Background. Morphological changes in the corpus callosum (CC) have been described in bipolar disorder, but with inconsistencies among the reports. We investigated the CC areas by magnetic resonance imaging (MRI) in 12 first-episode patients with bipolar disorder and 12 controls.

Method. Twelve medication-naive patients with bipolar I disorder (six males, six females; aged 28·2±6·5 years) with manic or mixed episodes and 12 age- and gender-matched healthy controls (six males, six females; aged 26·8±7·6 years) were recruited to the study. MRI scans was obtained using a 1.5-T GE Signa Excite high-speed scanner. Anatomical measurements were conducted on a computer workstation with the software Scion Image Beta-3b for Windows. Statistical analysis was performed using an analysis of covariance (ANCOVA), the t test, χ2 and partial correlation analyses.

Results. Bipolar patients had significantly smaller areas of total CC, anterior body posterior body and isthmus compared with healthy control subjects by ANCOVA, with age, gender and intracranial volume (ICV) as covariates. There was a negative correlation between total CC, posterior body and isthmus areas and Young Mania Rating Scale (YMRS) scores.

Conclusion. The findings suggest that CC morphology may be associated with the pathophysiology of bipolar disorder.

Background. Intellectual disabilities (ID) are common and lifelong. People with ID have health inequalities compared with the general population, but little is known about the epidemiology of affective disorders in this population. This study was undertaken to determine the point prevalence of affective disorders, and to investigate factors associated with depression.

Method. This population-based study (n=1023) included comprehensive individual assessments with each person. A two-stage process was used for diagnosis of affective disorders. Factors independently associated with depression were investigated through logistic regression analysis.

Results. The point prevalence was higher than that reported previously for the general population; DC-LD yielded 3·8% for depression and 0·6% for mania. Additionally, 1·0% had bipolar disorder currently in remission, and 0·1% first episode of mania currently in remission. Similar to general population findings, depression was associated with female gender, smoking, number of preceding family physician appointments, and preceding life events. Important differences were the association of not having a hearing impairment, and the trends for not living in deprived areas, and being married. Unlike general population findings, not having daytime occupation and obesity were not independently associated; nor was previous long-stay hospital residence, severity of ID, or sensory impairments.

Conclusions. This study has found a high point prevalence of affective disorders in adults with ID. The factors associated with depression have differences to general population findings. An understanding of this is important in order to develop appropriate interventions, public strategy and policy, to reduce existing health inequalities.

Background. Biases in the processing of emotional information have been shown to be abnormal in subjects with major depression, both during an episode and after full recovery. However, it is unclear whether these biases are a cause or an effect of the depression. This study set out to explore whether such biases represent a vulnerability factor for depression by looking at unaffected first-degree relatives of those with major depressive disorder. We also measured waking salivary cortisol, as the regulation of the hypothalamo–pituitary–adrenal (HPA) axis is thought to be impaired in depressive disorder.

Method. Twenty-five female relatives and 21 age-matched controls completed a facial expression recognition task, an emotional categorization task with positive and negative personality characteristics, and had their waking salivary cortisol measured on a work day and a non-work day.

Results. The depressed relative group was significantly faster to recognize facial expressions of fear than controls. The depressed relative group also showed significantly increased reaction time to recognize positive versus negative personality characteristics in the categorization task. There was no difference in waking salivary cortisol between groups, although there was an effect of work day versus non-work day.

Conclusions. Subtle biases in the processing of emotional information may exist in the unaffected first-degree relatives of those with depression. As such, this may represent a familial vulnerability factor to developing a depressive illness.

Background. Previous studies have suggested that men and women process emotional stimuli differently. In this study, we used event-related functional magnetic resonance imaging (fMRI) to investigate gender differences in regional cerebral activity during the perception of positive or negative emotions.

Method. The experiment comprised two emotional conditions (positively/negatively valenced words) during which fMRI data were acquired.

Results. Thirty-eight healthy volunteers (19 males, 19 females) were investigated. A direct comparison of brain activation between men and women revealed differential activation in the right putamen, the right superior temporal gyrus, and the left supramarginal gyrus during processing of positively valenced words versus non-words for women versus men. By contrast, during processing of negatively valenced words versus non-words, relatively greater activation was seen in the left perirhinal cortex and hippocampus for women versus men, and in the right supramarginal gyrus for men versus women.

