As the different affective temperament-types (depressive, hyperthymic, cyclothymic, irritable and anxious) play a significant role in the development and symptom-formation of bipolar and unipolar major mood episodes, the aim of this study was to examine these affective temperaments in persons making suicide attempts.

Using the Hungarian version of the full-scale 110-item version of the TEMPS-A questionnaire. we compared the affective temperament profiles of 150 nonviolent (106 female and 44 male) suicide attempters (121 of them have had current major depressive episode) and 717 normal controls (438 females and 279 males).

Compared to controls, both female and male suicide attempters scored significantly higher in four of the five temperaments, containing mWre or less depressive component (depressive, cyclothymic, irritable and anxious). On the other hand, however, no significant difference between suicide attempters and controls was found for the hyperthymic temperament scores. Significantly higher rate of suicide attempters (135/150=90.0%) than controls (138/717=19.2%) have had some kind of dominant (mean score + 2 SD or above) affective temperament (p=0.0001).

The findings support the strong relationship between depression and suicidal behaviour even on temperamental level, suggesting that hyperthymic temperament has no predisposing role for suicidal behaviour at least in case of nonviolent attempters. As current depression and dysregulated central serotonergic function are well-known suicide risk factors, these findings are also in good agreement with recent results on the significant relationship between the s allele of the serotonin transporter gene and depressive, cyclothymic, irritable and anxious temperaments, but not with hyperthymic temperament.

44 patients with major depression.

21-item Hamilton Rating Scale for depression; Test BASE (projective questionnaire) for the estimation of: search activity (SA), stereotyped activity (St), chaotic behavior (Ch), passive behavior (Pa). As a normal configuration of BASE we have estimated BASE with positive values (>0)of Sa and St and negative values (<0) of Ch and Pa (without taking into consideration the absolute values).

1. SA is decreased and Pa is increased in patients. Patients with the Hamilton scale <22.7 and > 31.1 do not display significant differences in BASE scales. Both groups displayed abnormal configuration of BASE. Correlations between behavioral attitudes and Hamilton scale are absent. 2. In patients with the abnormal configuration of BASE Hamilton scale was significantly higher (27.7) than in patients with normal configuration (24.6).

The severity of depression does not determine the indexes of the single behavioral attitudes. The level of depression is related to the configuration of behavioral attitudes.

44 patients with major depression.

21-items Hamilton Rating Scale for depression. BASE Test for the estimation of behavioral attitudes. Sleep questionnaire.

1. In patients satisfied with night sleep stereotyped behavior (St) was higher than in patients not satisfied with their sleep (3.16 vs. 0.6, p=0.03). 2. Patients with the negative values of search activity (SA) and/or St and positive values of passive behavior (Pa) are more often dissatisfied with their sleep than the opposite group. 3. In patients who report the increase of dreams after the positive emotional experience St is higher than in patients who do not report it (2.62 vs. –0.16, p=0.02). 4. In patients who like to see dreams in comparison to those who do not like it SA is higher, Pa is lower, while Hamilton Rating Scale is also lower.

The configuration of behavioral attitudes is more important for subjective sleep estimation than the level of depression.

In an interim evaluation on baseline data of the German PADRE observational study the correlation between physician- and patient assessment of emotional and physical symptoms of depressed patients was evaluated.

This multicenter, prospective, 6-month observational study focused on adult outpatients with a depressive episode as diagnosed according to ICD-10 criteria, chosen by their physician to start new anti-depressive treatment with duloxetine. Correlations between the applied depression and/or pain scales were calculated via Spearman's correlation coefficient. Symptoms were evaluated via clinician rated 'Inventory for Depressive Symptomatology' ([IDS-C], total score, including item 25), patient rated 5-item scale 'KUSTA', (rating mood, activity, tension-relaxation, sleep and appetite on visual analog scales [VAS]), and patient rated VAS for 'Pain'.

