 382, 390, 410, 460, 461, 616, 620, 629, 654 Contact dermatitis, 616, 661 Contamination, 616, 653 Continuum, 616 Contraceptive, 616, 645 Contraindications, ii, 616 Control group, 4, 10, 11, 617 Controlled clinical trial, 428, 617 Controlled study, 324, 338, 541, 571, 617 Convulsions, 601, 617, 624, 635 Convulsive, 478, 617, 624 Convulsive Therapy, 478, 617 Coordination, 611, 617, 648 Cor, 179, 446, 617, 618 Coronary Arteriosclerosis, 617, 648 Coronary Artery Bypass, 617 Coronary Disease, 482, 617 Coronary heart disease, 610, 617 Coronary Thrombosis, 618, 646, 648, 649 Coronary Vessels, 617, 618 Corpus, 618, 643, 650, 661, 677 Corpus Callosum, 618, 677 Corpus Luteum, 618, 643, 661 Corpus Striatum, 618, 650 Cortex, 11, 313, 314, 334, 480, 485, 603, 618, 625, 627, 628, 649, 660, 665, 666 Cortical, 11, 181, 331, 332, 618, 627, 660, 669, 676 Cortices, 13, 618

Corticosteroids, 360, 618, 631 Corticotropin-Releasing Hormone, 179, 618 Cortisol, 391, 412, 598, 618 Cortisone, 618, 621 Cranial, 435, 460, 611, 618, 632, 639, 656, 680, 681 Craniocerebral Trauma, 605, 618, 632, 676, 677 Criterion, 540, 618 Cross-Sectional Studies, 618, 626 Curative, 618, 652, 676 Cutaneous, 616, 618, 643 Cyclic, 176, 446, 458, 460, 596, 608, 618, 632, 652, 658, 662, 669, 676 Cyclohexanones, 441, 618 Cystitis, 619 Cytoplasm, 605, 611, 619, 625, 647, 650, 651, 668, 675 Cytotoxic, 619, 665, 671 D Data Collection, 323, 619, 628 Databases, Bibliographic, 549, 619 Deamination, 448, 619, 647 Decarboxylation, 606, 619, 634 Decidua, 619, 647, 658 Decision Making, 528, 619 Degenerative, 526, 619, 633, 644, 648, 654 Dehydration, 441, 619 Dehydroepiandrosterone, 356, 485, 619 Deletion, 619 Delirium, 18, 508, 525, 602, 619 Delivery of Health Care, 619, 633 Delusion, 619 Dendrites, 620, 651 Density, 411, 414, 429, 607, 620, 623, 642, 653, 672 Dental Caries, 620, 628 Dentate Gyrus, 620, 634 Depersonalization, 620, 655, 669 Deprenyl, 459, 460, 461, 620 Deprivation, 620 Derealization, 620, 655 Dermal, 620, 641 Desensitization, 473, 491, 526, 620 Desipramine, 438, 439, 457, 620 Detoxification, 348, 442, 495, 620 Deuterium, 620, 635 Developed Countries, 482, 620 Dexamethasone, 178, 337, 620 Dextroamphetamine, 463, 466, 599, 621, 646

688 Depression

Dextrorotatory, 452, 471, 498, 621 Diabetes Mellitus, 602, 621, 631, 633 Diabetic Foot, 312, 621 Diagnostic procedure, 431, 539, 621 Dialyzer, 621, 633 Diaphragm, 621 Diarrhea, 599, 621, 639 Diastolic, 621, 635 Diathesis, 621 Diencephalon, 611, 621, 626, 636, 650, 660, 676, 677 Diffusion, 334, 399, 606, 621 Digestion, 598, 605, 607, 621, 623, 639, 642, 656, 673 Digestive system, 430, 621 Dihydroxy, 621 Dilatation, 621, 661 Diploid, 621, 658 Direct, iii, 338, 613, 614, 621, 622, 630, 666, 675 Disease Progression, 327, 621, 681 Disinfectant, 595, 622, 626, 673 Disorientation, 616, 619, 622 Dispenser, 622 Dissociation, 503, 597, 622 Dissociative Disorders, 622 Distal, 617, 622, 624, 630, 659, 661, 663 Diuretic, 446, 483, 622 Diurnal, 14, 622 Dizziness, 622, 655 DNA Topoisomerase, 622, 630 Domestic Violence, 551, 622, 660 Dominance, 622, 640 Dopa, 609, 622, 641 Dopa Decarboxylase, 609, 622 Doping, 623 Doxepin, 438, 439, 457, 623 Drive, ii, vi, 309, 467, 532, 561, 565, 623, 641 Drug Interactions, 494, 623 Drug Tolerance, 623, 677 Duct, 599, 623, 627, 668 Dyskinesia, 602, 613, 623 Dyslipidemia, 432, 623 Dyspepsia, 623 Dysphoria, 427, 463, 467, 623 Dysphoric, 443, 620, 623 Dysplasia, 554, 623 Dyspnea, 623, 655 Dystonia, 602, 623 Dystrophy, 468, 554, 623

E Eating Disorders, 343, 443, 480, 623 Effector, 595, 615, 623, 640, 650, 651 Effector cell, 623, 640, 650, 651 Efficacy, 17, 175, 176, 181, 323, 330, 331, 335, 338, 373, 377, 378, 379, 380, 396, 397, 401, 402, 411, 414, 415, 418, 419, 422, 423, 424, 425, 428, 437, 445, 449, 452, 454, 464, 466, 470, 486, 493, 500, 501, 540, 608, 623, 643, 679 Elasticity, 617, 623 Elective, 5, 623 Electric shock, 462, 624 Electroacupuncture, 326, 624 Electrocardiogram, 413, 624 Electrode, 467, 600, 610, 624 Electrolysis, 600, 610, 624 Electrolyte, 619, 624, 660, 672 Electrons, 602, 605, 610, 624, 639, 644, 654, 665 Electroplating, 624 Electroshock, 624 Elementary Particles, 624, 644, 663 Emaciation, 595, 624 Embolus, 624, 637 Embryo, 384, 624, 637 Emergency Treatment, 624 Emesis, 497, 624 Emollient, 624, 631 Emphysema, 613, 624 Empirical, 325, 374, 379, 402, 403, 624 Enalapril, 446, 624 Encephalitis, 624, 625, 645 Encephalomyelitis, 625 Endocrine System, 625, 650 Endocrinology, 625, 632 Endometrium, 619, 625, 645, 647 Endorphin, 467, 625 Endothelium, 625, 652 Endothelium-derived, 625, 652 End-stage renal, 613, 625, 659 Energetic, 337, 625 Enhancers, 508, 625 Entorhinal Cortex, 5, 625, 634 Enuresis, 543, 625 Environmental Exposure, 625, 653 Environmental Health, 548, 550, 625 Enzymatic, 476, 606, 609, 615, 620, 625, 634, 668 Eosinophils, 625, 641 Ependymal, 625 Epidemic, 625, 673