Conclusions. Our findings suggest gender-related neural responses to emotional stimuli and could contribute to the understanding of mechanisms underlying the gender disparity of neuropsychiatric diseases such as mood disorders.

Background. In this study we examined patients' false memory, that is memory for a non-presented event, to search for a further source of converging evidence for the impairment of semantic memory in individuals with schizophrenia. In two experiments we compared the pattern of false memory created by the Deese–Roediger–McDermott (DRM) paradigm between individuals with schizophrenia and those of a normal control group.

Method. Experiment 1 tested participants on both recall and recognition of lists of semantically related words. Experiment 2 adopted the meaning recognition test, in addition to the standard recognition test, to assess the participants' gist memory.

Results. Individuals with schizophrenia performed worse than normal controls on both recall and recognition of studied words. The schizophrenia patients had higher rates of false recall and false recognition for semantically unrelated words than did the normal controls, suggesting an abnormal pattern of semantic activation in the former group. More importantly, no differences were found between the two groups with regard to false recall and false recognition of semantically related words. When the participants were tested for meaning recognition, however, the schizophrenia patients gave fewer ‘old’ responses to non-studied semantically related words than did the control group, indicating an impaired gist memory in schizophrenia patients.

Conclusions. When asked to consciously retrieve word lists, individuals with schizophrenia showed impairment not only in item-specific memory but also in gist memory. The pattern of results is consistent with the storage deficit view of semantic memory in schizophrenia.

Riese, H., Rosmalen, J. G. M., Ormel, J., Van Roon, A. M., Oldehinkel, A. J. & Rijsdijk, F. V. The genetic relationship between neuroticism and autonomic function in female twins. Psychological Medicine. Published online 9 November 2006. doi:10.1017/S0033291706009160.

Background. Well-being is an important determinant of health and social outcomes. Measures of positive mental health states are needed for population-based research. The 12-item General Health Questionnaire (GHQ-12) has been widely used in many settings and languages, and includes positively and negatively worded items. Our aim was to test the hypothesis that the GHQ-12 assesses both positive and negative mental health and that these domains are independent of one another.

Method. Exploratory (EFA) and confirmatory (CFA) factor analyses were conducted using data from the British Household Panel Survey (BHPS) and the Health Survey for England (HSE). Regression models were used to assess whether associations with individual and household characteristics varied across positive and negative mental health dimensions. We also explored higher-level variance in these measures, between electoral wards.

Results. We found a consistent, replicable factor structure in both datasets. EFA results indicated a two-factor solution, and CFA demonstrated that this was superior to a one-factor model. These factors correspond to ‘symptoms of mental disorder’ and ‘positive mental health’. Further analyses demonstrated independence of these factors in associations with age, gender, employment status, poor housing and household composition. Statistically significant ward-level variance was found for symptoms of mental disorder but not positive mental health.

Conclusions. The GHQ-12 measures both positive and negative aspects of mental health, and although correlated, these dimensions have some independence. The GHQ-12 could be used to measure positive mental health in population-based research.

Background. Abnormal serotonergic neurotransmission has long been demonstrated in suicidal behavior. The dorsal and median raphe nuclei housing the main serotonergic cell bodies and the prefrontal cortex (PFC), particularly the ventral part innervated by the serotonergic system, have therefore been studied extensively in suicidal behavior research. However, only a few studies have described neuropsychological function impairment in suicidal patients. We investigated PFC-related neuropsychological function in patients with suicidal behavior, separating dorsolateral PFC (DLPFC)- and orbitofrontal cortex (OFC)-related functions.

Method. We compared 30 euthymic patients with suicidal behavior aged 18–65 years with 39 control subjects, for the following neuropsychological domains: global intellectual functioning, reward sensitivity, initiation, inhibition, and working memory. Patients and controls were compared by means of univariate and multivariate analyses, adjusting for age at interview, level of education and mood state at the time of evaluation. Trait impulsivity, measured with the Barratt Impulsivity Scale version 10 (BIS-10), was also included as a covariate in a subset of analyses.

