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This study assessed the prevalence of pathological dissociation in the general population, and the relationship between pathological dissociation and sociodemographic and several psychiatric variables.The stratified population sample consisted of 2001 subjects. The study questionnaires included the Dissociative Experiences Scale, the Dissociative Experiences Scale-Taxon, the Toronto Alexithymia Scale, the Beck Depression Inventory, and sociodemographic background.The prevalence of pathological dissociation (DES-T ≥ 20) was 3.4% in the general population and did not differ significantly between genders. Men scored higher than women in the amnesia subscale, and women in the absorption and imaginative involvement subscale. The relationship between pathological dissociation, alexithymia, depression and suicidality was strong. The likelihood of pathological dissociation was nearly nine-fold higher among depressive subjects, more than seven-fold higher among alexithymic subjects, and more than four-fold higher among suicidal subjects than among the others. Frequent alcohol consumption also associated significantly with pathological dissociation.A significant relationship between pathological dissociation, depression, alexithymia, and suicidality was found in the general population. The importance of these factors should be examined in a prospective study design to determine causality. [ABSTRACT FROM AUTHOR]

The objective of this population-based study was to determine whether traumatic experiences in general, and multiple traumatic experiences in particular, are associated with persistent self-rated depressive symptoms in adult Finnish subjects over 2 years of follow-up. The study sample included 1405 subjects aged 25-64 years. Subjects (n=217) who were depressed both at baseline in 1999 and on follow-up 2 years later in 2001 (having persistent depressive symptoms) were compared with subjects (n = 987) having no depressive symptoms either at baseline or on follow- up. All six categories of traumatic experiences (wartime experience, natural disaster, life- threatening accident, victim of violent crime, domestic violence and childhood sexual abuse) pertained to the respondents' whole life span. Odds ratios, adjusted for significant covariates, were obtained from multiple logistic regression models that estimated the likelihood of persistent depressive symptoms in different trauma categories. Persistent depressive symptoms had a significant positive graded relationship with the number of traumatic experiences. The adjusted odds of persistent depression was 6.05 (95% CI 1.76-20.7) for men and 6.99 (95% CI 2.69-18.2) for women in those with three or more traumatic experiences compared with those with no such experiences at all. Multiple traumatic experiences substantially increase the likelihood of persistent depressive symptoms. Mental health intervention, as early as possible, may serve to prevent the chronicity of depressive reactions among victims of multiple traumas. [ABSTRACT FROM AUTHOR]

Background: Results of studies of the association between blood concentrations of homocysteine and depression in general populations and among psychiatric patients are inconsistent. Objective: The objective was to study the association between depression and serum concentrations of total homocysteine (tHcy). Design:Across-sectional study of a sample of 924 men aged 46-64 y was conducted as a part of the Kuopio Ischaemic Heart Disease Risk Factor Study. Those who had a history of psychiatric disorder (6.0%) were excluded. Depressive symptoms were assessed with the 18-item Human Population Laboratory Depression Scale. Those who scored ≥5 at baseline or at the 4-y follow-up were considered to have a tendency toward depression. Results: The participants were ranked according to their blood tHcy concentration and divided into tertiles. Those in the upper tertile for serum tHcy had a more than twofold (odds ratio: 2.30; 95% CI: 1.35, 3.90; P =0.002) higher risk of being depressed than did those in the lowest tertile for serum tHcy. The results remained significant after adjustment for the month of study, history of ischemic heart disease, smoking habits, alcohol consumption, marital status, education, and socioeconomic status in adulthood (odds ratio: 2.23; 95% CI: 1.30, 3.83; P = 0.004). Conclusion: High serum concentrations of tHcy may be associated with depression in middle-aged men. [ABSTRACT FROM AUTHOR]

Background: Several cross-sectional studies have focused on the low blood folate levels of depressive patients. Nevertheless, no prospective studies have been published on the association between dietary folate and depression.Methods: We studied the association between dietary folate and cobalamin and receiving a discharge diagnosis of depression in a prospective follow-up setting. Our cohort was recruited between 1984 and 1989 and followed until the end of 2000, and it consisted of 2,313 men aged between 42 and 60 years from eastern Finland.Results: The mean intake of folate in the whole cohort was 256 microg/day (SD=76). Those below the median of energy-adjusted folate intake had higher risk of getting discharge diagnosis of depression (RR 3.04, 95% CI: 1.58, 5.86) during the follow-up period than those who had a folate intake above the median. This excess risk remained significant after adjustment for current socioeconomic status, the baseline HPL depression score, the energy-adjusted daily intake of fibre and vitamin C, and the total fat intake.Conclusions: A low dietary intake of folate may be a risk factor for severe depression. This also indicates that nutrition may have a role in the prevention of depression. [ABSTRACT FROM AUTHOR]

