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Aims: Screening tools can help improve the detection of depression in patients with diabetes, yet the psychometric properties of most translations of scales, which are originally published in English, have not been assessed. Thus we studied the screening performance of widely used depression measures., Method: We applied the cut-off points of the English-language versions of the Beck Depression Inventory (BDI); Hospital Anxiety and Depression Scale (HADS); Depression in Diabetes Self-Rating Scale (DDS-RS); Brief Self-Rating Scale of Depression and Anxiety (BS-RSDA); and Problematic Areas in Diabetes Survey (PAID), all of which were used to assess diabetes-specific distress in a sample of 101 patients with Type 2 diabetes. The Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale (HDRS) were used to diagnose depression., Results: When the English cut-off points were used, the tools had varied values of both sensitivity and specificity. When the best cut-off points were used, all measures had either very good or good sensitivity. Taking into account their length, the HADS and the BS-RSDA seem to be the best among the screening tools., Conclusions: Effective initial diagnosis of depression in patients with diabetes during a routine medical visit requires the use of screening tools that have adequate cut-off points. The analyses presented in this article show that screening tools should be validated and the cut-off points that are used should be population-specific., (Copyright © 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Aims/hypothesis: No studies have evaluated whether the frequently observed associations between depression and diabetes could reflect the presence of comorbid psychiatric conditions and their associations with diabetes. We therefore examined the associations between a wide range of pre-existing Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders with self-reported diagnosis of diabetes., Methods: We performed a series of cross-sectional face-to-face household surveys of community-dwelling adults (n = 52,095) in 19 countries. The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Diabetes was indicated by self-report of physician's diagnosis together with its timing. We analysed the associations between all mental disorders and diabetes, without and with comorbidity adjustment., Results: We identified 2,580 cases of adult-onset diabetes mellitus (21 years +). Although all 16 DSM-IV disorders were associated with diabetes diagnosis in bivariate models, only depression (OR 1.3; 95% CI 1.1, 1.5), intermittent explosive disorder (OR 1.6; 95% CI 1.1, 2.1), binge eating disorder (OR 2.6; 95% CI 1.7, 4.0) and bulimia nervosa (OR 2.1; 95% CI 1.3, 3.4) remained after comorbidity adjustment., Conclusions/interpretation: Depression and impulse control disorders (eating disorders in particular) were significantly associated with diabetes diagnosis after comorbidity adjustment. These findings support the focus on depression as having a role in diabetes onset, but suggest that this focus may be extended towards impulse control disorders. Acknowledging the comorbidity of mental disorders is important in determining the associations between mental disorders and subsequent diabetes.

We performed the factor analysis of the Polish version of the Hypomania Check List (HCL-32) scale and assessed the utility of HCL-32 in discriminating patients with treatment-resistant and treatment non-resistant depression. The study included 1,051 patients with single or recurrent depressive episode among which 569 met the criteria for treatment-resistant depression. The Polish version of HCL-32 was employed to all patients. The Cronbach's alpha for entire scale was 0.93 which indicates high degree of consistency. The factor analysis of the scale yielded three factors with item loadings of 0.4 or more. Factor 1, comprising ten items connected with elevated mood and increased activity explained more than half of total variance, Factor 2 (two items) was connected with sexual activity, and factor 3 (three items) with irritability. The mean score of HCL-32 was significantly higher in treatment-resistant versus non-resistant depression (11.9 +/- 8.3 vs. 8.5 +/- 7.7, respectively, P < 0.001). Also, the percentage of patients having positive response to 14 or more items of the scale was significantly higher in treatment-resistant than in non-resistant depression (43.9 vs. 30.0%, respectively, P < 0.001). Therefore, using Polish version of HCL-32 we have confirmed the association between bipolarity and worse response to antidepressant drugs in patients with mood disorders.