All participating physicians are psychiatrists/neurologists. 2.748 patients (71% female, mean age 52.7 yrs) were evaluated. Any pain symptoms were documented in 88.9% of patients at baseline. When comparing patient- with physician-assessments, correlation of PPS scales was low to moderate and varied for different pain types: IDS-C item 25 (="somatic disorders") vs. overall pain-VAS: r=0.421 (95% CI 0.390, 0.452), IDS-C item 25 vs. abdominal pain: r=0.189; IDS-C item 25 vs. chest-pain: r=0.179. When comparing IDS-C total vs. the KUSTA items, correlation was moderate in all cases (e.g.: r= -0.510 for IDS total vs. KUSTA mood).

Only a low to moderate correlation was observed between physician- and patient assessment for PPS in depressed patients. Therefore, patient pain ratings should explicitly be included in the assessment of depressed patients.

Postpartum depression (PPD) is one of the most common psychiatric disorders following delivery. This disorder makes serious problem for mother, child and family; therefore the identification of its risk factors is a must. One of these factors is kind of delivery. This study has been carried out to evaluate relationship between kind of delivery and PPD in kashan IRAN 2006.

This case control-study evaluated 460 women during 2-3 first months after delivery divided in 2 equal groups (depressed and normal group who were named case and control group respectively).The Beck standard test and a researcher-made questionnaire were used for evaluation. Some factors effecting on depression were omitted in the study and some mother age and birth order were matched in 2 groups. X2 and T test were used to analyze the data.

The results showed that there was no relationship between kind of delivery and PPD (p<0/574).In cases group; mild, moderate and severe depression were 42/2%, 47/4% and 10/4% and normal vaginal delivery (NVD) was53/9% and in control group NVD was 47/8%. In this matter, there was no significant relationship between mother education and job, neonatal gender, number of live birth and wanted or unwanted pregnancy with PPD.

There is no a relationship between kind of delivery and PPD.Its recommended to do cohort study and effect of other factors in PPD in much more sampling in future researches.

Postpartum depression, Normal vaginal delivery, Cesarean section

Teenagers specially girls have many problem with adaptation of development and their need during adolescence.one of the most serious problem that they faced to is depression.prevalence of depression in teenagers is 40-70% and it is in girl twice as many as boys. This study has been carried out to evaluate prevalence of depression and it's related factors in high school girls in Kashan -IRAN 2006.

This descriptive crossectional study was performed to evaluate 762 high school girls whom were selected randomly from the school of Kashan IRAN 2006.The Beck questionnaire was used for depression assessment scores less than 5,5-7,8-15 and more than 16 were considered normal, mild, moderate and severe depression respectively. In addition some questions about demographic criteria was asked. X2 and T test were used to analyze the data.

The frequency of mild, moderate and severe depression were 148(%19/4), 183(%24) and77 (%10) respectively (on the whole 53/4%). There was no relationship between depression and mother education, mother and father job, number of sisters and brothers and father's age while there was significant relationship between depression and father education(p<0/007).in depression group there was 28/9% illiterate and primary school fathers and 16/2% university education fathers while in normal group was 21/2% and 22/9% respectively.

Because of high prevalence of depression in teenagers, it's recommended to study more on effective factors on depression especially in teenagers.

Depression, Teenagers

To compare therapeutic efficacy, social function, discontinue rate, relapse and recurrence rate of the depression outpatients with first episode between Venlafaxine extended release and Fluoxertine hydrochloride treatment. Methods In this 48 week natural parallel follow-up study, total 188 patients who meet ICD-10 criteria for a major depressive episode were admitted and assigned to receive either Venlafaxine Extended Release (Venlafaxine XR group) (n=89) or Fluoxertine hydrochloride(Fluoxertine group) (n=99).At baseline,week2,8,12,16,24,32,48,Hamilton Rating Scale for Depression (HAMD)-17 item was used to value disease severity, and Social Disability Screening Schedule(SDSS)for social disability, and the discontinue, relapse and recurrence rates were compared. Results (1) At week 24 Venlafaxine XR group had much lower HAMD17 total score than Fluoxertine group (P<0.05). (2)The remission rate and response rate between two groups had no statistical difference (P>0.05). (3) At week 12, Venlafaxine XR group had a higher SDSS score than Fluoxertine group (P<0.05).(4)At week 12, 16, 24, 32,48,Venlafaxine XR group displayed lower discontinue rates (P<0.05). Venlafaxine XR group had a longer treatment course than Fluoxertine did [(30.99±15.98) weeks vs. [(22.57±15.26) weeks] (P<0.01). (5) The relapse and recurrence rates of two groups had no statistical difference (P>0.05). Conclusions In the acute phase, Venlafaxine XR has a better effect for social function and treatment adherence than Fluoxertine hydrochloride. In the continued phase and sustained phase, Venlafaxine XR performs better for symptoms relief and treatment adherence.Venlafaxine XR has parallel performance with Fluoxertine hydrochloride by the terms of therapeutic efficacy, social function restore, relapse and recurrence rate.