Index 689

Epidemiologic Studies, 13, 625 Epidemiological, 6, 8, 10, 15, 180, 453, 529, 626 Epidermal, 626, 641, 645 Epidermis, 626, 641 Epinephrine, 448, 597, 606, 622, 626, 652, 680 Epithalamus, 621, 626, 642 Erectile, 626 Erection, 626 Erythema, 616, 626, 674 Erythrina, 360, 364, 626 Erythrocytes, 600, 607, 626 Esophageal, 626, 630 Esophagitis, 626, 630 Esophagus, 621, 626, 630, 643, 657, 666, 673 Essential Tremor, 554, 626 Estradiol, 413, 626 Estrogen, 310, 413, 419, 427, 488, 499, 536, 626, 661 Ethanol, 433, 483, 613, 626 Ether, 433, 626 Evoked Potentials, 435, 627 Excitability, 331, 484, 503, 627, 649, 650 Excitation, 174, 492, 612, 627, 663 Excitatory, 312, 492, 495, 496, 627, 631, 640 Excitatory Amino Acid Agonists, 627, 640 Excitatory Amino Acids, 492, 627 Exocrine, 612, 627, 654 Exogenous, 606, 609, 627, 679 Exon, 627 Expiration, 627, 667 Extensor, 627, 663 Extracellular, 603, 616, 627, 628, 654, 672 Extracellular Matrix, 616, 627, 628, 654 Extrapyramidal, 480, 598, 602, 622, 627 Extremity, 607, 627 F Facial, 5, 328, 627, 644, 672 Family Planning, 549, 627 Family Relations, 627 Fathers, 377, 381, 627 Fatty acids, 432, 598, 609, 628, 662 Femoral, 412, 628 Femur, 628 Fenfluramine, 452, 628 Fetus, 628, 658, 680 Fibrin, 606, 628, 677 Fibroblasts, 628, 639 Fibrosis, 554, 598, 628, 669 Finasteride, 628

Fissure, 618, 620, 628, 660 Flatus, 628, 629 Flexor, 627, 628, 641 Fluorine, 433, 628 Flush, 628 Fluvoxamine, 7, 177, 357, 442, 443, 486, 495, 628 Focus Groups, 628 Folate, 310, 317, 319, 475, 482, 628 Fold, 446, 628 Folic Acid, 316, 317, 475, 482, 628 Foot Ulcer, 621, 628 Forearm, 607, 628 Fosinopril, 445, 446, 629 Fourth Ventricle, 629, 642, 677 Friction, 629 Frontal Lobe, 11, 13, 421, 485, 600, 611, 629, 660 Fumigation, 597, 629 Fungistatic, 605, 629 G GABA, 357, 383, 440, 462, 493, 613, 629, 671 Gait, 18, 611, 629 Gallbladder, 595, 606, 612, 621, 629 Gallium, 629 Gamma Rays, 629, 665 Ganglia, 480, 485, 595, 605, 629, 650, 656, 674 Gap Junctions, 629, 675 Gas, 599, 609, 612, 621, 628, 629, 635, 639, 652, 674, 680, 681 Gastric, 610, 629, 630, 634, 656 Gastric Acid, 629 Gastric Juices, 629, 656 Gastric Mucosa, 629, 656 Gastrin, 629, 634 Gastroenteritis, 608, 629 Gastroesophageal Reflux, 343, 630 Gastroesophageal Reflux Disease, 343, 630 Gastrointestinal, 432, 480, 607, 612, 613, 626, 630, 670, 672, 674 Gastrointestinal tract, 480, 613, 626, 630, 670, 672 Gelatin, 630, 631, 677 Gene Expression, 177, 484, 502, 503, 555, 630 General practitioner, 175, 180, 630 Generator, 467, 630 Genetics, 622, 630 Genistein, 488, 630 Genital, 630, 632

690 Depression

Genotype, 10, 470, 630 Geriatric Assessment, 17, 630 Gestation, 630, 656, 658 Giardiasis, 630, 646 Gifted, 375, 380, 394, 396, 401, 630 Ginseng, 354, 358, 363, 630 Gland, 412, 416, 453, 596, 618, 631, 654, 658, 663, 669, 673, 677 Glucocorticoid, 621, 631, 647 Glucose Intolerance, 621, 631 Glucuronic Acid, 631, 633 Glutamate, 175, 176, 178, 179, 311, 467, 492, 631, 640, 646 Glutamic Acid, 358, 628, 631, 662 Glutamine, 359, 440, 631 Glutathione Peroxidase, 631, 670 Glycerol, 432, 500, 608, 631, 657 Glycine, 440, 605, 631 Gonad, 631 Gonadal, 631, 673 Governing Board, 631, 660 Grade, 381, 391, 631 Graft, 631, 636 Grafting, 617, 631, 637 Granule, 313, 620, 631, 668 Grasses, 628, 632 Guanabenz, 632 Guanidine, 632 Guanylate Cyclase, 632, 652 Gynecology, 329, 632 Gyrus Cinguli, 600, 632, 642 H Habitual, 612, 632 Haematemesis, 624, 632 Hair follicles, 632, 682 Hallucinogens, 632, 664 Haloperidol, 632 Haploid, 632, 658 Happiness, 417, 512, 515, 632 Headache, 343, 347, 608, 632, 635 Headache Disorders, 632 Health Behavior, 632 Health Care Costs, 633 Health Expenditures, 633 Health Policy, 633 Health Promotion, 540, 564, 633 Health Resources, iv, 530, 633 Health Services, 526, 619, 633 Health Status, 380, 632, 633 Heart attack, 610, 633 Heart failure, 328, 633 Hemodialysis, 371, 621, 633

