Self-rated residual symptoms do not predict 1-year recurrence of depression

Background

Residual depressive symptoms are generally documented as a risk factor for recurrence. In the absence of a specific instrument for the assessment of residual symptoms, a new 25-item Depression Residual Symptom Scale (DRSS) was elaborated and tested for recurrence prediction over a 1-year follow-up.

Sampling and methods

Fifty-nine patients in remission after a major depressive episode (MDE) were recruited in two centres. They were assessed with the DRSS and the Montgomery-Asberg Depression Rating Scale (MADRS) at inclusion and followed for 1 year according to a seminaturalistic design. The DRSS included specific depressive symptoms and subjective symptoms of vulnerability, lack of return to usual self and premorbid level of functioning.

Results

Severity of residual symptoms was not significantly associated with increased risk of recurrence. However, DRSS score was significantly higher among patients with three or more episodes than one to two episodes. Number of previous episodes and treatment interruption were not identified as significant predictors of recurrence.

Conclusion

The proposed instrument is not predictive of depressive recurrence, but is sensitive to increased perception of vulnerability associated with consecutive episodes. Limitations include small sample size, seminaturalistic design (no standardisation of treatment) and content of the instrument.

Prevalence of pathological gambling in Switzerland after the opening of casinos and the introduction of new preventive legislation

OBJECTIVE

This survey aimed to evaluate the prevalence of pathological gambling (PG) in the Swiss population in 2005 and the link between PG and alcohol abuse. This replication study made it possible to compare the prevalence rates of PG measured before and after the introduction of casinos and new preventive legislation.

METHOD

A total of 2803 telephone interviews were completed using standardized assessment instruments for identifying gamblers (South Oaks Gambling Screen) and alcohol abuse (CAGE).

RESULTS

The past-year prevalence rates were 0.8% for problem and 0.5% for PG. No relationship was found between alcohol abuse and gambling behaviour. The past-year prevalence of disordered gambling did not change between 1998 and 2005.

CONCLUSION

Despite widespread openings of casinos in Switzerland since 2002, the prevalence estimates of past-year disordered gambling have remained stable. The discussion focuses on different factors (social measures, legal obligations and social adaptational capacities) that may account for the stabilization of prevalence estimates.

Lithium dose prediction based on 24 hours single dose levels: a prospective evaluation

The authors present the results of the utilization of a pharmacokinetic prediction test for lithium posology. Based on a single point (plasma lithium determination 24 h after a single dose) such a test aims to adapt the posology as soon as the second day of treatment rather than after one week as clinicians must wait for a steady state to be achieved. Built on the previous work of Perry, the test targeted the plasma lithium level at 0.8 +/- 0.1 mmol l(-1). Thirty-one patients took part in the study. There were two drop-out cases and the results were available for 29 patients: among them, 51% had their plasma level in the targeted zone. Although there was no control group, the prediction test often allowed us to use a higher dose than the usual fixed dose whose amount is limited by the risk of overdosing for the slower metabolizers.

Mania resulting from continuous positive airways pressure in a depressed man with sleep apnea syndrome

The authors report the case of a 50-year-old man, with no previous history of bipolar illness, hospitalized with a very severe depression and who was resistant to a 7-weeks treatment of venlafaxine and trazodone (the respective daily doses were 300 and 50 mg which were stable during the last 4 weeks). A diagnosis of sleep apnea syndrome led to the use of the continuous positive airways pressure technique (CPAP). A few days after starting CPAP, he presented a mood switch, first hypomanic, then mixed. The authors discuss the contribution of the sleep apnea syndrome to the appearance and the maintenance of the depressive disorder.

Prevalence estimates of pathological gambling in Switzerland

OBJECTIVE

The purpose of this study was to evaluate the prevalence of pathological gambling in the Swiss adult population before the introduction of new forms of gambling, and the link between pathological gambling and alcohol abuse.

METHOD

2526 telephone interviews were completed using standardized assessment instruments for identifying potential and probable pathological gamblers (SOGS) and alcohol abuse (CAGE).

RESULTS

The current prevalence of probable and potential pathological gamblers were estimated to be 0.8% and 2.2%, respectively. The results also show a clear correlation between alcohol abuse and gambling behaviours.

CONCLUSION

For the first time estimations are available of the Swiss prevalence rates of pathological gambling. Considering the link between gambling availability and increases in the prevalence of pathological gambling and the correlation between alcohol abuse and pathological gambling, the implications of these results for the prevention and treatment of this debilitating disorder are discussed.

[Neuropsychological functioning in hebephrenic patients. Comparison between visual and auditory stimuli initially projected either in one or in both cerebral hemispheres]

The performances of 14 hebephrenic patients and 14 normal subjects were studied through visual and auditory tests concerning the comparison of the number of stimuli projected either in the left, or in the right, or in both cerebral hemispheres. Schizophrenic patients were less efficient than normal subjects and, in both populations, no difference in the performances with regard to the locus of projection was observed. This suggests that information processing in schizophrenia might be deficient not only at the level of interhemispheric connections, but also in intrahemispheric functioning.

[Neuropsychological functioning of hebephrenic patients. Study of the relationship between visual and manual functional systems]

Relations between visual and manual responses after prismatically displaced vision are studied in 15 schizophrenics and 15 normals. Results show that the changes in visual and manual responses are concordant in normals, whereas the responses of these two modalities are dissociated in schizophrenics. This suggests that the information processing in schizophrenia might be deficient not only at the level of interhemispheric connections, but also in intra-hemispheric functioning. These results cannot be explained by the generally accepted hypothesis of a dysfunction localised in a single hemisphere.