Motor activity and depression severity in adolescent outpatients.

OBJECTIVES: The present study investigated the association between motor activity and severity of depression in 6 depressed adolescent outpatients. METHOD: Motor activity was assessed by actigraphy and the severity of depression was assessed weekly using the CDRS-R. The levels of motor activity were analyzed by considering activity parameters. RESULTS: Among the parameters of motor activity studied, the mean total activity, the mean 24-hour activity levels, the mean waking activity, and the mean activity level between 12:00 and 18:00 h were inversely correlated with severity of depression. The means of the 10 most active hours tended toward a negative correlation with the depressive severity score. CONCLUSION: The results seem to suggest an association between motor activity level and severity of depression in adolescents. Nevertheless, in order to reach a more conclusive understanding, it would be necessary to replicate this study using a larger number of individuals as well as a longer observation period.

Reversal of abnormal dexamethasone suppression test in alcoholics abstinent for four weeks.

Fourteen of 64 alcoholic inpatients (22%) showed a nonsuppression postdexamethasone response when tested between the second and fifth days of admission. No association with alterations of hepatic enzymes (GGT, SGOT, SGPT) was observed. At retest (in the fourth week of abstinence), no abnormal response to the Dexamethasone Suppression Test (DST) was detected. The nonsuppressor alcoholics did not meet the criteria for major depression according to the Research Diagnostic Criteria (RDC). The data indicate a lack of specificity of the DST for the diagnosis of depression in alcoholics during the first days of withdrawal.

Lack of agreement between the salivary flow and finger-sweat print methods for the determination of the anticholinergic effects of antidepressant drugs.

The purpose of the present study was to compare the extent of salivary flow and finger sweating after single acute oral doses of mianserin (30 mg), amitryptiline (75 mg), imipramine (75 mg) and maprotiline (75 mg) and placebo in healthy volunteers in a double-blind assay. Maprotiline and mianserin were less active in reducing salivary flow but were more active than amitryptiline and imipramine in reducing finger sweating. The lack of association between these methods for the measurement of the anticholinergic effect of antidepressant drugs is analyzed in terms of possible mechanisms for the control of palmar sweating.

Comorbidity of obsessive-compulsive disorder and personality disorders. A Brazilian controlled study.

The aim of this study was to evaluate the presence of personality disorders (PDs) in 40 patients with obsessive-compulsive disorder (DSM-III-R criteria) from the Medical School of Botucatu (UNESP), São Paulo, Brazil. It is a case-control study. Patients were 24 women and 16 men, 16-68 years old, referred to our outpatient psychiatric service for treatment. Controls were 40 nonpsychiatric outpatients matched to the cases by sex, age and marital status. The instrument used was the Portuguese version of the Structured Interview for DSM-III-R Personality Disorders (SIDP-R). All interviews (n = 80) were made simultaneously by 2 raters, with independent scoring, so that the interrater reliability of the instrument could also be assessed (kappa statistics). The consensual axis II diagnoses in the OCD group were: avoidant (52.5%, kappa = 0.80), dependent (40%, kappa = 0.84), histrionic (20%, kappa = 0.83), paranoid (20%, kappa = 0.74), obsessive-compulsive (17.5%, kappa = 0.86), narcissistic (7.5%, kappa = 1.00), schizotypal (5%, kappa = 0.65), passive-aggressive (5%, kappa = 0.79) and self-defeating (5%, kappa = 0.55). At least one PD diagnosis was made in 70% of the patients, while only 6 controls had a PD diagnosis (p < 0.01). A great deal of diagnostic overlap was found in the OCD group (57.5% had two or more PDs), especially between avoidant and dependent PDs. The features of these two PDs may be secondary to the OCD. The study also suggests that there is not a close relationship between OCD and obsessive-compulsive personality disorder (OCPD). Patients with OCPD or even 3 or 4 O-C traits had significantly less insight into their obsessions and compulsions (p < 0.01).

Applicability and reliability of a portuguese version of the structured interview for DSM-III-R personality disorders

The importance of personality psychopathology has been recently recognized, since it may influence the manifestation and prognosis of the other psychiatric conditions. The systematic evaluation of patients for personality disorders (PD) has been favored by some structure instruments developed in the past few years. The aim of this study was to translate into Portuguese and evaluate the applicability and interrater reliability of the "Structure Interview for DSM-III-R Personality Disorders" (SIDP-R). The subjects were 40 patients with DSM-III-R obsessive-compulsive disorder (OCD) and 40 nonpsychiatric patients from a university outpatient service. All 80 interviews were made simultaneously by two raters, with independent scoring. The coefficient of agreement (Kappa) was calculated for nine individual PDs and ranged from 0.55 to 1.00. The OCD patients had significantly (p <0.01) more PDs (70 percent) than the nonpsychiatric group (15 percent). No significant sex differences were found in the prevalence of PDs. There was much diagnostic overlap, specially between avoidant and dependent PDs. The Portuguese version of the SIDP-R had good applicability and satisfactory interrater reliability and may be a useful instrument to assess axis II disorders