Alexithymic features are often associated with depression, which is the most important risk factor for suicidal behaviors. Nevertheless, little is known about the associations between alexithymia and suicidality. In this 12-month follow-up study we investigated the relationship between alexithymia and suicidal ideation in a sample of the general population (N = 1,563) using the 20-item Toronto Alexithymia Scale (TAS-20) and the 21-item Beck Depression Inventory (BDI). Suicidal ideation was more common among subjects with alexithymia than among nonalexithymic subjects (32% v 9% at baseline and 36% v 9% after 12 months). In cross-sectional analyses, alexithymia associated with the presence of suicidal ideation even after adjustment for sex, age, and several psychosocial and socioeconomic factors and the presence of depression. Moreover, after adjustment for depression at baseline, the decrease and increase in alexithymic features during the study period associated independently with recovery from and the occurrence of suicidal ideation, respectively. Nevertheless, these associations were no longer independent when adjusted for concomitant changes in the level of depressive symptoms. In conclusion, if depression presents alexithymic features the subject has an additive impact on the risk of suicidal ideation. [ABSTRACT FROM AUTHOR]

This 3-year follow-up study examined background factors, stressful life-events, and changes in alexithymia and depression scores in four groups of subjects from a general population (N = 1,339): alexithymic (A), depressed (D), simultaneously alexithymic/depressed (AD), and non-alexithymic/non-depressed (O). Alexithymia was assessed using the 20-item version of the Toronto Alexithymia Scale (TAS) and depression using the 21-item Beck Depression Inventory (BDI). A questionnaire screening sociodemography and stressful life-events was also used. The results showed that alexithymia was associated with male gender and blue-collar working, whereas depressive symptoms associated with female gender, older age, poor subjective health, poor financial situation, and low life satisfaction. During the follow-up the sum of stressful life-events was higher among groups AD and D than in groups A and O. The most common stressful life-events were the death of a close relative or friend, a negative change in the health of a family member, and financial problems. The TAS scores decreased only in groups A and AD. The BDI scores decreased in group AD but remained relatively unchanged in group D. Interestingly, if only those without depressive symptoms are considered, alexithymia appears to be a rarer phenomenon than has been reported previously. Furthermore, it seems that depressive symptoms were chronic and long-lasting among the general population. [ABSTRACT FROM AUTHOR]

Background: Hopelessness is associated with depression and suicidality in clinical as well as in non-clinical populations. However, data on the prevalence of hopelessness and the associated factors in general population are exiguous. Aims: To assess the prevalence and the associated factors of hopelessness in a general population sample. Methods: The random population sample consisted of 1722 subjects. The study questionnaires included the Beck Hopelessness Scale (HS), Beck Depression Inventory (BDI), Toronto Alexithymia Scale (TAS-20) and Life Satisfaction Scale (LS). Results: Eleven percent of the subjects reported at least moderate hopelessness. A poor financial situation (OR 3.64), poor subjective health (OR 2.87) and reduced working ability (OR 2.67) independently associated with hopelessness. Moreover, the likelihood of moderate or severe hopelessness was significantly increased in subjects dissatisfied with life (OR 5.99), with depression (OR 4.86), with alexithymia (OR 2.37) and with suicidal ideation (OR 1.85). Conclusions: This study demonstrated a moderately high prevalence of hopelessness at the population level. Hopelessness appears to be an important indicator of Iow subjective well-being in the general population that health care personnel should pay attention to. [ABSTRACT FROM AUTHOR]

This prospective study aimed to assess the suitability of the 21-item Beck Depression Inventory (BDI-21) as a screening method for current episodes of major depressive disorder in different phases of the disease. In a sample of treatment-seeking outpatients ( n =125), a structured interview method (SCID) was used twice with a 2-year interval to screen whether the patient had a current episode of major depressive disorder. The validity of the BDI-21 was also analysed by means of receiver operating characteristic (ROC) curves. The results showed that with a cut-off point of 14/15 the BDI-21 can be used to indicate the presence of a major depressive episode regardless of the phase of the major depressive disorder. The sensitivity and specificity were quite satisfactory with this cut-off point. The areas under the ROC curves were large (0.81 at baseline and 0.93 at follow-up). The same BDI-21 cut-off point is suitable for screening major depression among outpatients in any phase of the disease. [ABSTRACT FROM AUTHOR]

