The Diagnostic Apathia Scale predicts the ability to return to work following depression or anxiety.

OBJECTIVE: The aim of this study was to evaluate the validity of a new apathy rating scale in predicting the ability to return to work (RTW) in patients with depression or anxiety a year after discharge from a psychiatric hospital. METHODS: We evaluated 56 patients with depression or anxiety, who participated in an on-going randomised clinical trial using RTW as primary outcome. The degree of apathy was measured by the Diagnostic Apathia Scale, which contains six items covering the following neuropsychological symptoms: concentration/memory problems, difficulties in decision making, lassitude, tiredness/fatigue, insomnia, and reduced ability to work and engage in personal interests. The scale was analysed for psychometric validity (scalability) and for its ability to predict RTW. Finally, the predictive validity of the Diagnostic Apathia Scale regarding RTW was compared with scales measuring severity of depression/anxiety symptoms, disability, and psychological well-being. RESULTS: The Diagnostic Apathia Scale displayed sufficient scalability, that is, the total score was a psychometrically valid measure of apathy. Only the Diagnostic Apathia Scale, and not the scales measuring severity of symptoms, disability, or psychological well-being, had predictive validity regarding RTW. Thus, 76% with 'clinically significant apathy' at baseline were unable to RTW versus 50% of the patients without apathy (p<0.05). CONCLUSION: The Diagnostic Apathia Scale was found to have an acceptable predictive validity in terms of patients' ability to RTW 1 year after discharge from hospitalisation for depression or anxiety.

Personality traits and cancer survival: a Danish cohort study.

We conducted a population-based prospective cohort study in Denmark to investigate associations between the personality traits and cancer survival. Between 1976 and 1977, 1020 residents of the Copenhagen County completed a questionnaire eliciting information on personality traits and various health habits. The personality traits extraversion and neuroticism were measured using the short form of the Eysenck Personality Inventory. Follow-up in the Danish Cancer Registry for 1976-2002 revealed 189 incidents of primary cancer and follow-up for death from the date of the cancer diagnosis until 2005 revealed 82 deaths from all-cause in this group. A Cox proportional-hazards model was used to estimate the hazard ratios (HRs) of death from all-cause according to extraversion and neuroticism adjusting for potential confounding factors. A significant association was found between neuroticism and risk of death (HR, 2.3 (95% CI=1.1-4.7); Linear trend P=0.04) but not between extraversion and risk of death (HR, 0.9 (0.4-1.7); Linear trend P=0.34). Similar results were found when using cancer-related death. Stratification by gender revealed a strong positive association between neuroticism and the risk of death among women (Linear trend P=0.03). This study showed that neuroticism is negatively [corrected] associated with cancer survival. Further research on neuroticism and cancer survival is needed.

Anticipations and experiences of menopause in a Danish female general population cohort born in 1936.

INTRODUCTION: Few studies on menopause consider the impact of sociopsychological factors on women's experiences of menopause. OBJECTIVE: To focus on women's experiences of menopause: complaints, health, attitudes and stereotypes of menopause and ageing. DESIGN: Prospective population study, initiated in 1976 with follow-ups in 1981, 1987 and 1996 with a high participation rate, a representative sample of all women born in 1936 and living in the County of Copenhagen. STUDY METHODS: Questionnaires and personal interviews: sociodemographic data, menopause, general health, sexuality, ageing. RESULTS: The strongest predictors of the way in which women experienced menopause, including sexuality, were their general health earlier in life, their social circumstances and their expectations of menopausal changes. The biological changes had significant correlation to hot flushes. Menopause was seen as a symbol of ageing. Only a minority suffered from serious problems, typically originating earlier in life.

Description of women's personality traits and psychological vulnerability prior to choosing hormone replacement therapy.

INTRODUCTION: Data suggest that women using hormone replacement therapy (HRT) represent a special subgroup of the general population regarding, for instance, cardiovascular risk factors and education. OBJECTIVE: To analyse if women who choose HRT are characterised a priori by high neuroticism score or by psychological vulnerability. DESIGN: A prospective population-based study was initiated in 1976 with follow-ups in 1981, 1987 and 1996. The population comprises a random sample of 621 women born in 1936 and living in the county of Copenhagen. STUDY METHODS: The analyses are based on data on two sub-cohorts of 268 and 235 women from the large population-based study. These subgroups consist of the women participating in both baselines at 40 and 45 years respectively and at follow-up in 1996. At the age of 40 the women participated in a comprehensive examination, which apart from baseline characteristics included Eysencks personality questionnaire concerning intro/extroversion and neuroticism. At the age of 45, the re-examination of the women included a test for psychological vulnerability. The participants reported whether or not they used HRT at the age of 40, 45, 51 and 60 years. The analyses comprised "never users" of HRT and "future users", defined as women who started HRT subsequent to baseline registration during the observation period. The groups were compared by multivariate statistical methods to adjust for confounding factors. RESULTS: Women with high neuroticism score at the age of 40 were more likely to become users of HRT in the future compared to women with low neuroticism score. At the age of 45, psychologically vulnerable women were more likely to become users of HRT in the future compared to non-vulnerable women. The associations became insignificant when correcting for potential confounders. The study suggests that selection bias among women choosing HRT may also include personality traits.

