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Introduction: Adjunctive treatment with supraphysiological doses of levothyroxine (L-T4 ) in bipolar depression shows promise, but the neurobiological mechanisms underlying clinical improvement are unknown. It has been postulated from animal studies that exogenous thyroid hormones may exert their modulatory effects in patients with affective disorders via an increase in serotonergic neurotransmission. Therefore, we investigated the loudness dependence of auditory evoked potentials (LDAEP) as a measure of central serotonergic activity and response to L-T4. Methods: This 6-week, double-blind, randomized, placebo-controlled study assessed the effi cacy of L-T4 adjunctive to continuing treatment with mood stabilizer and/or antidepressant medication in 20 patients with bipolar depression. LDAEP was assessed before and after treatment with L-T4. Results: Scores of the Hamilton Depression Rating Scale and Montgomery Asberg Depression Rating Scale decreased significantly during the study. There was no difference in pre- and posttreatment LDAEP between the groups, and no correlation between LDAEP and psychometric measures in the course of the study. Discussion: The hypothesis of a relationship between response of augmentation therapy with levothyroxine in bipolar depression and serotonergic activity could not be confirmed. [ABSTRACT FROM AUTHOR]

Introduction The mismatch negativity (MMN) represents one of the major paradigms in cognitive neurophysiology. The attenuation of this subtraction wave of auditory event-related potentials (being a marker of discrimination of rare deviant stimuli among a series of standard stimuli) is well established in schizophrenia research. Moreover, first MMN results in patients with alcohol dependence mostly indicated an enhanced MMN though heterogeneously. In contrast to this “traditional” oddball MMN an optimized MMN including a higher number of deviants but within the same time interval was deficient in schizophrenia patients as shown by our group. Interestingly, the two clinical entities (schizophrenia, alcohol dependence) are in a close connection to glutamate neurotransmitter system underlying the generation of MMN. Methods 25 inpatients with alcohol dependence received a multichannel EEG with auditory MMN in i) oddball (20% deviants) as well as optimized MMN (50% standards, five deviants with 10% each). 25 healthy subjects without harmful use of alcohol served as controls. Results Following alcohol withdrawal patients showed decreased MMN amplitudes in the fronto-central region and increased latencies as compared to controls. Especially when taking the optimized MMN, the amplitudes of the cortico-central region significantly correlated positively (deviants: duration, intensity, localization: 0.001 > p ’s) with length of time of alcohol abstinence. Conclusion Attenuation of optimized MMN might indicate down-regulation of glutamatergic systems after withdrawal. Further, this study confirms the alteration of latencies representing delay of early auditory information processing in alcohol patients. Efficient neurospychobiological monitoring could improve diagnostic evaluation and potentially prediction of effects of psychotropic agents in patients with substance dependence. [ABSTRACT FROM AUTHOR]

As opposed to suicide that is officially registered risk factors for suicide attempts are more difficult to establish. Therefore, a large data set of inpatients in a university hospital was transformed and analyzed for accompanying risk factors at admission of suicidal patients. Apart from standard hospital data additional items were also derived from medical records and follow-up entries. The initial data file consisted of 16,895 data sets (i.e., hospitalizations) from year 1985 until 2005 that was transformed into a final file with 5,146 consistent data sets covering 233 variables. The analysis is based on a main group classification into suicide attempts 'positive” and suicide attempts 'negative”. Statistical analysis was done with Mann-Whitney-U-Tests, CHI2, correlation coefficients (r and ϕCOLE) and logistic regression. Patients with suicide attempts were significantly younger and were at higher risk for personality disorder (RR=1.69, p<0.001), affective disorder (RR=1.49, p<0.001) and neurotic disorder (RR=1.37, p<0.001). Male individuals and those with repeated suicide attempts used the more severe methods. Further risk factors included suicidality at admission, childhood trauma or abuse, and suicide of related parties (RR's between 1.39 and 3.07). Patients with suicide attempts showed higher numbers of hospitalizations though shorter duration of their inpatient treatment than patients without suicide attempts. By means of a large and elaborated data file of inpatients a profile of risk factors for attempted suicide was identified providing a basis for more close intervention during inpatient treatment and thereafter. [ABSTRACT FROM AUTHOR]

Abstract Background The study aimed at presenting normative data for both parallel forms of the "Rasch-based Depression Screening (DESC)", to examine its Rasch model conformity and convergent and divergent validity based on a representative sample of the German general population. Methods The sample was selected with the assistance of a demographic consulting company applying a face to face interview (N = 2509; mean age = 49.4, SD = 18.2; 55.8% women). Adherence to Rasch model assumptions was determined with analysis of Rasch model fit (infit and outfit), unidimensionality, local independence (principal component factor analysis of the residuals, PCFAR) and differential item functioning (DIF) with regard to participants' age and gender. Norm values were calculated. Convergent and divergent validity was determined through intercorrelations with the depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS-D and HADS-A). Results Fit statistics were below critical values (< 1.3). There were no signs of DIF. The PCFAR revealed that the Rasch dimension "depression" explained 68.5% (DESC-I) and 69.3% (DESC-II) of the variance, respectively which suggests unidimensionality and local independence of the DESC. Correlations with HADS-D were rDESC-I = .61 and rDESC-II = .60, whereas correlations with HADS-A were rDESC-I = .62 and rDESC-II = .60. Conclusions This study provided further support for the psychometric quality of the DESC. Both forms of the DESC adhered to Rasch model assumptions and showed intercorrelations with HADS subscales that are in line with the literature. The presented normative data offer important advancements for the interpretation of the questionnaire scores and enhance its usefulness for clinical and research applications.

Background: The study aimed at presenting normative data for both parallel forms of the "Rasch-based Depression Screening (DESC)", to examine its Rasch model conformity and convergent and divergent validity based on a representative sample of the German general population.Methods: The sample was selected with the assistance of a demographic consulting company applying a face to face interview (N = 2509; mean age = 49.4, SD = 18.2; 55.8% women). Adherence to Rasch model assumptions was determined with analysis of Rasch model fit (infit and outfit), unidimensionality, local independence (principal component factor analysis of the residuals, PCFAR) and differential item functioning (DIF) with regard to participants' age and gender. Norm values were calculated. Convergent and divergent validity was determined through intercorrelations with the depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS-D and HADS-A).Results: Fit statistics were below critical values (< 1.3). There were no signs of DIF. The PCFAR revealed that the Rasch dimension "depression" explained 68.5% (DESC-I) and 69.3% (DESC-II) of the variance, respectively which suggests unidimensionality and local independence of the DESC. Correlations with HADS-D were rDESC-I = .61 and rDESC-II = .60, whereas correlations with HADS-A were rDESC-I = .62 and rDESC-II = .60.Conclusions: This study provided further support for the psychometric quality of the DESC. Both forms of the DESC adhered to Rasch model assumptions and showed intercorrelations with HADS subscales that are in line with the literature. The presented normative data offer important advancements for the interpretation of the questionnaire scores and enhance its usefulness for clinical and research applications. [ABSTRACT FROM AUTHOR]

The article provides information on a study that demonstrated alterations of physiological parameters relevant for depression over a continuous and complete monitoring period of six weeks. Variations of circadian activity profiles and sleep patterns were altered in various somatic and neuropsychiatric disorders. It evaluates the course of a depressive episode in a group of in-patients during their treatment in hospital. It reveals the results of the study.