Background: Despite of an increasing body of research the associations between vitamin B12 and folate levels and the treatment outcome in depressive disorders are still unsolved. We therefore conducted this naturalistic prospective follow-up study. Our aim was to determine whether there were any associations between the vitamin B12 and folate level and the six-month treatment outcome in patients with major depressive disorder. Because vitamin B12 and folate deficiency may result in changes in haematological indices, including mean corpuscular volume, red blood cell count and hematocrit, we also examined whether these indices were associated with the treatment outcome. Methods: Haematological indices, erythrocyte folate and serum vitamin B12 levels were determined in 115 outpatients with DSM-III-R major depressive disorder at baseline and serum vitamin B12 level again on six-month follow-up. The 17-item Hamilton Depression Rating Scale was also compiled, respectively. In the statistical analysis we used chi-squared test, Pearson's correlation coefficient, the Student's t-test, analysis of variance (ANOVA), and univariate and multivariate linear regression analysis. Results: Higher vitamin B12 levels significantly associated with a better outcome. The association between the folate level and treatment outcome was weak and probably not independent. No relationship was found between haematological indices and the six-month outcome. Conclusion: The vitamin B12 level and the probability of recovery from major depression may be positively associated. Nevertheless, further studies are suggested to confirm this finding. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate mental health and social isolation in surviving family members (n=56) 10 years after a suicide as compared to sex and age matched general population controls. Minor mental disorders were more common among suicide survivors than among general population controls (30% vs. 16%), especially in surviving spouses (39% vs. 11%). Suicide survivors had fewer close friends than their controls. According to multivariate logistic regression analyses adjusted for several socioeconomic factors and the number of close friends, surviving spouses, but not relatives by blood, had a significantly increased risk of having minor mental disorder as compared to general population controls. Our conclusion is that suicide may be associated with mental symptoms and lack of social relationships in surviving spouses even 10 years later. [ABSTRACT FROM AUTHOR]

Objective - To investigate whether depression was associated with cardiac status and socio-demographic factors in patients with coronary heart disease (CHD). Methods - The sample consisted of 144 symptomatic patients with CHD. For screening depression the Beck Depression Inventory was administered on the day before elective coronary angiography. Results - Twenty-four per cent of patients had probable depressive disorder, but none of them had been previously identified as suffering from depression, or been treated for depression. Alexithymia and dissatisfaction with life were common in depressed patients. Logistic regression analysis showed that neither the cardiac status nor sociodemographic factors were associated with depression. Conclusion - Depression is a common finding and should be looked for independently of other risk factors in patients with CHD. [ABSTRACT FROM AUTHOR]

Objective: The objective was to study factors associated with psychiatric diagnosis among adolescents (n = 164) seeking psychiatric care for mental symptoms. Method: Psychiatric diagnosis was confirmed by a structured diagnostic interview. Psychosocial functioning was assessed with the Global Assessment of Functioning Scale, and the Beck Depression Inventory and Offer Self-Image Questionnaire were also used. Background data were gathered. Results: A majority (76%) of the adolescents met DSM-III-R criteria for psychiatric diagnosis. The self-image was more negative and the Beck score was higher among these adolescents than the others. All who had attempted suicide had a psychiatric disorder. Those diagnosed as having a psychiatric disorder consumed alcohol in order to get drunk more often than others. Continual conflicts with parents and smoking were not associated with the existence of a psychiatric disorder. In logistic regression analysis, low psychosocial functioning (OR = 3.9) and an uncertain or pessimistic attitude towards the future (OR = 9.1) proved to be independent risk factors for psychiatric disorders. Conclusions: Health service staff should be aware of factors associated with psychiatric disorders in adolescents so that they can identify those at high risk. [ABSTRACT FROM AUTHOR]

Abstract Background The aim was to examine associations between memory complaints, cognitive performance and mood in 174 adult, clinically depressed, neurologically healthy patients at baseline and during six months of follow-up. Methods Subjective memory disturbance was assessed using the Memory Complaint Questionnaire (MCQ). Levels of cognitive function, including memory, were assessed using a battery of neuropsychological tests. Mood and personality traits were assessed using rating scales, including the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS) and the 90-item Symptom Check List (SCL-90). Results At baseline, patients complaining of memory disturbances had higher BDI and HDRS scores than patients not complaining of memory problems. They also did less well in objective memory performances but not in other cognitive functions. Complaints of memory problems decreased during the follow-up. This change was associated with mood improvement and with reductions in other mental symptoms but not with changes in cognitive performance. In logistic regression analysis factors independently associated with MCQ change were age (OR 0.96) and BDI change (OR 1.06). Conclusions Subjective memory problems usually decline if depression is alleviated. [ABSTRACT FROM AUTHOR]