Hemoglobin, 600, 626, 633 Hemoglobinuria, 554, 633 Hemorrhage, 618, 632, 633, 663, 674 Hemostasis, 633, 670 Heparin, 633 Hepatic, 396, 410, 598, 619, 633, 647, 659 Hepatitis, 378, 527, 528, 633 Hepatocellular, 334, 634 Hepatocellular carcinoma, 334, 634 Hepatocyte, 612, 634 Hepatotoxicity, 528, 634 Hereditary, 634, 648, 650, 668 Heredity, 541, 595, 630, 634 Heritability, 634 Heroin Dependence, 313, 634 Heterozygotes, 622, 634 Hexanes, 464, 634 Hippocampus, 174, 175, 176, 177, 182, 484, 620, 634, 642, 650, 670, 674 Histamine, 359, 432, 467, 601, 602, 606, 623, 634 Histidine, 634 Histology, 634, 651 Homeostasis, 607, 634, 672 Homicide, 634 Homogeneous, 616, 634 Homologous, 598, 634, 669, 675 Homozygotes, 622, 634 Hormonal, 412, 416, 604, 634 Hormone, 314, 338, 412, 427, 429, 446, 457, 488, 597, 604, 613, 618, 626, 629, 634, 638, 639, 641, 645, 647, 661, 667, 668, 669, 671, 672, 676, 677 Hormone Replacement Therapy, 427, 634 Hospice, 315, 339, 634 Humidifier, 634 Hybridomas, 635, 639 Hydrolysis, 313, 458, 492, 603, 606, 635, 642, 659, 663 Hydrophilic, 635 Hydrophobic, 635, 642 Hydroxides, 444, 635 Hydroxylation, 476, 635 Hypercholesterolemia, 344, 623, 635 Hypericum, 177, 311, 327, 359, 366, 428, 469, 474, 516, 565, 635 Hyperlipidemia, 623, 635 Hyperplasia, 628, 635, 641 Hypersensitivity, 342, 598, 620, 635, 668 Hyperthyroidism, 561, 635, 662 Hypertriglyceridemia, 623, 635 Hypertrophy, 617, 635, 679

Index 691

Hypnotic, 487, 532, 635 Hypoglycaemia, 619, 635 Hypoglycemia, 344, 635 Hypoglycemic, 432, 635 Hypokinesia, 460, 636, 655 Hypomania, 452, 501, 636 Hypophyseal, 636, 644 Hypotension, 461, 602, 617, 636 Hypotensive, 450, 636 Hypothalamic, 177, 446, 636 Hypothalamus, 446, 604, 618, 621, 636, 642, 644, 658, 670, 672, 677 Hypoxia, 619, 636 I Id, 316, 340, 559, 566, 567, 568, 575, 588, 590, 636 Idazoxan, 475, 636 Idiopathic, 315, 636 Ileum, 432, 447, 455, 636 Imidazole, 447, 455, 634, 636 Imipramine, 174, 177, 327, 404, 438, 439, 457, 486, 613, 636, 663, 679 Immune function, 327, 510, 636 Immune response, 601, 604, 618, 636, 674, 681 Immune system, 426, 510, 532, 623, 636, 643, 648, 680, 682 Immunity, 333, 426, 509, 510, 595, 598, 636, 653 Immunodeficiency, 507, 532, 554, 564, 570, 595, 636 Immunodeficiency syndrome, 532, 636 Immunologic, 425, 636, 665 Immunology, 509, 597, 636 Immunosuppressive, 631, 636 Immunotherapy, 620, 636 Implantable pump, 467, 637 Implantation, 444, 616, 637 Impotence, 461, 468, 626, 637, 682 In situ, 637 In vitro, 174, 313, 447, 455, 637 In vivo, 314, 332, 435, 447, 455, 633, 637 Inbreeding, 173, 178, 382, 403, 637 Incision, 637, 639 Incompetence, 630, 637 Incontinence, 17, 468, 543, 637, 669 Indicative, 451, 510, 637, 655, 680 Induction, 17, 174, 177, 178, 181, 311, 379, 425, 473, 491, 602, 624, 637, 661 Inertia, 637 Infant Behavior, 612, 637 Infant Mortality, 579, 637

Infant, Newborn, 597, 637 Infarction, 175, 482, 611, 618, 637, 646, 648, 649, 662 Inflammatory bowel disease, 432, 637 Informed Consent, 528, 638 Infuse, 467, 638 Infusion, 466, 467, 638 Ingestion, 488, 500, 628, 638, 646, 659 Inhalation, 597, 638, 659, 673 Initiation, 7, 528, 529, 638 Inlay, 638, 667 Innervation, 607, 623, 638 Inorganic, 434, 605, 635, 638, 648, 657 Inositol, 177, 311, 313, 360, 638, 646, 669 Inotropic, 603, 622, 638 Inpatients, 6, 18, 382, 638 Insomnia, 311, 326, 344, 379, 437, 445, 467, 482, 493, 496, 497, 502, 510, 592, 638 Institutionalization, 13, 638 Insulator, 638, 648 Insulin, 178, 416, 485, 602, 638, 679 Insulin-dependent diabetes mellitus, 638 Insulin-like, 485, 638 Interferon, 410, 537, 638, 643 Interferon-alpha, 537, 638 Interleukin-6, 639 Intermediate Filaments, 639, 650 Intermittent, 639, 643, 656 Internal Medicine, 6, 625, 639 Interpersonal Relations, 379, 509, 639 Interstitial, 639, 667 Intestinal, 432, 612, 639, 644 Intestine, 432, 607, 639, 640 Intoxication, 619, 639, 682 Intracellular, 174, 177, 608, 637, 639, 646, 652, 660, 662, 666, 669, 670, 671 Intracranial Hypertension, 632, 639, 677 Intramuscular, 639, 655 Intraperitoneal, 444, 639 Intravenous, 444, 463, 466, 638, 639, 655 Invasive, 312, 636, 639, 644 Involuntary, 435, 543, 605, 612, 625, 626, 639, 649, 666, 672 Iodine, 433, 639 Ion Channels, 603, 639, 651, 675 Ionizing, 625, 639, 665 Ions, 413, 605, 622, 624, 632, 635, 639, 647, 660 Irritable Bowel Syndrome, 344, 639 Ischemia, 312, 604, 608, 639 Isopropyl, 460, 461, 640 Isotretinoin, 640