Venlafaxine extended release (XR) stands as an optimal therapeutic choice for the major depressive disorder (MDD) and generalized anxiety disorder (GAD) dual diagnosis.

We focused upon the evaluation of venlafaxine XR efficacy in treating MDD and GAD dual diagnosis patients, using an selective serotoninergic reuptake inhibitor comparator, fluoxetine.

A 23 patients group, 13 male and 10 female, mean age 36.7, admitted in our clinic, that met the DSM IV TR criteria for both MDD and GAD, were distributed in two groups, receiving venlafaxine XR in 75-150 mg flexible dose (n=12) or fluoxetine 20-40 mg flexible dose (n=11). We assessed patients evolution under treatment every two weeks for 6 months using Hamilton Depression Rating Scale 17 items (HAMD-17), Hamilton Anxiety Scale for Anxiety (HAMA), Global Assessment of Functioning Scale (GAF) and Clinical Global Impressions (CGI).

In the intent-to-treat (ITT) and last-observation-carried-forward (LOCF) analysis, differences between groups became statistically significant at week 4, venlafaxine XR treated patients improved better as HAMD-17 (-7.8 points, p<0.05) and HAMA (-8.9 points, p<0.05) reflected. The end-point HAMD-17 and HAMA scores were smaller in the venlafaxine treated group (6.7 and 9.1, p<0.05). Endpoint CGI (1.5) and GAF (92) scores were also better in venlafaxine XR treated group (p<0.01).

The 6 months clinical trial proved venlafaxine XR superior to the active comparator, fluoxetine, in the treatment of MDD and GAD dual diagnosis.

During the research we included 30 patients with anxiety and depression symptoms after cardio-surgical intervention. They were chosen randomly, hospitalized and treated in the Specialized cardio-surgical clinic Filip II, Skopje. The patients were of both sexes, aged 30-65. They were all treated with Asentra tablets in dosages of 50mg taken only in the morning over the period of 3 months. They were evaluated by HAMD and HAS in the beginning, after being treated for 4 weeks and after being treated for 6 months.

In 18 patients there was a significant improvement which resulted in score decline. In 5 patients there was a slight improvement. And in 7 patients there was no significant improvement after 4 weeks or after 6 months.

Asentra(Sertraline) efficient and safe SSRI anti-depressive in treating patients with anxiety and depression symptoms after cardio-surgical interventions.

We investigated the impact of eszopiclone 3mg on next day driving ability (on-the-road brake-reaction-time, BRT) and cognitive and psychomotor performance in patients with primary insomnia.

Patients with DSM-IV primary insomnia completed this study. Treatment was administered 30min before bedtime, and next day driving ability was assessed by on-the-road BRT approximately 9.5 hours postdose. A cognitive test battery measured residual effects on information processing, divided attention, psychomotor tasks, and working memory. Overnight polysomnography was conducted to assess sleep architecture; subjective ratings of morning sedation and sleep quality were also obtained.

There were no significant differences in BRT following night time administration of eszopiclone 3mg compared with placebo (p=0.39) and there were no significant differences in objective cognitive tests of information processing, divided attention, psychomotor tasks and working memory (p values>0.15). No significant effect on subjective next day ratings of morning sedation, coordination or mood was observed (p values>0.22). There was improvement compared with placebo (p<0.0001) in subjective ease of getting to sleep and quality of sleep the morning following dosing, and no perceived impairment of behavior following awakening or early morning awakenings. Polysomnography demonstrated significant improvements in sleep onset and maintenance.

