Alteration of Plasma beta-Nerve Growth Factor Concentration in Depressed Patients with Suicidal Attempt

OBJECT: Nerve growth factor(NGF) is a protein involved in neuronal survival and plasticity in the central nervous system, which might play an important role in stress, depression and suicide. This study was performed to determine whether there is an alteration in plasma NGF concentrations in depressed patients with suicidal attempt. METHODS: The subjects were 32 depressed patients who attempted suicide and admitted in emergency room. Forty-four hospitalized non-suicidal depressive patients and the 30 normal controls were closely matched with the suicidal group in terms of age and sex. Individuals in all 3 groups were evaluated independently by a semistructured interview for the purpose of establishing a DSM-IV criteria diagnosis. The severity of depressive symptoms was evaluated using Hamilton depression rating scale(HDRS). The severity of the suicidal behavior was evaluated by Weisman and Worden's risk-rescue rating(RRR) system and the Lethality Suicide Attempt Rating Scale(LSARS). Plasma NGF level was measured by the enzyme linked immunosorbent assay(ELISA) method. RESULTS: There were no statistically significant differences of the plasma NGF levels among groups. LSARS and RRR did not reveal any significant correlation with beta-NGF level in suicidal depressive patients. CONCLUSION: This study do not support an association between beta-NGF and suicidal depression. However it is necessary to investigate this association through other route such as postmortem brain.

A Study on the Reliability and Validity of the Korean Version of the Calgary Depression Scale for Schizophrenia(K-CDSS) / 신경정신의학

OBJECTIVES: This study was performed to standardize the Korean Version of Calgary Depression Scale for Schizophrenia (K-CDSS), a semi-structured interview scale to assess depression in schizophrenia patients and to determine the psychometric properties and clinical utility of the K-CDSS. METHODS: Sixty-one patients diagnosed as schizophrenia by DSM-IV criteria were recruited in this study. Then, the patients were interviewed using the Structure Clinical Interview for DSM-IV (SCID) by a trained psychologist. Subsequently, the KCDSS, Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale (MADRS) and Simpson Angus Rating Scale (SAS) were administered by a psychiatrist. Lastly, the K-CDSS was re-assessed by a second independent rater without any previous information of patients to confirm the inter-rater reliability. RESULTS: The internal consistency using Cronbach's alpha was 0.852. Inter-rater reliability using Intraclass Correlation Coefficient (ICC) for single items and for sum score were 0.659-0.889 and 0.963, respectively. K-CDSS was assessed by a second Factor analysis and ROC (receiver operating characteristic) curve analysis were conducted. The factor analysis revealed a single factor that accounted for 53.7% of the total variance, suggesting that the uni-dimensional structure of the K-CDSS may be retained. In addition, K-CDSS showed a good convergent validity with very strong correlations with HDRS (r=0.75) and MADRS (r=0.81), respectively. However, K-CDSS was not correlated with PANSS-positive, PANSS-negative and SAS, demonstrating its satisfactory discriminant validity. The area under the ROC curve was 0.968 (standard error=0.036, p<.001). With a cut-off point of 8, the K-CDSS had a sensitivity 83.3%, specificity 97.9%, positive predictive value 90.9% and negative predictive value 95.8%. CONCLUSION: K-CDSS is considered as a short and valid tool to identify depressive symptoms in schizophrenia.

Decreased Concentration of Plasma Brain-Derived Neurotrophic Factor in Suicide Attempters

OBJECTS: Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. METHODS: The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. RESULTS: In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. CONCLUSION: These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.