692 Depression

J Joint, 5, 603, 628, 640, 654, 675 K Kainate, 313, 621, 640 Kainic Acid, 492, 640 Kb, 548, 640 Kidney Disease, 430, 532, 548, 554, 565, 595, 640 Killer Cells, 640 Kinetic, 401, 639, 640 L Lactates, 438, 439, 640 Lactation, 640, 661 Lag, 640 Large Intestine, 621, 639, 640, 666, 671 Larynx, 640, 678, 680 Latency, 394, 409, 487, 640 Latent, 398, 640, 660 Laterality, 640 Least-Squares Analysis, 640, 666 Lectins, 626, 640 Lens, 610, 641, 667 Lesion, 529, 617, 628, 641, 642, 675, 680 Lethal, 494, 604, 641 Lethargy, 541, 592, 641 Leucocyte, 598, 641, 643 Leukemia, 554, 641 Leukocyte Count, 641 Leukocytes, 605, 607, 625, 638, 641, 647, 651 Levo, 460, 461, 622, 641 Levodopa, 361, 609, 622, 641 Levothyroxine, 314, 338, 641 Libido, 437, 482, 493, 497, 641 Library Services, 588, 641 Lichen Planus, 641 Life cycle, 526, 597, 641 Life Expectancy, 528, 641 Ligament, 641, 663, 673 Ligands, 481, 641 Likelihood Functions, 641, 666 Limbic, 332, 480, 599, 632, 642, 660 Limbic System, 480, 599, 632, 642, 660 Linear Models, 642, 666 Linkage, 442, 642 Lip, 642 Lipid, 602, 612, 631, 638, 642, 648, 657 Lipolysis, 432, 642 Lipopolysaccharide, 313, 642 Lipoprotein, 623, 642, 643 Liquor, 642 Lithium Carbonate, 482, 497, 642

Lobe, 611, 642 Local Government, 642 Localization, 337, 435, 642 Localized, 608, 620, 637, 641, 642, 647, 649, 658, 680 Locomotion, 642, 658 Locus Coeruleus, 642 Logistic Models, 643, 666 Longitudinal study, 643 Long-Term Care, 4, 525, 526, 643 Long-Term Potentiation, 173, 174, 181, 182, 313, 314, 492, 643 Low-density lipoprotein, 623, 642, 643 Lower Esophageal Sphincter, 630, 643 Loxapine, 599, 643 Lumbar, 604, 643 Lupus, 344, 347, 509, 542, 561, 643, 675 Luteal Phase, 643, 647 Lutein Cells, 643, 661 Lymphatic, 625, 637, 643, 659 Lymphoblastic, 643 Lymphoblasts, 596, 643 Lymphocyte, 595, 601, 640, 643, 645 Lymphocyte Count, 595, 643 Lymphoid, 601, 618, 641, 643, 644 Lymphoma, 554, 643, 644 Lysine, 311, 644 M Macula, 644 Macula Lutea, 644 Macular Degeneration, 644 Magnetic Resonance Imaging, 334, 412, 417, 421, 644 Magnetic Resonance Spectroscopy, 644 Malabsorption, 345, 554, 644 Malaise, 623, 644 Malignancy, 644 Malignant, 554, 595, 596, 602, 644, 649, 665 Malnutrition, 598, 604, 644, 648 Mammary, 617, 644 Mandible, 598, 644, 667 Mania, 425, 438, 439, 468, 478, 501, 517, 579, 636, 644 Manic-depressive psychosis, 644, 664 Maprotiline, 644 Marital Status, 453, 644 Marital Therapy, 644 Meatus, 644, 680 Median Eminence, 446, 644 Mediate, 176, 475, 492, 622, 640, 644 Mediator, 174, 390, 612, 622, 644, 670 Medical Records, 645, 668

Index 693

Medicament, 481, 488, 645 MEDLINE, 549, 553, 554, 645 Medroxyprogesterone, 427, 645 Medroxyprogesterone Acetate, 427, 645 Megaloblastic, 628, 645 Meiosis, 645, 675 Melanin, 643, 645, 657, 680 Melanocytes, 645 Melanoma, 554, 645 Membrane Glycoproteins, 645 Memory Disorders, 9, 10, 13, 645 Meninges, 611, 618, 645 Menopause, 345, 427, 499, 514, 536, 645, 656, 659, 661, 662 Menstrual Cycle, 643, 645, 661 Menstruation, 345, 619, 643, 645, 661 Mental Health Services, iv, 552, 572, 582, 646 Mental Processes, 622, 646, 664 Mental Retardation, 398, 555, 646 Mesencephalic, 643, 646, 666 Mesolimbic, 484, 502, 602, 646, 681 Meta-Analysis, 176, 311, 324, 335, 646 Metabolic disorder, 646 Metabolite, 454, 606, 613, 629, 646, 652, 661 Metabotropic, 175, 176, 492, 646 Methanol, 433, 646 Methionine, 323, 573, 646, 674 Methylphenidate, 463, 465, 646 Methyltransferase, 454, 646 Metoclopramide, 363, 646 Metronidazole, 458, 646 MI, 444, 450, 458, 460, 471, 477, 480, 509, 594, 646 Microbe, 646, 678 Microbiology, 596, 604, 646 Microtubule-Associated Proteins, 646, 650 Microtubules, 639, 646, 650 Microwaves, 646, 665 Midwifery, 326, 338, 647 Mifepristone, 647 Milliliter, 607, 647 Millimeter, 647 Mineralization, 609, 647 Miscarriage, 345, 647 Mobilization, 647 Modification, 388, 492, 525, 647, 665 Molecular Structure, 454, 647, 679 Monitor, 12, 428, 647, 652, 681 Monocytes, 639, 641, 647 Monotherapy, 489, 647