Aim: Genetically determined activity ofCYP2D6 may be modified by some drugs through inhibition processes. Inhibition properties of TCA's were confirmed mainly in in vitro studies. The aim of the study was to assess the influence of clomipramine on CYP2D6 activity in vivo., Method: 11 patients diagnosed with depression according to ICD-10 and DSM-IV (major depression) criteria were included in the study. In all the cases clomipramine therapy was indicated. CYP2D6 activity was assessed by the phenotyping method. All patients were treated simultaneously. Each of the patients ingested one tablet containing 100 mg of sparteine sulfate. Urine excreted during the following 6 h was collected. Based on sparteine metabolic ratio (MR) the phenotype status was estimated twice: after the wash-out period, before clomipramine treatment, sparteine metabolic ratio (MRI), and after 2-weeks of clomipramine treatment (MR2)., Results: During clomipramine treatment MR2 values were statistically significantly higher than MRI. In 3 patients (27.3%) treated with clomipramine the changes of phenotype status were observed., Conclusions: Clomipramine is a CYP2D6 inhibitor and may change the CYP2D6 phenotype status (EM into PM).

Aim: The aim of the study was to define the correlation between anxiety/depressive symptoms, distress and functioning., Method: The research is based on the analysis of 104 persons (65 women, 39 men), who were patients of psychiatrists (42 persons), or general physician attenders (62 persons) complaining of anxiety or depressive symptoms. Distress was estimated with the General Health Questionnaire (GHQ-30), psychopathological symptoms and diagnoses were evaluated with the Present State Examination (PSE) and the level of functioning with Global Assessment of Functioning (GAF). The intensity of ICD-10 symptoms was calculated for: generalized anxiety disorder, agoraphobia, social phobia, panic disorder, depressive disorder and dysthymia., Results: The lowest score of distress was found in the group with sub-clinical, sole anxiety or depressive symptoms. An intermediate level was present in the group with anxiety and mixed anxiety-depressive disorders, and the highest in the group with depression. The functioning scores were in an inverse order., Conclusions: The differences in scores of distress and functioning between groups of patients with anxiety disorders, mixed anxiety-depressive disorders and depression are dependent on the intensity of depressive symptoms and are independent of the intensity of anxiety symptoms.

Aim: The authors analyzed patients' psychopathological symptoms and subjective quality of life (QoL) for evaluating the effectiveness of treatment in day hospital versus inpatient wards. Analyses concerned patients from Wrocław and recruited within the framework of an EU funded multi-centre study EDEN., Method: 238 patients admitted to the Psychiatric Hospital in Wrocław were randomly assigned to treatment in either day hospital (n=l15) or inpatient ward (n=123). Patients were interviewed at 4 time-points comprising their stay in hospital. Differences between settings in terms of dynamics of psychopathological symptoms and subjective QoL were expressed in mean scores of BPRS subscales and MANSA. Two parameters of effectiveness were considered: the static--the score on the scale at a given time-point and average score level, and the dynamic--describing dynamics of changes (gradients). Statistical methods included ANOVA and ANCOVA with co-variables., Results: In terms of manic and excitement symptoms inpatient wards proved to be more effective as measured at discharge, no differences in dynamics between settings were found. Day hospital was superior in alleviating negative symptoms during treatment but improvement in that respect was quicker in the inpatient ward. In terms of alleviating positive symptoms, the inpatient ward was more effective only at the beginning of the treatment. Day hospital was more effective in handling symptoms of depression and anxiety but only at the beginning of treatment. Dynamics of subsiding of the symptoms at the beginning of hospitalization was better for the inpatient ward. No differences in QoL in both settings were found., Conclusions: Taking into consideration the static and the dynamic parameters of effectiveness of treatment, the superiority of inpatient treatment over day hospital has not been, therefore, definitely proven.

Background: Haematological treatment is associated with excessive distress due to side effects of cytostatics and due to severe life consequences of the illness. It could be a cause of anxiety or depressive states in vulnerable persons., Aim: The purpose of the study was to assess prevalence of depression, anxiety disorders, and distress among patients treated due to haematologic malignancies., Methods: 45 patients with leukaemia or lymphoma, 29 treated due to other internal diseases and 28 healthy persons were assessed. The following research instruments were used: the Present State Examination (PSE), the General Health Questionnaire (GHQ-30), criteria scales (ICD-10) for depression and anxiety., Results: Depression was diagnosed in 29% of the patients with hematological illnesses and in 11% of patients with other internal illnesses. Prevalence of GAD was appropriately 11% and 9%. Generally, psychiatric disorders were present in a half of the patients in every group. About 1/4 th of the haematologic patients had much more severe depressive symptoms than others., Conclusion: The groups of patients have much higher, depressive and distress scores than controls. Psychiatric or psychotherapeutic treatment could be considered as part of the treatment of malignant haematologic cancers.