The construct validity of the Offer Self-Image Questionnaire (OSIQ) was examined among 13-year-old Finns. Questionnaires were completed by 268 pupils at school. The construct validity was studied by means of factor analysis. Factor analysis involving 130 items yielded 5 factors with different content: an anxious self, a coping self, awareness by the adolescents of their place in the world, social relationships, and sexuality. The factor solution was moderately useful; it included most of the original items (71%) and explained 31% of the total variance. Boys were more anxious and had a more negative social and sexual self-image than the girls. The OSIQ estimates adolescents' self-images in a multidimensional manner. When interpreting the scores, it is important to consider sex differences and the developmental stage of the adolescent. Despite its limitations, the OSIQ remains a moderately valid and clinically relevant method for use in the clinical assessment of adolescents. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the prevalence of mental disorder and associated factors during an economic recession. Random samples of Finnish general population were collected in 3 consecutive years, 1993-95. The prevalence of mental disorders was assessed by means of the 12-item General Health Questionnaire (GHQ). The prevalence of mental disorders varied among Finnish men from 15.6% to 19.2% and among women from 21 to 24.5%. Mental disorder was more common among women than among men in every study year. Mental disorder was more common among the unemployed than among other respondents both in women and men in every year. Subjective poor health, suicidal thoughts and poor economic situation were constantly associated with mental disorder in both sexes every year. Using logistic regression analyses, problems with a partner, uncertain future orientation and use of psychoactive drugs, in particular, were found to be fairly permanent independent risk factors in relation to mental disorder. As studied by gender no major changes occurred in the mental health status of Finns during economic recession, although in many specific groups mental disorder was markedly more common than in the general population. [ABSTRACT FROM AUTHOR]

The present study examined the relationship between smoking and depression among patients with different psychiatric diagnoses according to DSM-III-R criteria. The study sample of 1217 consecutive in- and outpatients, treated at the Department of Psychiatry, Kuopio University Hospital, in eastern Finland, was interviewed with two sets of questions during May 1993. The prevalence of smoking was higher among severely depressive than among mildly or moderately depressive patients in all diagnostic categories, except in male schizophrenics. However, this difference in rate of smoking was statistically significant only among men with major depression and women with personality disorder. The best determinants of severe depression in a multiple logistic model were diagnosis of major depression, personality disorder, and dysthymia. According to the model, current smokers had a 40% higher risk of severe depression than nonsmokers. Because both smoking and depression are major public health problems, the observed association deserves more thorough research, especially by psychiatric specialists. [ABSTRACT FROM AUTHOR]

This study investigated the association between the quality of marriage as manifested by subjective happiness and common mental disorders in a national sample of the Finnish population. Mental disorders were screened by means of the 12-item General Health Questionnaire. Marriage per se was not found to be associated with common mental disorders. However, men in general, but not those in an unhappy marriage, suffered from mental disorders less frequently than did women. Men and women who were unhappy in their marriages suffered from common mental disorders more often than others who were not. Both men and women in unhappy marriages were found to be at significantly higher risk of common mental disorders as compared with the unmarried and to those in a happy marriage, after adjusting for several confounding factors. [ABSTRACT FROM AUTHOR]

This is a study on associations between suicide mortality, unemployment, divorce rate and mean alcohol consumption during an economic cycle in Finland, from 1985 to 1995. Data on annual suicide mortality, gross domestic product, unemployment, divorce rate and mean alcohol consumption were collected from official Finnish statistics. Regression analyses using a correction for serial autocorrelation were performed. Suicide mortality in both males and females increased during an economic upswing from 1985 to 1990, and decreased during an economic recession from 1990 to 1995. Suicide mortality was not associated with unemployment or divorce rate. These results are opposed to those of many previous studies. However, a significant association was found between male suicide mortality and mean alcohol consumption, in accord with other studies. In conclusion, the results suggest diversity in associations between suicide mortality, socio-economic factors and alcohol consumption. [ABSTRACT FROM AUTHOR]