In this study, the first to assess next day on-the-road driving in primary insomniacs following hypnotic use, eszopiclone 3mg improved both objective and subjective measures of sleep onset and maintenance without residual impairments on next day driving ability or cognitive and psychomotor performance.

Support for this study provided by Sepracor Inc., Marlborough, MA.

A new computerized cognitive behavioural therapy (CCBT) program was offered to consecutive referrals to the clinical psychology department where the referral letter had noted the presence of depression/low mood as a major problem. The exclusion criteria were age below 16 or above 65, current active suicidal intent, psychosis and an inability to read.

Seventy-eight consecutive referrals were offered an appointment for CCBT; 20 (26%) attended at least one session of CCBT and 14 (70% of starters) completed all six hour-long sessions. A clinically and statistically significant fall of over 11.07 points (SD 6.16) on the BDI-II occurred between baseline and 6 weeks, from a mean score of 30 (severe) to 18.93 (mild). The equivalent mean differences between the baseline and 6-week scores were 7.66 points for the BAI (SD 11.25), 2.93 points for the BHS (SD 5.54), and –3.93 points for the SASS (SD 8.35). Beck Depression Inventory scores (BDI-II) fell from a mean of 28.15 (SD 11.41) to 20.00 (SD 10.41) (p=.000) over the 6-week intervention period using an intention to treat analysis. The mean time with a self-help support nurse supporting their use of the CD Rom was 52 minutes in total.

Only a quarter of patients on this psychology waiting list chose to use a CBT CD-Rom. The package seems to lead to improved mood. A randomised controlled study is required and is in progress.

The aims of this study were to examine whether different domains of quality of life (QOL) are differently affected by depressive disorders by comparing QOL of subjects with and without depressive disorders, and to examine the association of QOL with self-stigma, insight and adverse effects of medication among subjects with depressive disorders.

The QOL on the four domains of the WHOQOL-BREF Taiwan version were compared between the 229 subjects with depressive disorders and 106 control subjects without depressive disorder. Among the subjects in the depressive group, the association between the four QOL domains and subjects' self-stigma, insight, and adverse effects of medication were examined using multiple regression analyses by controlling for the influence of depression, socio-demographic and clinical characteristics and family function.

The results found that subjects with depressive disorders had poorer QOL on the physical, psychological and social relationship domains than the non-depressive control group. The depressive subjects who had more severe self-stigma had poorer QOL on all four domains. The depressive subjects who had higher levels of awareness of illness had poorer QOL on the physical and psychological domains. The depressive subjects who perceived more severe adverse effects from medication had poorer QOL on the physical, psychological and environmental domains.

The results of this study demonstrate that different domains of QOL are differently affected by depressive disorders, and that clinicians must consider the negative influences of self-stigma, insight and adverse effects from medication on QOL of subjects with depressive disorders.

Although much attention has been paid to predictors of mortality after an acute myocardial infarction (MI), patients are at least as concerned with their physical function (PF). One study found no relationship between depression at the time of MI and PF 4 months later, whereas another reported a relationship at 6 months but not at 12 months. We assessed whether symptoms of depression assessed in-hospital predict overall PF 12 months later.

Prospective observational study of 484 patients with MI or unstable angina assessed with the Beck Depression Inventory (BDI) and SF-12 Health Survey during hospitalization and with the SF-12 Health Survey 12 months later. Linear regression was used to predict the overall SF-12 PF score at 12 months, controlling for baseline PF score and for age, gender, Killip class, history of MI, diagnosis (MI vs unstable angina), and BDI score.

At the time of the index hospitalization, 151 patients (31.2%) scored 10 or greater on the BDI. Mean (± SD) T score for the PF subscale of the SF-12 was 41.4 ± 11.4 in-hospital and 41.7 ± 11.6 12 months later. Significant predictors of 12-month PF score were age (p <.001), female gender (p = .005), baseline PF score (p < .001), and BDI score (p < .001).

Older age, female gender, and symptoms of depression are important predictors of 12-month PF after controlling for baseline PF. Consistent with other studies, other clinical characteristics do not appear to predict PF during recovery.