Purpose: The aim of the study was to compare a clinical course and treatment results of depression occurring as the first depressive episode, the second depressive episode or the third or further depressive episode. The study was 1-year, prospective, naturalistic observation made by Polish psychiatrists., Methods: One-hundred and seventy-nine patients with the first depressive episode (group I), 170 patients with the second episode (group II) and 183 patients with the third or further episode of depression (group III) were compared. The main analysed variable was remission, defined as the score of < or =7 points on 17-item Hamilton depression rating scale (HDRS), after 6 and 12 months of observation., Results: The groups of patients studied did not initially differ as to age, proportion of gender and intensity of depression. The percentages of remission after 6 months of observation in groups I-III were: 49%, 41% and 32%, and after 12 months 69%, 60% and 50%, respectively., Conclusions: The results obtained indicate that the course of subsequent depressive episodes is less favourable compared to the first depressive episode. The percentages of remission obtained in individual groups studied may have implications regarding duration of pharmacological treatment of depressive episode.

The paper present results of last decade studies on mood and anxiety disturbances in patients who underwent coronary artery bypass grafting (CABG). Cardiovascular disease is currently the leading cause of death and morbidity in the industrialized world. CABG is the most common among surgical methods of its treatment. The incidence of mental disorders in patients after CABG is high. Its cause and pathogenesis are not clearly known. Depression is the risk factor of cardiovascular system diseases and also one of its causes. The heart operation itself is the strong stressful, life-threatening factor. The earlier course of cardiovascular disease and then heart surgery cause changes in style of life and combine with burdensome and arduous rehabilitation process. The social situation of the patients often deteriorates. Depression makes recovery difficult.

Aim. The present study aimed at analyzing the prevalence of depressive symptoms in a group of learning young adults, as well as the social support as a predictor of depression in late adolescence during the COVID-19 pandemic Method. An online national survey of young adults attending schools was conducted. The semi-structured questionnaire, including a section on sociodemographic data, stressors, needs and sources of support, as well as brief version of the Kutcher Adolescent Depression Scale, was distributed to young Poles. The final sample consisted of 1,500 students aged 18-23. Multivariable logistic regression assessed the relationships between support needs and sources and depressive symptoms. Results. The support needs that are most commonly reported by young adults are support from loved ones (family, friends) (n = 843; 56.2%) and teachers (e.g., care, appreciation) (n = 603; 40.2%). Fifty-six per cent of Polish young adults are experiencing significant depressive symptoms (95% confidence interval [CI]: 1.82-13.96). Young adults with no social support had higher KADS score than participants reporting some form of support (b = 1.794; 95% BCa CI = 0.659, 2.947). Participants receiving support from mother, both parents and siblings had a lower severity of depressive symptoms, while young people receiving support from father had more severe symptoms. Conclusions. This study provides initial findings in terms of depressive symptoms and support needs of young adults during the COVID-19 pandemic. It is imperative for mental health services, communities and schools to provide the necessary support to young adults. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic. Methods: The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms. Results: 56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression. Conclusions: The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions. [ABSTRACT FROM AUTHOR]

Purpose: Assessment of the relationship between psychological and sociodemographic factors with the levels of glycated hemoglobin (HbA1c) and Body Mass Index (BMI) among people with advanced type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 2574 persons, among them 1381 (53.7%) women, with type 2 diabetes, during the period of switching from biphasic mixtures of human insulin to insulin analogues. The age of participants ranged from 22 to 94 years (M = 63.5; SD = 9.58), and their treatment period was in the time frame from 2 years to 43 years (M = 10.2; SD = 6.1). Participants filled out a Scale for Perception of Self-Influence on the Diabetes Course, Well-Being Index WHO-5, two questions from the Brief Method of Evaluating Coping with a Disease. Results: Statistically significant correlations were found between the HbA1c levels and (1) disease duration (rs=0.067; p < 0.001); (2) number of complications (rs = 0.191, p < 0.001) (3) the perception of self-influence on the diabetes course (rs=- 0.16; p < 0.001); (4) well-being (risk of depression) (rs=- 0.10; p < 0.001). The regression analysis showed that 7% of HbA1c variability is explained by age, a perception of self-influence on the diabetes course, the number of complications, place of residence, education, BMI. The most important findings concerning BMI were found in regression analysis, which indicated a week relationship between BMI and a number of complications, perception of self-influence on the diabetes course and coping styles (3% of the resultes' variability). The group at high risk of depression had the highest levels of HbA1c. Conclusion: Sociodemographic and psychological factors show weak but statistically significant relationships with the current levels of HbA1c and BMI. [ABSTRACT FROM AUTHOR]