Abstract Rationale: There are no previous data available regarding [[sup 123I]beta-CIT binding to the dopamine transporter sites in the basal ganglia in depressed patients. Objective: The present study tested the hypothesis that the brain DAT density in depressed patients is lower than that in matched healthy controls. Methods: Fifteen drug-naive outpatients with major depression and 18 healthy controls were investigated using single photon emission computerized tomography (SPECT) with a high-affinity dopamine transporter specific radioligand, [sup 123]I-labeled beta-CIT (2 beta-carbomethoxy-3 beta-(4-iodophenyl)-tropane). Results: We found a significantly higher [[sup 123]I] beta-CIT uptake both sides of the basal ganglia in patients with major depression than in the controls (Mann-Whitney U-test, P = 0.002 on the right and P = 0.003 on the left). Conclusions: The radioligand uptake reflecting the DAT density was significantly higher among the patients than in the controls. This finding is unexpected, since it is generally believed that monoaminergic neurotransmission is lower in depression, and therefore it could be assumed that a reduction in dopamine transmission would lead to secondary down-regulation of DAT density. However, it is possible that up-regulation of the DAT may be the primary alteration, which leads to lower intrasynaptic dopamine concentration and to lower dopamine neural transmission. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the discriminant validity of the Offer Self-Image Questionnaire (OSIQ) in 13-year-old Finns. Two hundred and sixty-eight 13-year-old Finns completed the OSIQ in their classrooms. The adolescents were divided into three groups on the basis of raw scores: good development (20%), normal development (65%), and problematic development (15%). Adolescents from all three groups were chosen for interview as follows: 29 from the normal development group, 28 from the good development group, and 26 from the problematic development group. The interviews were conducted by two experienced psychiatrists specialized in adolescent psychiatry, unaware of the OSIQ scores. The psychiatrists' development assessment was then used as the gold standard. Development as assessed by the two psychiatrists and classification based on raw OSIQ scores correlated moderately well. The specificity of the OSIQ was 79%, and the sensitivity 71%, but the positive predictive value (PPV) was only 46%, and the negative predictive value (NPP) was 91%. Total OSIQ raw score and assessed development correlated well. The OSIQ differentiates well between adolescents with normal development and other adolescents, but among adolescents who have developmental problems the test is only allusive. The OSIQ can, therefore, be used as a screening method in research and clinical practice, but conclusions about adolescents' problematic development can be made only on the basis of clinical interview. [ABSTRACT FROM AUTHOR]

Five suicides committed within a day of discharge from a psychiatric hospital between 1991 and 1994 in the province of Kuopio, Finland, are described. The suicides occurred when psychiatric services in the region were being reorganized and when there also was great pressure for reductions in the number of psychiatric beds and for changes in the nature of psychiatric inpatient treatment. Common to all cases was a possible neglect of individual clinical assessment and consequent underestimation of the severity of the patients' symptoms. The case histories also suggest that internal and external pressures on treatment communities and staff can result in problems relating to basic clinical tasks. Careful individual examination and appropriate treatment based on the results of such examination continue to be of the utmost importance in preventing suicides among psychiatric patients. [ABSTRACT FROM AUTHOR]

The usefulness of the application of the psychodynamic frame of reference in person- to-person health education is examined in the present study. The health educator's proper understanding of his client through an integrative use of his own cognitive and emotional responses to the client is first discussed. Depending on the level of maturity of their personalities, and on the nature of their formative relations, the clients will develop different modes of interaction in their relationships with the health educator. Learning to adequately recognize and meet clients showing different interactional modes is considered to substantially increase the prospects of the health educator helping his clients to accomplish a change in health behaviour. Four levels of interaction and their proper encountering are described and discussed. It is concluded that health education and individual health educators would benefit from an increased familiarity with, and use of, the psychodynamic body of knowledge. [ABSTRACT FROM AUTHOR]

Several studies have shown that impulsive violent and suicidal behaviour is associated with a central serotonin deficit, but until now it has not been possible to use laboratory tests with high sensitivity and specificity to study this kind of deficit or to localize the sites of serotonergic abnormalities in the living human brain. The aim of this study was to test the hypothesis that monoamine transporter density in brain is decreased in subjects with impulsive violent behaviour. We studied serotonin (5-HT) and dopamine (DA) transporter specific binding in 52 subjects (21 impulsive violent offenders, 21 age- and sex-matched healthy controls, and ten nonviolent alcoholic controls) with single-photon emission tomography (SPET) using iodine-123-labelled 2β-carbomethoxy-3β(4-iodophenyl)tropane ([[sup 123]I]β-CIT) as the tracer. The blind quantitative analysis revealed that the 5-HT specific binding of [[sup 123]I]β-CIT in the midbrain of violent offenders was lower than that in the healthy control subjects (P<0.005; t test) or the non-violent alcoholics (P<0.05). The results imply that habitual impulsive aggressive behaviour in man is associated with a decrease in the 5-HT transporter density. [ABSTRACT FROM AUTHOR]