Mood Disorders, 413, 414, 419, 450, 462, 465, 469, 484, 498, 503, 505, 647 Morphine, 648, 649, 653 Morphology, 610, 648 Mother-Child Relations, 648 Motility, 432, 480, 648, 670 Motion Sickness, 648, 649, 669 Movement Disorders, 435, 602, 648, 676 Mucosa, 612, 629, 643, 648, 661 Mucus, 648, 680 Multicenter Studies, 648 Multicenter study, 648 Multiple sclerosis, 509, 648 Muscle Contraction, 441, 475, 648 Muscle Fibers, 648, 649 Muscular Atrophy, 554, 648 Muscular Dystrophies, 623, 648 Musculature, 636, 648 Myasthenia, 632, 648 Mydriatic, 648, 669, 682 Myelin, 648 Myocardial Ischemia, 537, 600, 617, 648 Myocardium, 600, 646, 648, 649 Myosin, 311, 648, 649 Myotonic Dystrophy, 468, 554, 649 N Naloxone, 439, 649 Naltrexone, 313, 415, 438, 439, 649 Narcolepsy, 463, 465, 468, 621, 646, 649 Narcosis, 649 Narcotic, 443, 648, 649 Natural killer cells, 649 Nausea, 497, 601, 602, 629, 649, 655 NCI, 1, 430, 547, 613, 649 Neck Pain, 649 Necrosis, 607, 611, 637, 646, 648, 649 Neocortex, 649, 650 Neonatal, 313, 637, 649 Neoplasia, 554, 649, 650 Neoplasms, 595, 602, 649, 665, 676 Neoplastic, 635, 644, 650 Neostriatum, 312, 610, 618, 650, 665 Nephrologist, 533, 650 Nephropathy, 640, 650 Nerve Endings, 475, 650 Nerve Fibers, 607, 650 Nerve Growth Factor, 650, 651 Nervous System, 326, 433, 435, 444, 445, 447, 448, 455, 457, 459, 463, 465, 468, 477, 486, 492, 494, 543, 554, 595, 597, 598, 599, 604, 605, 608, 609, 611, 612, 614, 621, 627, 629, 631, 641, 642, 645,

694 Depression

646, 648, 650, 651, 656, 669, 670, 674, 675, 676, 679, 680 Nervousness, 524, 650 Neuroanatomy, 642, 650 Neurodegenerative Diseases, 472, 605, 650 Neuroeffector Junction, 650 Neuroendocrine, 480, 650 Neuroendocrinology, 446, 650 Neurofibrillary Tangles, 5, 650 Neurofilaments, 650, 651 Neurogenic, 505, 651 Neurogenic Inflammation, 505, 651 Neuroleptic, 598, 602, 614, 651 Neurologic, 435, 509, 542, 543, 601, 651 Neuroma, 542, 651 Neuromuscular, 404, 595, 651 Neuromuscular Junction, 595, 651 Neuronal, 311, 438, 439, 467, 476, 484, 486, 503, 613, 649, 651 Neuronal Plasticity, 651 Neuropeptide, 436, 489, 618, 651 Neurosis, 651, 657 Neurotic, 496, 524, 531, 600, 651, 680 Neurotoxicity, 481, 640, 651 Neurotransmitters, 440, 442, 467, 475, 477, 478, 486, 495, 599, 623, 627, 651, 661, 672 Neurotrophins, 466, 651 Neutralization, 651 Neutrophils, 641, 651 Niacin, 316, 652, 679 Nicotine, 312, 394, 468, 526, 652 Nifedipine, 652 Nitric Oxide, 652 Nitrogen, 433, 480, 598, 599, 631, 652, 679 Nonverbal Communication, 652, 664 Nortriptyline, 7, 414, 438, 439, 457, 459, 652 Nuclear, 604, 624, 627, 629, 642, 649, 652, 676 Nuclear Family, 627, 652 Nuclei, 446, 480, 599, 624, 626, 644, 652, 659, 663, 670, 681 Nucleic acid, 652, 665 Nucleus Accumbens, 176, 484, 502, 652, 681 O Obsession, 616, 652 Obstetrics, 329, 653 Occipital Lobe, 653, 682 Occupational Therapy, 18, 568, 653 Octanes, 490, 653 Odds Ratio, 10, 653

Odour, 603, 653 Omega-3 fatty acid, 320, 324, 333, 500, 653 Oncogene, 554, 653 Oncology, 336, 653 On-line, 572, 591, 653 Opacity, 610, 620, 653 Opium, 648, 653 Opportunistic Infections, 595, 653 Optic Chiasm, 636, 653 Oral Health, 653 Orthostatic, 461, 602, 653 Osmolality, 653 Osmoles, 653 Osmosis, 653, 654 Osmotic, 598, 653, 654 Osteoarthritis, 323, 573, 654 Osteoblasts, 412, 654 Osteoporosis, 345, 411, 429, 530, 540, 607, 654 Outpatient, 8, 10, 13, 17, 385, 427, 456, 654 Ovaries, 654, 667, 671 Ovary, 618, 626, 631, 654 Overdosage, 529, 654 Overdose, 313, 494, 654 Ovum, 618, 619, 630, 641, 654, 661 Oxazolidinones, 487, 654 Oxidation, 595, 602, 606, 631, 654 Oxides, 654 Oxygen Consumption, 654, 667 P Palliative, 528, 530, 654, 676 Palsy, 578, 654, 672 Pancreas, 595, 621, 638, 654, 672 Pancreatic, 554, 610, 612, 630, 654 Pancreatic cancer, 554, 654 Pancreatic Juice, 630, 654 Panic Disorder, 412, 419, 443, 491, 497, 558, 566, 573, 628, 636, 655, 670 Parenteral, 655 Parenteral Nutrition, 655 Paresthesias, 655 Pargyline, 448, 655 Parietal, 11, 600, 655, 656 Parietal Lobe, 600, 655 Parkinsonism, 457, 553, 602, 609, 641, 655 Paroxetine, 7, 319, 328, 427, 474, 655 Paroxysmal, 554, 600, 632, 655 Partial remission, 179, 655, 667 Partial response, 501, 655 Parturition, 653, 655, 661 Patch, 655, 678 Pathogenesis, 510, 655

Index 695

Pathologic, 606, 617, 635, 655, 663, 667, 680 Pathologies, 655 Pathophysiology, 655 Patient Advocacy, 581, 655 Patient Education, 529, 560, 586, 588, 594, 656 Pelvic, 656, 663 Pepsin, 656 Pepsin A, 656 Peptic, 656 Peptic Ulcer, 656 Peptide, 445, 495, 496, 505, 612, 656, 659, 663, 677 Perception, 375, 390, 394, 410, 492, 616, 620, 632, 656, 669 Perennial, 635, 656, 679 Pericardium, 656, 675 Perimenopausal, 310, 499, 656 Perinatal, 637, 656 Perioperative, 656 Peripheral blood, 638, 656 Peripheral Nervous System, 650, 654, 656, 661, 672, 674 Peritoneal, 371, 639, 656 Peritoneal Cavity, 639, 656 Peritoneal Dialysis, 371, 656 Peritoneum, 656, 668 Personality Disorders, 478, 656 Personality Inventory, 409, 656 Perylene, 474, 657 Pesticides, 606, 657 PH, 179, 607, 657 Pharmaceutical Preparations, 482, 611, 626, 630, 657 Pharmacist, 657 Pharmacokinetic, 657 Pharmacologic, 413, 566, 579, 600, 657, 678 Pharynx, 630, 657, 680 Phenyl, 434, 441, 447, 450, 455, 460, 461, 463, 465, 473, 486, 487, 657 Phenylalanine, 364, 449, 475, 476, 656, 657, 679 Phobia, 443, 499, 657 Phobic Disorders, 657 Phosphates, 458, 485, 657 Phospholipids, 627, 638, 642, 657 Phosphorus, 176, 353, 458, 484, 609, 657, 658 Phosphorylated, 658 Phosphorylates, 458, 658 Phosphorylation, 458, 658, 663 Phototherapy, 658, 669