AIMH), Geneva, SwitzerlandCorrespondence: Andrzej KokoszkaII Department of Psychiatry, Medical University of Warsaw, 03-242 Kondratowicza 8 street, Warsaw, PolandTel/Fax +48 22 326 58 92Email [email protected] Purpose: The aim of this study was to assess the structure and validate the Polish version of the Problem Areas in Diabetes (PAID) scale, as the current translations of the original English version significantly vary in their psychometric properties. Patients and Methods: Two hundred and sixteen consecutive Polish outpatients were invited to participate in this international cross-sectional study on depression in diabetes. The research was based on the demographic and clinical characteristics of the study population, including the level of glycated hemoglobin (HbA1c) and scores obtained in the Polish versions of the following questionnaires: PAID, World Health Organization-Five Well-Being Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9). The psychiatric diagnosis was conducted with the use of Mini-International Neuropsychiatric Interview (M.I.N.I.). Results: Exploratory factor analyses yielded a 1-factor structure that included all 20 items. The internal consistency of the Polish version of PAID was high (Cronbach α = 0.97). There were significant positive correlation between PAID and PHQ-9 and a negative correlation between PAID and WHO-5. We also observed a negative association between PAID scores and age and a positive correlation between PAID and HbA1c levels. Patients with depression reported significantly higher PAID scores as compared with those without depressive symptoms. Conclusion: The Polish version of PAID has a one-factor structure and is a reliable, valid outcome measure for Polish outpatients with type 2 diabetes and it may constitute a useful instrument for screening for psychologic issues in diabetic patients during their appointments at the diabetes clinic. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: No studies have evaluated whether the frequently observed associations between depression and diabetes could reflect the presence of comorbid psychiatric conditions and their associations with diabetes. We therefore examined the associations between a wide range of pre-existing Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders with self-reported diagnosis of diabetes. Methods: We performed a series of cross-sectional face-to-face household surveys of community-dwelling adults ( n = 52,095) in 19 countries. The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Diabetes was indicated by self-report of physician's diagnosis together with its timing. We analysed the associations between all mental disorders and diabetes, without and with comorbidity adjustment. Results: We identified 2,580 cases of adult-onset diabetes mellitus (21 years +). Although all 16 DSM-IV disorders were associated with diabetes diagnosis in bivariate models, only depression (OR 1.3; 95% CI 1.1, 1.5), intermittent explosive disorder (OR 1.6; 95% CI 1.1, 2.1), binge eating disorder (OR 2.6; 95% CI 1.7, 4.0) and bulimia nervosa (OR 2.1; 95% CI 1.3, 3.4) remained after comorbidity adjustment. Conclusions/interpretation: Depression and impulse control disorders (eating disorders in particular) were significantly associated with diabetes diagnosis after comorbidity adjustment. These findings support the focus on depression as having a role in diabetes onset, but suggest that this focus may be extended towards impulse control disorders. Acknowledging the comorbidity of mental disorders is important in determining the associations between mental disorders and subsequent diabetes. [ABSTRACT FROM AUTHOR]