Alterations in brain serotonin (5-HT) and dopamine (DA) activity are associated with several neuropsychiatric disorders, but until now it has not been possible to simultaneously visualize or quantify the 5-HT and the DA transporter density in the living human brain. In this paper we report on the imaging of 5-HT and DA transporters in 28 healthy controls with single-photon emission tomography using iodine-123 labelled 2β-carbomethoxy-3β-(4-iodophenyl)tropane ([I]β-CIT) as the tracer. The [I]β-CIT distribution showed the most prominent 5-HT activity in the medial frontal cortex, hypothalamus, midbrain and occipital cortex and the greatest DA activity in the basal ganglia. The specific binding of the 5-HT transporters in the medial frontal cortex was 0.377±0.031 and that of the DA transporters in the basal ganglia, 0.916±0.007. Gjedde-Patlak plots indicated two separate components: the first was assumed to represent 5-HT transporters with a slope of 1.29±0.27 h and the second, DA transporters with a slope of 0.30±0.04 h. This distinct kinetic pattern and the fact that 5-HT and DA transporters are situated in different parts of the brain provides an opportunity to study in vivo patients suffering from various neuropsychiatric disorders. [ABSTRACT FROM AUTHOR]

Thirteen drug-naive outpatients with major depression and seven healthy controls were investigated using single-photon emission computerized tomography (SPECT) with [sup 123]I-labeled iomazenil. Depression was diagnosed in accordance with the criteria of the DSM-III-R, and the severity of depression was evaluated using the 21-item Hamilton depression rating scale. Patients had significantly lower benzodiazepine receptor density in the both cerebral hemispheres and, especially, in the left temporal cortex than did the controls. Significant negative correlations were observed between psychic anxiety in patients and the benzodiazepine receptor density in the left (r 0.73) and right (r 0.74) temporal cortex. The results suggest that benzodiazepine receptor density is associated with anxiety symptoms among depressed patients. [ABSTRACT FROM AUTHOR]

Studies the differences in dopamine trasnporter (DAT) densities in major depression between those with and without cluster C personality disorders. Calculation of effect size; Percentage of difference in DAT densities between the depression groups and control groups; Effect of cluster C personality disorder on DAT levels relative to the effect of depression. [ABSTRACT FROM AUTHOR]

Investigates the prevalence and risk of common mental disorders in Finland during an upswing in the national economy. Compilation of study material through telephone interviews; Use of the general health questionnaire to screen for the presence of mental symptoms; Increase in the prevalence of mental disorders in accordance with unemployment rate.

Background: Major depressive disorder (MDD) is characterized by increased oxidative and nitrosative stress. We compared nitric oxide metabolism, i.e., the global arginine bioavailability ratio (GABR) and related serum amino acids, between MDD patients and non-depressed controls, and between remitted and non-remitted MDD patients.Methods: Ninety-nine MDD patients and 253 non-depressed controls, aged 20-71 years, provided background data via questionnaires. Fasting serum samples were analyzed using ultra-performance liquid chromatography coupled to mass spectrometry to determine the serum levels of ornithine, arginine, citrulline, and symmetric and asymmetric dimethylarginine. GABR was calculated as arginine divided by the sum of ornithine plus citrulline. We compared the above measures between: 1) MDD patients and controls, 2) remitted (n=33) and non-remitted (n = 45) MDD patients, and 3) baseline and follow-up within the remitted and non-remitted groups.Results: Lower arginine levels (OR 0.98, 95% CI 0.97-0.99) and lower GABR (OR 0.13, 95% CI 0.03-0.50) were associated with the MDD vs. the non-depressed group after adjustments for potential confounders. The remitted group showed a decrease in GABR, arginine, and symmetric dimethylarginine, and an increase in ornithine after the follow-up compared with within-group baseline values. The non-remitted group displayed an increase in arginine and ornithine levels and a decrease in GABR. No significant differences were recorded between the remitted and non-remitted groups.Limitations: The MDD group was not medication-free.Conclusions: Arginine bioavailability may be decreased in MDD. This could impair the production of nitric oxide, and thus add to oxidative stress in the central nervous system. [ABSTRACT FROM AUTHOR]