Background. The differential diagnosis of early dementia of the Alzheimer's type from depression in the elderly is often made difficult by the presence of significant memory impairment in depressed patients. The Delayed Word Recall test (DWR) was developed to facilitate the early diagnosis of Alzheimer's disease. The DWR involves: (a) repeated elaborate encoding of ten separate words; (b) a filled delay; (c) delayed free recall. A recognition memory test has also been recently developed. The available evidence suggests impressive sensitivity and specificity when the DWR has been used to separate patients with early Alzheimer's disease from very well matched controls.

Methods. In the present study, the DWR was evaluated with regard to its ability to separate a group of 50 patients with early Alzheimer's disease from 50 elderly patients with major depression in a between-subjects experimental design.

Results. For both free recall and recognition indices, the between-group overlap was large. Using recommended cut-off scores for the detection of Alzheimer's disease, 44% of the depressed patients would have been misclassified as demented based on their free recall scores, and 48% of the depressed patients would have been misclassified on the basis of their recognition scores.

Conclusion. We conclude that the DWR is not specific enough to clearly distinguish patients with early Alzheimer's disease from elderly patients with major depression.

Background. Previous research has shown that parasuicides' view of the future is characterized by an absence of anticipation of positive experiences rather than the presence of anticipation of negative experiences. The present study aimed to replicate this finding and examine whether it would also be found in parasuicides who were not depressed.

Method. Depressed parasuicides (N=27), non-depressed parasuicides (N=17) and matched controls (N=34) were assessed on their anticipation of future positive and negative experiences using an adapted fluency paradigm, where they were given a set time to generate future positive and negative anticipated experiences.

Results. Consistent with previous findings, parasuicides showed an overall reduced anticipation of positive experiences and no overall increased anticipation of negative experiences. However, the parasuicides did show evidence of increased negative anticipation for the immediate future. The results for depressed and non-depressed parasuicides were essentially the same.

Conclusion. Lack of positive anticipation in the absence of increased negative anticipation is a feature of parasuicide. Although this lack of positive anticipation can occur in depression, it appears to be an independent feature of parasuicide.

With the support of the European Union Biomed programme, a database is being assembled on all known health surveys and general population epidemiological studies in Europe that have a mental health component. This database may be consulted free of charge. Workers who have conducted, or are conducting, relevant studies are invited to send information to be incorporated in the database. The contact person is: Catherine Polge, Equipe ‘Vieillissement cognitif’, CRLS, Val d'Aurelle, F 34298 Montpellier Cedex 5, France. Tel 33 04 67 61 30 28. E-mail: [email protected].