Objective. The aim of our study was to observe the outcome of MADD in comparison with depressive (DD) and anxiety (AD) disorders. Method. Patients treated with 12 weeks of group psychodynamic psychotherapy in a psychiatric day care ward were examined using SCAN 2.1 at admission and 1 year after admission. Treatment was indicated on the basis of diagnosis of ICD-10 - F4-F6. A total of 139 patients were included, 110 (79.1%) of whom were examined at the follow-up point. Results. The prevalence of MADD increased from 22.7% at the baseline to 33.6% at the end. The outcome of MADD was statistically different from the outcome of DD (χ2=18.4, P=0.0025), but not different from the outcome of comorbid DD and AD (χ2=1.8, P=0.84), nor generalized anxiety disorder (χ2=8.1, P=0.15), nor other AD (χ2=5.3, P=0.38). Conclusion. MADD is a useful diagnosis of a transitional or residual form of comorbid DD and AD in some specific population groups. A diagnosis of personality disorder can sustain long-term diagnosis of MADD. [ABSTRACT FROM AUTHOR]

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Purpose. – Heart surgery is a factor triggering off specific emotional and physiological responses of a patient. In spite of positive somatic effects of surgery, depression and anxiety can persist or appear for the first time after the operation worsening the patient’s psychosocial functioning and quality of life. The aim of this study is to offer a prospective view on the incidence and course of self-reported depression and anxiety in coronary artery bypass graft (CABG) patients.Subject and methods. – After informed consent, 53 patients who submitted to CABG were examined a few days before and after the operation and 3 months after CABG. They completed the Spielberger Anxiety Questionnaire and Beck Depression Inventory.Results. – Approximately 55% of the patients had high a level of anxiety preoperatively. Shortly after the surgery, 34% of patients and after 3 months 32% of them had clinically relevant level of anxiety. Thirty-two percent of patients before the surgery, 28% immediately after CABG and 26% at follow-up were depressed.Conclusions. – High preoperative depression, state and trait anxiety scores appear to be predictors of postoperative psychological outcome. Preoperative assessment can identify patients at risk for clinical levels of postoperative anxiety and depression. Psychological preventive counseling and psychiatric intervention can reduce patients’ emotional distress, medical and economic costs. [Copyright &y& Elsevier]

Rymaszewska J, Tulczynski A, Zagrobelny Z, Kiejna A, Hadrys T. Influence of whole body cryotherapy on depressive symptoms – preliminary report. Background: Cryotherapy has a long tradition in somatic medicine. Yet we know very little about its impact on psyche and mood disturbances in particular. Therefore there is a real need for scientific investigations into this problem. Objective: The study reported here was an initial approach to whole-body cryotherapy (WBCT) as a potential treatment modality for depression and was expected to provide rough data helping to design a future project with extended methodology, larger sample groups and longer follow-up. Methods: Twenty-three patients aged 37–70 years gave informed consent to participate in the study. Ten WBCT procedures (160 s, -150°C) were applied within 2 weeks. Participants were recruited from depressed day hospital patients. Antidepressive medication was not ceased. Symptoms were rated at the beginning and end of this intervention using the 21-item Hamilton Depression Rating Scale (HDRS). Changes in scores were analyzed in the group of patients for every item separately as well as for the sum of all items for each patient. Results: Almost for each individual HDRS item, the overall score for all patients together was significantly lower after WBCT. This means that all symptoms, except for day–night mood fluctuations, were presumably positively influenced by cryotherapy. The HDRS sum-score for each patient after WBCT was lower than that of the baseline and reached statistical significance in a paired samples t-test. Every patient was therefore considerably relieved after WBCT. Conclusions: It appears that WBCT helps in alleviating depression symptoms. Should this be confirmed in the extended study we are currently implementing, WBCT may become an auxiliary treatment in depression. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to validate and report the factorial analysis of the World Health Organization's 5-item Well-being Index (WHO-5) among outpatients with type 2 diabetes. We investigated the psychometric properties of the WHO-5 and its suitability for identifying potential depressive symptoms in Polish adults with diabetes.Methods: Participants were randomly chosen among Polish diabetes outpatients and invited to participate in the cross-sectional study (N = 216). Participants completed the Polish version of the WHO-5, Problem Areas in Diabetes Scale and Patient Health Questionnaire.Results: Factor analyses identified the one-factor structure of the Polish version of the WHO-5. The internal consistency of the Polish version of the WHO-5 is satisfying. With regard to convergent validity, there were significant negative associations between the WHO-5 and PAID, the PHQ-9, HbA1c and the amount of medical complications. The AUC indicates that the WHO-5 is an effective measure for identifying depressive symptoms. The optimal cut off values of ≤12 yielded the best sensitivity/specificity trade-off for identifying depression among people with diabetes.Conclusions: The Polish version of the WHO-5 is a reliable, valid outcome measure for outpatients with type 2 diabetes and can be a useful instrument for screening for depression in people with diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor has the potentially confounding role of childhood adversities been explored. The objective of this study was to examine associations between a wide range of temporally prior DSM-IV mental disorders and subsequent onset of ulcer, without and with adjustment for mental disorder comorbidity and childhood adversities. Methods: Face-to-face household surveys conducted in 19 countries (n=52,095; person years=2,096,486). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Peptic ulcer onset was assessed in the same interview by self-report of physician's diagnosis and year of diagnosis. Survival analyses estimated associations between first onset of mental disorders and subsequent ulcer onset. Results: After comorbidity and sociodemographic adjustment, depression, social phobia, specific phobia, post-traumatic stress disorder, intermittent explosive disorder, alcohol and drug abuse disorders were significantly associated with ulcer onset (ORs 1.3–1.6). Increasing number of lifetime mental disorders was associated with ulcer onset in a dose–response fashion. These associations were only slightly attenuated by adjustment for childhood adversities. Conclusions: A wide range of mental disorders were linked with the self-report of subsequent peptic ulcer onset. These associations require confirmation in prospective designs, but are suggestive of a role for mental disorders in contributing to ulcer vulnerability, possibly through abnormalities in the physiological stress response associated with mental disorders. [Copyright &y& Elsevier]