Phototransduction, 658, 669 Physical Examination, 413, 658 Physical Fitness, 540, 658 Physiologic, 328, 435, 443, 597, 606, 622, 636, 645, 658, 662, 666, 667, 679 Physiology, 313, 625, 632, 640, 658 Pigment, 606, 645, 658 Pilot study, 178, 325, 326, 331, 658 Pitch, 658 Pituitary Gland, 386, 618, 658 Placebo Effect, 658 Placenta, 626, 658, 661, 664 Plaque, 658 Plasma, 333, 463, 466, 598, 601, 611, 612, 630, 631, 633, 658, 667, 670, 681 Plasma cells, 601, 658 Plasma protein, 598, 658 Plasticity, 176, 332, 492, 659 Platelet Activation, 659, 671 Platelet Aggregation, 652, 659 Platelets, 427, 652, 659, 677 Pleomorphic, 652, 659 Plexus, 607, 659 Poisoning, 619, 629, 634, 639, 649, 659 Polycystic, 554, 659 Polymorphic, 442, 620, 659 Polymorphism, 9, 16, 491, 539, 659 Polyneuropathies, 634, 659 Polypeptide, 599, 614, 656, 659, 661, 672 Polyunsaturated fat, 659 Port, 659 Port-a-cath, 659 Portal System, 644, 659 Post partum, 534, 659 Posterior, 599, 603, 604, 611, 626, 649, 653, 654, 659 Postmenopausal, 393, 654, 659 Postoperative, 5, 660 Postsynaptic, 174, 175, 467, 650, 660, 671, 675 Post-synaptic, 477, 660 Post-traumatic, 474, 491, 632, 648, 660 Post-traumatic stress disorder, 474, 491, 660 Potassium, 178, 319, 441, 444, 660 Potassium Channels, 441, 660 Potassium hydroxide, 444, 660 Potentiate, 660 Potentiating, 443, 459, 599, 660 Potentiation, 177, 443, 468, 643, 660, 671 Practicability, 660, 679 Practice Guidelines, 552, 565, 660

696 Depression

Preclinical, 6, 437, 482, 493, 660 Precordial, 660 Precursor, 443, 475, 482, 603, 612, 622, 623, 625, 641, 652, 657, 660, 661, 679, 680 Predisposition, 529, 660, 676 Prefrontal Cortex, 660 Premedication, 661, 669 Premenopausal, 429, 661 Premenstrual, 345, 346, 443, 661 Presynaptic, 443, 473, 476, 490, 491, 495, 604, 623, 650, 661, 675 Presynaptic Terminals, 604, 623, 650, 661, 675 Preventive Health Services, 615, 661 Primula, 440, 661 Private Sector, 178, 661 Probe, 632, 657, 661 Problem Solving, 180, 661 Prodrug, 629, 661 Professional Impairment, 661 Progesterone, 365, 419, 427, 647, 661, 673 Prognostic factor, 661 Progression, 11, 509, 595, 600, 661 Projection, 652, 660, 661, 666, 681 Prolactin, 437, 661 Proline, 446, 614, 662 Promoter, 662 Prone, 543, 662 Prophase, 662, 675 Propofol, 332, 662 Proportional, 653, 662 Propranolol, 452, 471, 499, 603, 662 Prospective study, 643, 662 Prostaglandin, 662 Prostaglandins A, 662 Prostaglandins F, 647, 662 Prostate, 342, 346, 432, 554, 663 Protease, 615, 663 Protein C, 598, 599, 602, 604, 642, 663 Protein S, 174, 523, 554, 555, 606, 663, 668 Protein-Tyrosine Kinase, 630, 663 Proteolytic, 598, 615, 663 Protocol, 4, 379, 517, 663 Protons, 635, 639, 644, 663, 665 Protriptyline, 438, 439, 663 Proximal, 622, 659, 661, 663, 670 Pruritic, 641, 663 Pseudoxanthoma, 541, 663 Pseudoxanthoma Elasticum, 541, 663 Psoriasis, 663 Psychic, 350, 481, 641, 651, 663, 664, 669 Psychological Adaptation, 664

Psychological Tests, 414, 664 Psychomotor, 14, 427, 609, 619, 651, 664 Psychopathology, 12, 18, 399, 664 Psychosis, 12, 14, 18, 477, 491, 511, 536, 561, 567, 602, 664 Psychotomimetic, 599, 621, 664 Psychotropic, 16, 17, 482, 497, 529, 561, 664 Psychotropic Drugs, 482, 497, 664 Puberty, 663, 664 Public Health, 310, 311, 408, 552, 664 Public Policy, 549, 664 Publishing, 173, 448, 664 Puerperium, 653, 664 Pulmonary, 607, 612, 616, 617, 664, 665, 681 Pulmonary Artery, 607, 664, 681 Pulmonary Edema, 612, 664 Pulmonary hypertension, 617, 665 Pulse, 647, 665 Purines, 485, 665 Putamen, 600, 605, 618, 650, 665 Pyramidal Tracts, 627, 665 Q Quaternary, 665, 669 Quiescent, 665 R Race, 434, 452, 463, 465, 471, 499, 622, 623, 665 Radiation, 600, 624, 625, 629, 639, 646, 665, 674, 682 Radio Waves, 413, 646, 665 Radioactive, 412, 635, 637, 652, 665 Radioimmunotherapy, 665 Radiolabeled, 486, 665 Radiopharmaceutical, 630, 665 Radiotherapy, 665 Randomized clinical trial, 14, 666 Rape, 660, 666 Reagent, 612, 666 Reality Testing, 664, 666 Receptors, Serotonin, 666, 670 Recombinant, 666 Rectum, 602, 607, 621, 628, 629, 637, 640, 663, 666 Recur, 666, 669 Recurrence, 421, 426, 488, 606, 613, 644, 666, 669 Red Nucleus, 603, 666, 681 Reductase, 628, 666 Refer, 1, 444, 608, 615, 622, 630, 642, 644, 651, 653, 664, 665, 666

