The INTERPRET-DD study of diabetes and depression: a protocol.

AIM: People with diabetes are at an increased risk of developing depression and other psychological disorders. However, little is known about the prevalence, correlates or care pathways in countries other than the UK and the USA. A new study, the International Prevalence and Treatment of Diabetes and Depression Study (INTERPRET-DD) aims to address this dearth of knowledge and identify optimal pathways to care across the globe. METHOD: INTERPRET-DD is a 2-year longitudinal study, taking place in 16 countries' diabetes outpatients' facilities, investigating the recognition and management of depressive disorders in people with Type 2 diabetes. Clinical interviews are used to diagnose depression, with clinical and other data obtained from medical records and through patient interviews. Pathways to care and the impact of treatment for previously unrecognized (undocumented) depression on clinical outcomes and emotional well-being are being investigated. RESULTS: Initial evidence indicates that a range of pathways to care exist, with few of them based on available recommendations for treatment. Pilot data indicates that the instruments we are using to measure both the symptoms and clinical diagnosis of depression are acceptable in our study population and easy to use. CONCLUSIONS: Our study will increase the understanding of the impact of comorbid diabetes and depression and identify the most appropriate (country-specific) pathways via which patients receive their care. It addresses an important public health problem and leads to recommendations for best practice relevant to the different participating centres with regard to the identification and treatment of people with comorbid diabetes and depression.

Galantamine for the treatment of BPSD in Thai patients with possible Alzheimer's disease with or without cerebrovascular disease.

OBJECTIVES: This study was to investigate an efficacy of galantamine in treatment of behavioral and psychological symptoms of dementia in Thai elderly who suffered from possible Alzheimer's disease (AD) with or without cerebrovascular disease and vascular dementia. METHODS: A 6-month, multicenter, open-label, uncontrolled trial was undertaken in 75 patients. Eligible patients received an initial galantamine dose of 8 mg/dayand escalated over 5 to 8 weeks to maintenance doses of 16 or 24 mg/day. The behavioral response was assessed as an intention-to-treat analysis using the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). RESULTS: Galantamine improved behavioral and psychological symptoms of dementia (P < .05 vs baseline) over the 24 weeks of treatment. BEHAVE-AD score was significantly improved from baseline in paranoid and delusion ideation, diurnal rhythm disturbances, anxieties, and phobias. CONCLUSIONS: Galantamine may be a well-tolerated and effective treatment option for improving psychotic, behavioral, and psychological symptoms in Thai elderly with possible AD with or without cerebrovascular disease and vascular dementia.

Bipolar sensation seeking is associated with a propensity to abuse rather than to temperamental characteristics.

OBJECTIVE: As some temperament profiles may be markers of genetic vulnerability traits, we aimed to compare sensation seeking in euthymic bipolar patients and in controls. METHODS: One hundred ninety-four patients fulfilling DSM-IV diagnostic criteria for bipolar disorders (BP), 81% of whom presented type I BP, and 95 controls were included in this study. Euthymia was assessed using both the MADRS and Bech mania scales. Subjects were evaluated using the French abbreviated form of Zuckerman's Sensation Seeking Scale (SSS), which provide a total score (TS) and four subscores: Thrill and Adventure Seeking (TAS), Experience Seeking (ES), Disinhibition (Dis), and Boredom Susceptibility (BS). RESULTS: SSS total score differed significantly between men (17.2 +/- 0.5) and women (15.3 +/- 0.6) (P = 0.02) and all the subscores were negatively correlated with age. On adjustment for sex and age, we found that bipolar patients had a high Dis score (P = 0.003). However, if the same analysis was performed with a lifetime history of alcohol abuse or dependence as a covariable, no such difference was found (P = 0.436). The SSS demonstrated a high degree of test-retest reliability (ICC = 0.91). CONCLUSION: These results suggest that sensation seeking assessed with the SSS is not a temperament characteristic associated with bipolar disorders but is instead linked to a tendency towards alcohol abuse.

Epidemiological survey of mental disorders and knowledge attitude practice upon mental health among people in Bangkok Metropolis.

To find the prevalence of 8 mental disorders and study knowledge, attitude, practice (KAP) upon mental health among people in Bangkok Metropolis a cross sectional, descriptive community survey was conducted. Two thousand, nine hundred and forty eight samples aged 15-60 years were selected by a multistage simple random sampling technique. Data collection was made by qualified interviewers who had experience in mental health care and had been trained to use the questionaires. The questionaires had been modified from DSM-IV and CIDI that had been tested for good validity and reliability. The survey methodology was divided into 2 stages, screening and diagnosis. The results showed that the life time prevalence of mental disorders were; schizophrenia (1.3%), mood disorders; manic episode (9.3%), major depressive episode (19.9%), dysthymia (1%), anxiety disorders (10.2%), mental retardation (1.8%), epilepsy (1.3%), suicidal idea (7.1%), drug and substances use disorders (11.2%), and alcohol use disorders (18.4%). Knowledge score was good, attitude was fairly good, practice was still weak in promotion and prevention aspects. As such, this study was used as a pattern to conduct a national survey in 14 provinces all over Thailand and the results are being summarized. The information is similar to the Global Burden of Diseases. We produced a national training program on "Detection and Management of Depression" for Primary Care Physicians that was, a 2 days' workshop. Other national programs promoting prevention and control have also been set up.