Measuring depression: comparison and integration of three scales in the GENDEP study.

BACKGROUND: A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales. METHOD: The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores. RESULTS: The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely 'observed mood and anxiety', 'cognitive' and 'neurovegetative', provided a more detailed description of depression severity. CONCLUSIONS: The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.

Repeated low-dose ultraviolet (UV) B exposures of humans induce limited photoprotection against the immune effects of erythemal UVB radiation.

BACKGROUND: Exposure of human subjects to ultraviolet (UV) B radiation causes immunosuppression. Most experiments to date have not tested the effects of low daily doses of UVB radiation. OBJECTIVES: To ascertain whether photoprotection against several UV-induced immune effects might develop following repeated exposure. METHODS: Groups of approximately 30 healthy individuals were given whole-body UVB irradiation on each of 10 consecutive days with 0.7 minimal erythema dose, or whole-body irradiation as before followed by a single erythemal UVB dose on a small body area, or irradiated only with a single erythemal UVB dose on a small body area, or were not irradiated. They were sensitized with diphenylcyclopropenone (DPCP) 24 h after the final dose, and skin biopsies collected to assess cytokine mRNA expression and the number of cells with thymine dimers and expression cyclooxygenase (COX)-1 and COX-2. RESULTS: The contact hypersensitivity (CHS) response to DPCP was significantly lower in the three irradiated groups compared with the unirradiated controls, while cutaneous interleukin (IL)-1beta, IL-6, IL-10 and tumour necrosis factor-alpha mRNAs, COX-1 and COX-2 and thymine dimers were all significantly higher. When the single erythemal UVB dose was given following the repeated low exposures, a slight downregulation in cytokine expression and thymine dimer formation was indicated. CONCLUSIONS: The repeated low doses of UVB protected to a limited extent against the effects of an erythemal UVB dose on cytokine expression and thymine dimer formation, but not on CHS or COX enzymes.

Prophylactic lithium response and polymorphism of the brain-derived neurotrophic factor gene.

INTRODUCTION: Brain-derived neurotrophic factor (BDNF) has been involved in the pathogenesis of bipolar mood disorder and in the mechanism of mood-normalizing action of lithium. The aim of this study was to find a possible association between lithium prophylactic effect in bipolar patients and two polymorphisms of BDNF gene. METHODS: Eighty-eight patients (35 males, 53 females) with bipolar illness were studied. Duration of lithium prophylaxis ranged between 5-27 years (mean 15 years). Three categories of prophylactic lithium response were delineated: excellent responders (ER), partial responders (PR) and non-responders (NR). All patients were genotyped for two polymorphisms of BDNF gene: Val66Met and -270C/T. RESULTS: The Val/Met genotype of Val66Met polymorphism occurred more frequently (p = 0.037) and there was a trend for a higher incidence of Met allele (p = 0.076), in ER than in NR. A trend for C/T genotype and T allele of -270C/T polymorphism was observed to occur more frequently in ER than in NR (p = 0.057 and p = 0.065, respectively). CONCLUSION: The data obtained suggest that polymorphism of BDNF gene may be connected with a quality of lithium prophylaxis.

[Studies on the incidence and possibility of collective treatment of certain non-occlusal parafunctions in elementary school children]. / Badania nad czestoscia wystepowania i mozliwoscia zbiorowego leczenia wybranych parafunkcji niezwarciowych u uczniow szkoly podstawowej.

A study was carried out on the incidence and possibility of collective treatment of non-occlusal parafunctions in 216 elementary school children aged 7-14 years. Two objectively detectable non-occlusal parafunctions were analysed: nail-biting and pencil-biting. The study included four meetings during which the fingernails and pencils were inspected in all children and a talk was given, explaining the harmfulness of motor habits in the masticatory system, and the children with these habits were told to replace them with other non-harmful movements as habits. Among 216 children 131 (60.6%) had such non-occlusal parafunctions with nail-biting in 51.9% of them, and pencil-biting in 31%. In 22.2% both habits were found. During the third control visit the overall incidence of both parafunctions was found to be decreased, from 60.6% to 37.9%. Elimination of nail-biting was obtained in 37.5% of cases, and pencil-biting in 64.2%, with the proportions of treated children varying in various classes. The study showed that nail-biting and pencil-biting are widely spread habits in the studied population and that collective treatment of these parafunctions is possible.

Exposure to low doses of solar-simulated radiation induces an increase in the myeloid subtype of blood dendritic cells.

Exposure to ultraviolet radiation causes alterations of cutaneous and systemic immunity. The aim of our study was to assess the influence of low doses of solar-simulated radiation (SSR) on the phenotypes of blood dendritic cells (BDC). Healthy volunteers (94) were irradiated with a dose of 1.2 SED (standard erythema dose) of SSR for 2, 10 or 30 consecutive days. Blood samples were taken before the first exposure and 24 h after final exposure. The three main subsets of BDC were distinguished by flow cytometry: BDCA-2(+)/CD123(+)/HLA-DR(+) (plasmacytoid, PDC) and two myeloid subtypes BDCA-1(+)/CD11c(+)/HLA-DR(+) (MDC1) and BDCA-3(+)/CD32(-)/HLA-DR(+) (MDC2). The percentage of total DC was elevated in all groups by the UV exposure and was significantly increased after 2 and 30 days of irradiation (P = 0.006 and P = 0.018, respectively). A particularly distinct increase was observed in the percentage of the MDC1 after 2 and 30 days (P = 0.022 and P < 0.0001, respectively). The MDC2 showed an increase after 10 days and a subsequent significant decrease after 30 days of irradiation (P = 0.031). A significant increase in PDC was found after 2 days of irradiation (P = 0.0006). Exposure to SSR induced an increase in the percentage of BDC in healthy human individuals, especially apparent in the MDC1 subtype.