Index 697

Reflex, 447, 455, 666 Reflux, 630, 666 Refraction, 666, 673 Refractory, 181, 436, 438, 439, 463, 466, 489, 493, 503, 666 Regimen, 468, 623, 657, 658, 666 Regression Analysis, 4, 181, 666 Regurgitation, 630, 667 Rehabilitation Centers, 577, 667 Relapse, 335, 394, 414, 426, 501, 516, 667 Relaxin, 468, 667 Reliability, 13, 14, 16, 180, 667 Remission, 7, 606, 644, 666, 667 Renal failure, 619, 667 Renin, 609, 667 Renin-Angiotensin System, 609, 667 Resection, 667 Reserpine, 454, 667 Resolving, 420, 667 Resorption, 429, 607, 667 Respiration, 480, 492, 497, 602, 609, 612, 647, 667 Restoration, 485, 667 Retina, 600, 641, 644, 653, 658, 663, 667, 668 Retinal, 616, 653, 658, 668 Retinoblastoma, 554, 668 Retroperitoneal, 596, 668 Retrospective, 173, 668 Retrospective study, 173, 668 Rheumatism, 668 Rheumatoid, 404, 668 Rheumatoid arthritis, 668 Ribose, 176, 596, 668 Ribosome, 668, 678 Right to Die, 668 Rigidity, 475, 655, 658, 668 Risperidone, 428, 668 Rod, 604, 613, 668 Rubber, 595, 668 Rural Health, 668 Rural Population, 408, 668 S Saliva, 668 Salivary, 621, 654, 668 Salivary glands, 621, 668 Saphenous, 617, 669 Saphenous Vein, 617, 669 Schizoid, 669, 682 Schizotypal Personality Disorder, 620, 669, 682 Sclerosis, 554, 578, 648, 669

Scopolamine, 526, 605, 669 Seasonal Affective Disorder, 346, 413, 528, 558, 574, 669 Sebaceous, 669, 682 Second Messenger Systems, 492, 651, 669 Secretion, 446, 475, 595, 613, 634, 638, 640, 648, 669, 670 Secretory, 650, 669, 675 Sedative, 454, 497, 599, 636, 669, 679, 680 Sedatives, Barbiturate, 604, 669 Segregation, 669 Seizures, 435, 438, 439, 489, 529, 609, 613, 619, 655, 669 Selenium, 314, 319, 320, 669 Self Care, 596, 670 Self-Help Groups, 577, 578, 670 Semantic Differential, 670 Semen, 663, 670 Senile, 346, 386, 459, 462, 468, 654, 670 Sensor, 670 Sensory Deprivation, 332, 670 Sepsis, 670 Septal, 600, 642, 670 Septal Nuclei, 600, 642, 670 Septic, 670 Serotonin Uptake Inhibitors, 479, 670 Serum, 346, 437, 446, 485, 598, 615, 643, 670 Sex Characteristics, 596, 664, 671, 676 Sex Determination, 554, 671 Ships, 671 Shock, 462, 624, 671, 678 Signal Transduction, 638, 671 Signs and Symptoms, 453, 667, 671 Skeletal, 432, 613, 648, 671, 672 Skeleton, 433, 486, 596, 607, 628, 640, 662, 671 Skull, 618, 671, 676 Sleep apnea, 671 Sleep Deprivation, 330, 671 Small intestine, 613, 630, 634, 636, 639, 671 Smooth muscle, 313, 432, 598, 608, 634, 648, 662, 667, 671, 672, 674 Social Environment, 665, 671 Social Support, 370, 372, 373, 374, 377, 378, 382, 383, 387, 388, 397, 410, 550, 672 Social Work, 373, 376, 377, 385, 395, 396, 402, 409, 508, 525, 532, 672 Socialism, 369, 672 Sodium, 319, 444, 658, 672 Sodium Bicarbonate, 444, 672 Soft tissue, 429, 607, 671, 672

698 Depression

Solitary Nucleus, 604, 672 Solvent, 595, 605, 626, 631, 646, 653, 654, 672 Soma, 672 Somatic, 17, 371, 468, 596, 642, 645, 656, 660, 672, 680 Somatostatin, 467, 672 Sound wave, 616, 672 Soybean Oil, 659, 672 Spasm, 602, 617, 646, 672 Spastic, 346, 639, 672 Specialist, 583, 673 Species, 605, 626, 629, 645, 665, 673, 674, 678, 679, 681, 682 Specificity, 4, 6, 11, 399, 597, 673 Spectrum, 469, 646, 665, 673 Speech Disorders, 577, 673 Sperm, 613, 673 Spinal Cord Injuries, 576, 673 Sporadic, 650, 668, 673 Sprayer, 673 Stabilizer, 673 Steady state, 673 Steel, 390, 613, 673, 679 Steroid, 618, 673 Stimulant, 483, 599, 608, 621, 634, 646, 673, 675 Stimulus, 623, 624, 627, 638, 639, 640, 651, 655, 657, 666, 673, 677 Stomach, 595, 621, 626, 629, 630, 634, 643, 649, 656, 657, 666, 671, 673 Stool, 637, 639, 640, 673 Strained, 578, 673 Striatum, 620, 650, 652, 674 Stupor, 641, 649, 674 Styrene, 668, 674 Subacute, 637, 674 Subarachnoid, 629, 632, 674 Subclinical, 384, 637, 669, 674 Subcutaneous, 444, 655, 674 Subiculum, 634, 674 Sublingual, 485, 674 Subspecies, 673, 674 Substance P, 646, 669, 674 Substrate, 674, 679 Suction, 674 Sulfur, 646, 674 Sunburn, 347, 674 Supplementation, 329, 674 Support group, 17, 331, 578, 579, 580, 581, 674 Suppression, 674