Aim. Assessment of change in severity of depressive and generalized anxiety symptoms in patients with neurotic and personality disorders treated with psychodynamic psychotherapy. Material and methods. From a total of 105 patients, 82 (78%) finished the study: 21 men and 61 women aged range from 19 to 67 years of age (mean 35.4 years old). Symptoms and diagnoses of the depressive episode (ICD-10) were assessed using the PSE (Present State Examination from SCAN 2.0) questionnaire before, just after, and 1 year after the 12-week psychotherapy in a day hospital ward. Statistical analyses were based on a cluster analysis and the k-means clustering method. Results. 39 persons (48%) were diagnosed with a depressive episode before treatment. After treatment, 24 patients (29%) still fulfilled the criteria, and after next 12 months the number of diagnoses of depressive episode dropped to 10 (12%). 70% of the patients demonstrated marked decrease of depressive symptoms. 47 patients (57%) who had high initial rates of GAD symptoms demonstrated a marked drop of ratings. Conclusion. Psychodynamic psychotherapy is effective in reducing depressive and GAD symptoms concomitant with neurotic and personality disorders. [ABSTRACT FROM AUTHOR]

Background: Significant proportion of patients treated for depression may have various types of bipolar mood disorders. The aim of the study was to assess the frequency of bipolar disorders among outpatients having at least one major depressive episode, treated by 96 psychiatrists, representing all regions of Poland. Methods: The study included 880 patients (237 male, 643 female), identified to following diagnostic categories: bipolar I, bipolar II, bipolar spectrum disorder and major depressive disorder. Results: Bipolar mood disorders were found in 61.2% of patients studied, bipolar I more frequent in men and bipolar II in women, and bipolar spectrum in 12% of patients. Patients with age ranges 19–49 and 50–65 years did not differ as to the percentage of diagnostic categories. Patients with bipolar mood disorders compared to major depressive disorder had significantly more frequent family history of bipolar disorder, premorbid hyper- or cyclothymic personality, early onset of depression, symptoms of hypersomnia and hyperphagia, psychotic depression, post-partum depression, and treatment-resistant depression. Bipolar spectrum patients had most clinical features similar to classic types of bipolar disorders. Limitations: Neither structured interview for family history, nor formal criteria for a number of clinical manifestations were used. The population treated by psychiatrists may not be representative and present a subgroup with more severe mood disorders. Conclusions: Bipolar mood disorders may be very prevalent among depressive outpatients treated by psychiatrists in Poland, which is confirmed by the results of recent studies. Bipolar patients (including bipolar spectrum) significantly differ from major depressive disorder as to numerous clinical features related mostly to depressive episode. [Copyright &y& Elsevier]