Results. Multivariate comparisons demonstrated significant executive function deficits in patients with suicidal behavior. In particular, we observed impairment in visuospatial conceptualization (p<0·0001), spatial working memory (p=0·001), inhibition (Hayling B–A, p=0·04; go anticipations, p=0·01) and visual attention (or reading fluency) (p=0·002). Similar results were obtained following adjustment for motor impulsivity as a covariate, except for spatial working memory.

Conclusions. These deficits are consistent with prefrontal dysfunction in patients with suicidal behavior. Differentiation between DLPFC- and OFC-related neuropsychological functions showed no specific dysfunction of the orbitofrontal region in patients with suicidal behavior in our sample.

Background. The Lundby Study is a longitudinal cohort study on a geographically defined population consisting of 3563 subjects. Information about episodes of different disorders was collected during field investigations in 1947, 1957, 1972 and in 1997. Interviews were carried out about current health and past episodes since the last investigation; for all subjects information was also collected from registers, case-notes and key informants. This paper describes the course and outcome of 344 subjects who had their first onset of depression during the follow-up.

Method. In this study individuals who had experienced their first episode of depression were followed up. Their course was studied with regard to recurrence of depression related to duration of follow-up, transition to other psychiatric disorders including alcohol disorders, as well as incidence and risk factors of suicide.

Results. Median age at first onset of depression was around 35 years for individuals followed up for 30–49 years. The recurrence rate was about 40% and varied from 17% to 76% depending on length of follow-up. Transition to diagnoses other than depression was registered in 21% of the total sample, alcohol disorders in 7% and bipolar disorder in 2%. Five per cent committed suicide; male gender and severity of depression were significant risk factors.

Conclusion. The low rates of recurrence and suicide suggest a better prognosis for community samples than for in- and out-patient samples.

Background. Current cognitive models of positive symptoms of psychosis suggest a mechanism of defective self-monitoring that may be relevant for (i) expression of psychosis at the clinical and subclinical level and (ii) transmission of risk for psychosis.

Method. The study included 41 patients with psychosis, 39 non-psychotic first-degree relatives, 39 subjects from the general population with a high level of positive psychotic experiences, and 52 healthy controls with an average level of positive psychotic experiences. All subjects performed a speech attribution task in which single adjectives with a complimentary or derogatory meaning were presented to them on a computer screen; subjects had to read aloud and determine the source (self/other/uncertain) of the words they heard. In some of the trials, participants’ speech was distorted, in others they heard someone else's voice (alien feedback condition) that could also be distorted.

Results. No large or significant differences in errors in the speech attribution task were found between the four groups in any of the conditions.

Conclusions. Contrary to previous work using this paradigm, this study found no evidence that either expression of psychosis or risk for psychosis was associated with impairment in self-monitoring.

Background. No study to date has examined the effects of mood stabilizer alone and the combination of mood stabilizer and atypical antipsychotic, quetiapine, on hippocampal neurochemical markers of bipolar disordered patients concurrently. We therefore undertook a proton magnetic resonance spectroscopy (1H MRS) study of drug-free patients with bipolar disorder (drug-free group), patients undergoing valproate treatment (valproate group), patients administered valproate+quetiapine (valprote+quetiapine group) and healthy controls, focusing on the in vivo neuroanatomy of the hippocampus.

Method. Thirty patients from the Firat University School of Medicine Department of Psychiatry and 10 healthy controls gave written informed consent to participate in the study. The patients and controls underwent proton magnetic resonance spectroscopic imaging (1H MRSI), and measures of N-acetylaspartate (NAA), choline-containing compounds (CHO), and creatine+phosphocreatine (CRE) in hippocampal regions were obtained.

Results. The drug-free patients had significantly lower NAA/CRE and NAA/CHO ratios compared with the valproate and valproate+quetiapine groups and the healthy controls. The lower NAA/CRE and NAA/CHO ratios remained statistically significant even after covarying for age or whole brain volume compared with the valproate and valproate+quetiapine groups and healthy controls. In post hoc comparisons, a significant difference was found between the valproate+quetiapine group and the valproate group only with regard to NAA/CHO.

Conclusion. Our findings suggest that valproate has a neuroprotective effect. In post hoc comparisons, a significant difference was found between the valproate+quetiapine and the valproate group with regard to NAA/CHO, indicating that the addition of quetiapine further increases the level of NAA and provides an additional neuroprotective effect.