The Hospital Anxiety And Depression Scale.

There is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of suffering in the setting of medical practice. Most physicians are aware of this aspect of the illness of their patients but many feel incompetent to provide the patient with reliable information. The Hospital Anxiety And Depression Scale, or HADS, was designed to provide a simple yet reliable tool for use in medical practice. The term 'hospital' in its title suggests that it is only valid in such a setting but many studies conducted throughout the world have confirmed that it is valid when used in community settings and primary care medical practice. It should be emphasised that self-assessment scales are only valid for screening purposes; definitive diagnosis must rest on the process of clinical examination.

Oxygen capture by lithiated organozinc reagents containing aromatic 2-pyridylamide ligands.

The sequential reaction of ZnMe2 with a 2-pyridylamine (HN(2-C5H4N)R, R = Ph: 1; 3,5-Xy (=3,5-xylyl): 2; 2,6-Xy: 3; Bz (=benzyl): 4; Me: 5), tBuLi and thereafter with oxygen affords various lithium zincate species, the solid-state structures of which reveal a diversity of oxo-capture modes. Amine 1 reacts to give both dimeric THF [Li(Me)OZn[N(2-C5H4N)Ph]2] (6), wherein oxygen has inserted into the Zn-C bond of a [MeZn[N(2-C5H4N)-Ph]2] ion, and the trigonal Li2Zn complex, bis(OtBu)-capped (THF x Li)2-[[(mu3-O)tBu]2Zn[N(2-C5H4N)Ph]2] (7). The structural analogue of 6 (8) results from the employment of 2, while the use of more sterically congested 3 yields a pseudo-cubane dimer [(THF x [Li(tBu)OZn(OtBu)Me]]2] (9) notable for the retention of labile Zn-C(Me). Amines 4 and 5 afford the oxo-encapsulation products [mu4-O)Zn4[(2-C5H4N)-NBz]6] (10b), and [tBu(mu3-O)-Li3(mu6-O)Zn3[(2-C5H4N)NMe]6] (11), respectively, with concomitant oxo-insertion into a Li-C interaction resulting in capping of the fac-isomeric (mu6-O)M3M'3 distorted octahedral core of the latter complex by a tert-butoxide group.

An enquiry into recurrent brief depressive episodes in the general population.

Spontaneous remarks to the author concerning the experience of brief depressive episodes prompted an enquiry into the experience of these in the general population. The finding that a high proportion of subjects admitting to the experience of recurring brief depression, that the episodes were generally of less than 24 hours' duration, suggests that allowance should be made for such very brief episodes in future enquiry of the topic, as these would not be recognised by the criteria for recurrent brief depression in the ICD and DSM definitions. There was no association of duration of episode with either age or gender. There did not appear to be an association of episode duration with possible precipitants of stress, climatic conditions, season of year or dietary factors.

The First Molecular Main Group Metal Species Containing Interstitial Hydride.

Lithium cages containing hydride: The reaction of tBuLi with Me(2)AlN(2-Pyr)Ph in toluene gave [Li(8)(H){N(2-Pyr)Ph}(6)](+)[Li(Me(2)AltBu(2))(2)](-), whose cation is the first molecular main group metal species to contain interstitial hydride (the cluster core is shown in the picture). Treatment of the reaction mixture with THF gave the neutral hydride Li(7)(H)[N(2-Pyr)Ph](6), which has a capped octahedral (Li(+))(7) cluster core. 2-Pyr=2-pyridyl.

[German version of the Snaith-Hamilton-Pleasure Scale (SHAPS-D). Anhedonia in schizophrenic and depressive patients]. / Deutsche Version der Snaith-Hamilton-Pleasure-Scale (SHAPS-D). Erfassung von Anhedonie bei schizophrenen und depressiven Patienten.

The Snaith-Hamilton-Pleasure-Scale (SHAPS), introduced in English in 1995, assesses self-reported anhedonia in psychiatric patients. It has proven psychometric properties and advantages in applicability compared to other instruments assessing anhedonia. This study presents results of a systematic transcultural protocol translating the SHAPS into German (SHAPS-D). Quality of translation was confirmed on the one hand by bilingual reviewers with regard to equivalence in content and tone. On the other hand stable results were found in a test-retest-design crossing the English and German version with bilingual persons. SHAPS-D was obtained from schizophrenic (n = 50) and depressive (n = 33) patients and from healthy controls (n = 67). Results on applicability, internal consistency and relationship to depression, subjective quality of life, well-being as well as psychopathology indicate that the SHAPS-D is a useful and promising instrument in assessing anhedonia.

Present use of the Hamilton Depression Rating Scale: observation on method of assessment in research of depressive disorders.

BACKGROUND: The Hamilton Depression Rating Scale retains its primacy in research. There have been recent important critiques. It is clear that instructions provided by its author are widely overlooked. METHOD: A survey of the present use of the HDRS was conducted by inspection of five major journals publishing studies in the field of psychiatry. Note was especially made of whether a recognised version of the Scale was quoted; also of whether authors had selected specific scores on one or other of the versions to indicate a criterion for inclusion of a subject in a study, and likewise whether a specific score had been selected as an indication of recovery following some procedure or treatment. RESULTS: One hundred and fourteen articles were reviewed in which 71 had used a depression scale. This was the HDRS in 66% of the studies. There was considerable evidence that the instruction that the HDRS was only to be used in situations where the patient had received a diagnosis of a primary depressive illness had been ignored. There was considerable degree of arbitrary selection of Scale scores. CONCLUSION: The survey causes concern about the methodology of much research in the field as of assessment of severity of psychiatric disorder. The rationale of assessment by the rating scale method is considered and suggestion made for improvement in research practice.

What do anxiety scales measure?

At present researchers appear to rely on instruments for the assessment of anxiety without due consideration of what it is that the instrument may be presumed to measure. A survey was undertaken of the presently most frequently used rating scales which purport to assess anxiety. The allocation of items of the scales to the major aspects of anxiety was examined. It was found that the scales tapped different areas of psychopathology. Furtherance of research requires closer attention to the nature of the scales and the assumption that they all measure much the same construct must be discarded.

A scale for the assessment of hedonic tone the Snaith-Hamilton Pleasure Scale.

BACKGROUND: Hedonic tone and its absence, anhedonia, are important in psychopathological research, but instruments for their assessment are lengthy and probably culturally biased. METHOD: A new scale was constructed from the responses of a large sample of the general population to a request to list six situations which afforded pleasure. The most frequent items were reviewed and those likely to be affected by cultural setting, age, or sex were removed. A pilot study led to an abbreviated scale of 14 items, covering four domains of pleasure response. This questionnaire was subjected to psychometric evaluation in new samples from the general population and psychiatric patients. RESULTS: The scale was found to have a score range that would distinguish a 'normal' from an 'abnormal' response. Validity and reliability were found to be satisfactory. CONCLUSIONS: The new scale, the Snaith-Hamilton Pleasure Scale (SHAPS), is an instrument which may be recommended for psychopathological research.

Transsexualism and gender reassignment.

Gender reassignment for carefully assessed transsexual patients is now an established and accepted practice in many parts of the world. In other areas customary attitudes to those with sexual differences prevents consideration. A large number of autobiographies by reassigned patients have been published and all throw light on the experience of the writers. The one which may be recommended is that by Morris (1974). For the interested lay-person enquiring about the nature of transsexualism the brief book by Hodgkinson (1987) may be recommended.