Sympathetic Nervous System, 604, 674, 675 Sympathomimetic, 597, 599, 621, 622, 626, 652, 674, 679 Symphysis, 663, 675 Symptomatic, 388, 601, 675 Symptomatology, 6, 10, 13, 372, 399, 427, 529, 675 Synapses, 173, 175, 176, 180, 404, 467, 473, 476, 490, 491, 643, 650, 651, 675 Synapsis, 675 Synaptic Transmission, 182, 312, 492, 652, 675 Synaptic Vesicles, 675 Synergistic, 437, 493, 494, 661, 675 Systemic, 347, 360, 393, 469, 550, 602, 607, 608, 619, 626, 637, 639, 651, 659, 672, 675, 679 Systemic lupus erythematosus, 469, 675 Systolic, 635, 675 T Tachycardia, 447, 455, 457, 497, 675 Tacrine, 17, 675 Tardive, 602, 613, 675 Telangiectasia, 554, 676 Telencephalon, 604, 676 Temperament, 390, 416, 676 Temporal, 11, 386, 529, 599, 632, 634, 644, 676 Temporal Lobe, 599, 676 Teratogenic, 640, 676 Testicular, 676 Testis, 626, 676 Testosterone, 628, 666, 676 Tetrahydrocannabinol, 609, 676 Thalamic, 603, 626, 676 Thalamic Diseases, 603, 676 Thalamus, 618, 621, 626, 642, 660, 676 Theophylline, 665, 676 Therapeutic Community, 335, 676 Therapeutics, 348, 438, 439, 442, 448, 482, 497, 526, 647, 676 Thermal, 622, 676 Thigh, 628, 676 Third Ventricle, 626, 636, 644, 676, 677 Thoracic, 604, 607, 621, 677, 682 Thorax, 595, 643, 660, 677, 680 Threonine, 677 Threshold, 6, 331, 627, 635, 677 Thrombocytes, 659, 677 Thromboembolism, 677 Thrombosis, 663, 674, 677

Index 699

Thrombus, 618, 637, 648, 659, 677 Thyroid, 177, 181, 314, 338, 347, 521, 635, 639, 641, 677, 680 Thyroid Gland, 635, 677 Thyroid Hormones, 677, 680 Thyrotropin, 457, 677 Thyroxine, 598, 641, 657, 677 Tinnitus, 677, 681 Tolerance, 443, 613, 631, 677 Tomography, 13, 180, 484, 607, 644, 677 Tonic, 310, 613, 678 Tooth Preparation, 596, 678 Topical, 360, 487, 626, 640, 672, 678 Torsion, 637, 678 Toxic, iv, 310, 441, 450, 477, 494, 501, 604, 605, 625, 632, 636, 646, 652, 660, 670, 674, 678 Toxicity, 428, 458, 496, 623, 678 Toxicokinetics, 678 Toxicology, 550, 678 Toxins, 601, 624, 631, 637, 665, 678 Trace element, 612, 628, 678 Trachea, 432, 608, 640, 657, 677, 678 Traction, 613, 678 Trail Making Test, 678 Tranquilizing Agents, 664, 678 Transdermal, 437, 678 Transfection, 606, 678 Translation, 180, 181, 678 Translational, 678 Transmitter, 467, 595, 603, 604, 622, 627, 639, 645, 652, 675, 678, 679, 681 Transplantation, 445, 613, 678 Trauma, 619, 626, 649, 678 Treatment Failure, 679 Treatment Outcome, 310, 330, 679 Trees, 626, 668, 679 Tremor, 475, 497, 646, 655, 679 Trichomoniasis, 646, 679 Trichotillomania, 579, 679 Tricuspid Atresia, 617, 679 Trigger zone, 602, 679 Trimipramine, 438, 439, 679 Tryptophan, 311, 418, 443, 476, 614, 670, 679 Tubercle, 652, 679 Tuberculosis, 616, 643, 679 Tuberous Sclerosis, 554, 679 Tungsten, 610, 679 Type 2 diabetes, 679 Tyramine, 449, 460, 461, 606, 647, 679 Tyrosine, 361, 367, 475, 476, 622, 663, 679

U Ubiquitin, 650, 680 Ulcer, 656, 680 Ulcerative colitis, 432, 637, 680 Unconscious, 600, 636, 680 Urethra, 663, 680 Urinary, 17, 543, 619, 625, 637, 669, 680 Urine, 412, 413, 414, 468, 543, 601, 606, 622, 625, 632, 633, 637, 680 Uterus, 611, 618, 619, 625, 645, 654, 661, 680 V Vaccine, 528, 663, 680 Vagina, 612, 645, 680 Vaginal, 680 Vagus Nerve, 435, 447, 455, 672, 680 Valerian, 339, 367, 680 Valves, 680 Vasoconstriction, 626, 680 Vasodilator, 607, 622, 634, 652, 680 Vasomotor, 680 VE, 8, 338, 680 Vegetative, 12, 680 Vein, 412, 639, 652, 669, 680 Venlafaxine, 326, 367, 425, 680 Venous, 608, 611, 641, 663, 679, 680, 681 Venous blood, 608, 611, 641, 681 Ventral, 484, 502, 636, 652, 681 Ventral Tegmental Area, 484, 502, 681 Ventricle, 312, 599, 603, 610, 617, 634, 652, 664, 665, 675, 679, 681 Ventricular, 617, 679, 681 Vertebrae, 673, 681 Vesicular, 681 Vestibulocochlear Nerve, 677, 681 Vestibulocochlear Nerve Diseases, 677, 681 Veterinary Medicine, 549, 681 Video Recording, 531, 681 Videodisc Recording, 681 Viral, 528, 624, 681 Viral Load, 681 Virulence, 678, 681 Virus, 507, 528, 532, 564, 570, 595, 604, 611, 625, 638, 658, 681 Viscera, 672, 681, 682 Visceral, 604, 642, 656, 680, 682 Visceral Afferents, 604, 680, 682 Visual Cortex, 175, 176, 177, 682 Vitamin A, 638, 682 Vitro, 384, 633, 682 Vivo, 682

700 Depression

Volition, 639, 682 Vulgaris, 682 W Wakefulness, 619, 682 War, 387, 394, 407, 408, 409, 410, 512, 660, 682 Wart, 542, 682 Weight Gain, 467, 469, 471, 498, 501, 512, 669, 682 White blood cell, 596, 601, 641, 643, 648, 649, 658, 682

Windpipe, 657, 677, 682 Withdrawal, 340, 468, 474, 480, 484, 488, 496, 503, 528, 529, 619, 682 Word Processing, 682 Wounds, Gunshot, 673, 682 X Xenograft, 600, 682 X-ray, 607, 610, 629, 652, 665, 673, 682 Y Yohimbine, 314, 682

Index 701

702 Depression

Index 703

704 Depression

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