[Forensic psychiatric patients--diagnosis, criminality and sanctions]. / Retspsykiatriske patienter--diagnose, kriminalitet og sanktion.

During the last few years the number of persons who in connection with a breach of the penal code have been sentenced to psychiatric treatment has increased considerably. The case records of 38 such psychiatric patients have been reviewed with focus on diagnostic dispersion, patterns of abuse of alcohol and/or drugs and of crime. A majority of the patients (87%) had formerly been in contact with the psychiatric treatment system. At their latest psychiatric contact many (68%) were diagnosed as schizophrenic and were found to be involved in serious abuse of alcohol and drugs. The crimes committed consisted to a large extent of either real or potential injury to other persons. An unexpectedly large number of the patients had for a shorter or longer time been detained in custody. The examined criminal psychiatric clientele constitutes a strained group with a serious psycho-pathology and with a high frequency of alcohol or drug abuse. More extensive investigations of these patients and possibly also of the effects of their pre-trial detention would be desirable.

An epidemiological study of REM latency and psychiatric disorders.

In an epidemiological population study 87 subjects were studied with home sleep recordings. Nineteen subjects had minor psychiatric disorders: six subjects had a minor depression, six subjects had a generalized anxiety disorder, and seven subjects had a mild vegetative discomfort syndrome. Syndrome profiles of the three groups, using the AMDP system, showed a significantly higher degree of insomnia in the anxiety group than in the depressive group. The mean rapid eye movement (REM) latency in the anxiety group was significantly longer than in the other groups, including normals. The study showed a slight tendency towards a reduced REM latency in the minor depressives, but no statistical significance was obtained.

Integration of DSM-III and ICD-8 to be used in a consultation-liaison psychiatric service. Preliminary experiences.

In 1983 a total of 405 patients received psychiatric supervision in somatic departments in the general hospital. At this supervision, these patients were registered by means of a five-axial diagnostic coding according to the DMS III principle, and this was combined with a quantitative global assessment of the severity of the condition. Reliability testing was undertaken by five supervising physicians with a total of 15 patients. The total number of supervisions constituted one supervision per somatic bed per annum. Women were overrepresented, and medical departments made the greatest use of psychiatric supervision. Reactive conditions dominated parallel with a high relative incidence of alcohol-related conditions. In patients with diagnoses of psychoses, only slight to moderate psychiatric symptoms were encountered. This held true also for personality deviations. 50% of the patients had experienced significant psychosocial stress, but 10% of these were diagnosed as having non-reactive psychoses, 52% of the patients had moderate to pronounced disturbances of social function. Half of the patients supervised in this manner could be investigated or treated in the referring departments. Approximately half of the patients in whom referral to private psychiatric specialists was made did not keep these appointments. Reliability testing in the material shows the employability of the diagnostic armamentarium. All in all, the investigation suggests that extension of the liaison psychiatric service in somatic departments would result in a relative increase in the number of patients who could be treated in the referring department and an increase in the number of psychiatric conditions diagnosed. Establishment of a psychiatric outpatient clinic in the somatic environment appears to be indicated.

The effect of amitriptyline, desipramine and imipramine on the vivo brain synthesis of 3H-noradrenaline from 3H-L-dopa in the rat.

3H-L-Dopa was given to rats after a peripheral decarboxylase inhibitor Ro 4-4602 (50 mg/kg) and the effect of 30 min pretreatment with antiptyline (10 mg/kg), desipramine (10 mg/kg) and imipramine (10 mg/kg) on the brain formation of 3H-dopamine, 3H-noradrenaline and their major metabolites was investigated. Desipramine produced a decrease in the level of labelled noradrenaline and its major metabolites free and conjugated 3-methoxy-4-hydroxyphenyleneglycol and 3,4-dihydroxyphenyleneglycol. Imipramine decreased labelled noradrenaline and 3-methoxy-4-hydroxyphenyleneglycol, whereas amitriptyline produced no significant effect on noradrenaline metabolism. The thymoleptic drugs produced no significant effect on endogenous brain noradrenaline and dopamine. These findings provide a strong indication that desipramine and imipramine inhibit the 3H-noradrenaline biosynthesis from 3H-L-Dopamthe effect seems closely related to the well-known membrane inhibitory effect of these drugs, since desipramine produced a more marked effect than imipramine and amitriptyline showed no effect. No conclusive evidence for the precise mechanism of action was obtained but it is possible that the decreased 3H-noradrenaline synthesis is related to interference of desipramine and imipramine with the precursor (s) 3H-L-Dopa or 3H-dopamine at sites of 3H-noradrenaline biosynthesis.