Background. The potential association between vascular disease and depression have been the focus for much clinical psychiatric research, although few epidemiological prospective studies have looked into this association.

Aims. This study explores the a priori hypothesis of a prospective association between cardiovascular disease or its risk factors and incident depressive symptoms.

Method. A prospective primary care based study derived from a multi-centre randomized controlled trial of moderate hypertension. 2584 moderately-hypertensive volunteers were followed-up for 54 months when five assessments of depressive symptoms, vascular disease and its risk factors were made.

Results. We found an association between the dependent variable (incident depressive symptoms measured with the Self-CARE-D) and baseline smoker status, low serum cholesterol levels, poorer cognitive function (particularly executive dysfunction), female gender and increasing age. These associations were independent of all other cardiovascular risk factors (ECG evidence of ischaemia or arrythmia, systolic or diastolic blood pressure, blood pressure decline along the trial and body mass index).

Conclusions. Our results do not support the hypothesis of a specific association between vascular disease or its risk factors and incident depressive symptoms.

Work on implicit memory in normal subjects has demonstrated the influence of stimulus modality on the retrieval of semantic information. The present study examined the effects of auditory and visual semantic priming on the recognition of visual words using a lexical decision task. Performance was studied in a group of 20 patients with DSM–IV schizophrenia and 26 normal volunteers of similar age and sex. There were two versions of the task: ipsimodal, in which the word or nonword visual target followed 400 ms after the onset of a visual word prime which may or may not be semantically related to the target; and cross-modal, in which the visual target followed 400 ms after the onset of an auditory word prime. Both groups showed significant priming in both modality conditions, although the schizophrenia patients exhibited significantly greater priming in the cross-modal condition. Priming effects in the ipsimodal condition did not differ substantially between patients and controls. The priming effects in the two conditions correlated with each other in the schizophrenia patients only. The results suggest that priming may occur through amodal semantic representations. In schizophrenia, there appears to be increased cross-modal connectivity (reduced modality modularity and informational encapsulation) between lexical representations that could result in impaired language, particularly speech, processing. (JINS, 2002, 8, 884–892.)

Background. In other branches of epidemiology, stratum specific likelihood ratios (SSLRs) have been found to be preferable to fixed best threshold approaches to screening instruments. This paper presents SSLRs of GHQ-12 and GHQ-28 and compares the SSLR method with the traditional optimal threshold approach.

Methods. Random effects meta-analysis and meta-regression were used to obtain pooled estimates of SSLRs of the two questionnaires for the 15 centres participating in the WHO study of Psychological Problems in General Health Care. We illustrated the use of SSLRs by applying them to random samples of patients from centres with different backgrounds.

Results. For developed and urban centres, the estimates of SSLRs were homogeneous for 10 out of 12 strata of the GHQ-12 and GHQ-28. For other centres, the overall results, which were heterogeneous for six out of 12 strata, were deemed the currently available best estimates. When we applied these results to centres with different prevalences of mental disorders and backgrounds, the estimates matched the actually observed closely. These examples showed how the SSLR approach is more informative than the traditional threshold approach.

Conclusions. Those working in developed urban settings can use the corresponding SSLRs with reasonable confidence. Those working in non-urban or developing areas may wish to use the overall results, while acknowledging that they must remain less certain until further research can explicate heterogeneity. These SSLRs have been incorporated into nomograms and spreadsheet programmes so that future researchers can swiftly derive the post-test probability for a patient or a group of patients from a pre-test probability and GHQ score.

Background. The aim of this pilot study was to examine which unique factors (genetic and environmental) increase the risk for developing anorexia nervosa by using a case–control design of discordant sister pairs.

Methods. Forty-five sister-pairs, one of whom had anorexia nervosa and the other did not, were recruited. Both sisters completed the Oxford Risk Factor Interview for Eating Disorders and measures for eating disorder traits, and sib-pair differences. Blood or cheek cell samples were taken for genetic analysis. Statistical power of the genetic analysis of discordant same-sex siblings was calculated using a specially written program, DISCORD.

Results. The sisters with anorexia nervosa differed from their healthy sisters in terms of personal vulnerability traits and exposure to high parental expectations and sexual abuse. Factors within the dieting risk domain did not differ. However, there was evidence of poor feeding in childhood. No difference in the distribution of genotypes or alleles of the DRD4, COMT, the 5HT2A and 5HT2C receptor genes was detected. These results are preliminary because our calculations indicate that there is insufficient power to detect the expected effect on risk with this sample size.

Conclusions. A combination of intrinsic and extrinsic factors increases the risk of developing anorexia nervosa. It would, therefore, be informative to undertake a larger study to examine in more detail the unique genetic and environmental factors that are associated with various forms of eating disorders.