Social indices of social integration, such as divorce, were more successful in predicting the suicide rates of the elderly in the provinces of Hungary than they were in predicting the suicide rates of young adults.

The method of evaluation we describe attempts to establish the criteria applied by clinicians when recommending psychoanalytical psychotherapy or psychoanalysis. A questionnaire was constructed and a study of inter-rater agreement using this research tool was carried out. The results of inter-rater agreement as well as the variations concerning each rater are discussed. Continuation of this study will provide the opportunity to examine the validity of general principles underlying the psychoanalysts’ perceptions of their patients.

Platelet serotonin-binding (Bmax), using tritiated-seroionin as the ligand, was determined in 75 patients suffering from major depression with melancholia and in 26 patients diagnosed from dysthymic disorder. Twenty-five normal subjects were used as a control group. The melancholic group had significantly lower Bmax values (mean: 6.7 ± 6.1 pmol/108 platelets) than either dysthymic (9.3 ± 3.9 pmol/108 platelets) or control (9.2 ± 4.8 pmol/108 platelets) groups, while there were no significant differences between the two latter groups. There was also a significant difference on postdexamethasone Cortisol between melancholic (6.3 ± 7.1 μg/dL) and dysthymic (1.4 ± 1.4 μg/dL) groups, with a higher rate of nonsuppressors in melancholic groups. Although both tests were abnormal in the melancholic group, no relationship was found between platelet serotonin-binding and the dexaniethasone suppression test.

In order to determine the usage pattern of light therapy (LT), we performed a survey of all psychiatric hospitals in Germany in 1992. Our data reveal that 13% of all psychiatric hospitals perform LT and another 7% indicate their interest in this treatment. Stratification into different treatment facilities demonstrates that 57% of the psychiatric university hospitals use LT. The usage of LT started in Germany in 1982 and there was a sharp rise from 1987 onwards. The majority of hospitals (89% of those hospitals which use LT) use LT successfully for the treatment of seasonal affective disorder (SAD) and its subsyndromal form followed by non-SAD depression (68%). LT is used as monotherapy in 71% of SAD patients compared with 34% in non-SAD depression.

Several studies have reported immune cellular and humoral dysfunction during depression. We specifically focused on the study of the monocyte as it has a key role in the activation of the immune response. To examine the association between severity of depressive symptoms and values of monocyte parameters (HLA-DR, CD35, phagocytic activity and vimentin filaments), we used a longitudinal design and assessed monocyte markers at intake and at follow-up 12 weeks after discharge from the hospital in 49 depressed patients. Seventy percent of patients showed pretreatment a marked monocyte dysfunction (82.5% had at least one parameter altered). After treatment, alterations in immunological variables were significantly associated (P < 0.05) with depression scores higher than 15. The findings indicate that the monocyte dysfunction is temporally associated with the state of depression. Before and after treatment the immunoreactive vimentin filaments significantly increased (P < 0.01) after incubation of monocytes with naloxone, suggesting that an increased opioid activity might account for the monocyte dysfunction.

Patterns of interaction and attitudes in the relationships of 21 young schizophrenic patients, their parents and therapists were explored and compared with each other in this pilot study. The focus was on expressed emotion (EE), which was revealed to have an important impact on the course of the illness. In this study, the EE status of the relatives as well as of the therapists was rated using the five-minute speech sample method. Furthermore, data on the quality of interaction of therapists and parents with the patients were derived from the therapist/relative-patient interaction scale. Results showed that one-third of both the therapists and the parents were rated high on EE. High-EE relatives were rejected and perceived as inscrutable by the patients. The assessment of the therapeutic and familial relationships demonstrated the patients’ need for unequivocal communication. Differences and similarities in the interaction styles, and their implications for research and therapy are discussed.

A study was conducted on a group of 73 patients suffering from major depressive disorder (DSMIII) compared with 120 normal subjects using a subscale of physical pleasure (Fawcett Clark pleasure capacity scale-physical pleasure, FCPCS-PP). The major depressives were significantly more anhedonic than the normals and the distribution of the FCPCS-PP scores in these subjects was unimodal.

Keller and Shapiro (1982) reported that 26% of the first 101 patients who entered the National Institute of Mental Health (NIMH)-Clinical Research Branch Collaborative Program on the Psychobiology of Depression (Katz and Klerman, 1979; Katz et al, 1979) with a major depressive episode were found to have a pre-existing chronic minor depression of at least 2 years’ duration. They labeled this Phenomenon “double depression„ (Keller and Shapiro, 1982). Furthermore, patients with panic disorder almost universally suffer from major depression at some time in the course of their disorder (Coryell et al, 1988; Stein and Uhde, 1988; Vollrath et al, 1990). “Double diagnosis„, or identification of psychotic or related syndromes, co-existing with personality disorders, have received much attention in the literature in recent years (Sanderson et al, 1990; Torgersen, 1990; Barsky et al, 1992). Much of the research on comorbidity between depressive and anxiety disorders has been summarized in two edited volumes (Kendall and Watson, 1989; Maser and Cloninger, 1990).

There have been many contradictory reports on the effectiveness of antidepressant drug treatments in autistic syndromes with sell-injurious behavior (SIB). We report a retrospective case study in which norepinephrinergic antidepressants (inhibitors of the re-uptake of norepinephrine) increased SIB each time they were administered.

We report the case of a patient with major depression and obsessive-compulsive disorder who had simultaneously high serum citalopram, clomipramine, and alprazolam concentrations probably due to the reciprocal competitive inhibition of the cytochrome P450-catalyzed oxidative metabolism.

The association of eating disorders and bipolar disorders is less documented than the well-established association of eating disorders and unipolar depression. However, epidemiological studies have demonstrated an increased risk for bipolar disorders, especially bipolar II, in bulimic patients. We report the case of a patient displaying such a morbid association.