In a survey of the suicide trends in Italy between 1959 and 1988, a slight increase was recorded both among males (+ 19%) and females (+ 10%). Geographically, the regions with the highest suicide rate are the Northern ones (up to twice the national average). The age groups with the highest suicide risk are those over 74 years. Gender distribution differences show that among females over the age of 65, the suicide rate rose by 70% between 1974 and 1989, versus 77% for males of the same age. Between 1978 and 1989, the suicide rate among people in search of a first job rose by 25%; among the employed it rose by 37%, while among people in search of a new job it rose by 594%. The highest specific suicide rale was recorded among the divorced (32.4 × 100000), while ihe level of education with the highest suicide rate is the secondary school (9 × 100000). Suicide methods include hanging (30%), jumping (22.4%) and firearms (11.5%).

Norway was the first European country to be introduced to the American diagnostic system DSM III. In this paper the author presents some of the main results of the Norwegian studies of the DSM III personality disorders with particular emphasis on validity, comorbidity and treatment.

As a pre-test validity study, a French version of the 28-item general health questionnaire was carried out on 158 general psychiatric patients, without any selection on diagnosis. These patients were concomitantly assessed by psychiatrists with a list of DSM III-R criteria for affective and anxiety disorders. Internal consistency of the questionnaire proved to be excellent. Principal component analysis provided a 4-factor solution, including a ‘depressive’ factor, close to that originally proposed by Goldberg and Hilllier (1979), but with some differences in the loading of insomnia. Although there were some differences in case distribution between the centres, this study confirms internal validity of the GHQ-28 as a screening instrument for psychiatric research.

To prove the hypothesis of a common defect in the central nervous system and immune system in patients with major depression, we examined the inhibition of phytohemagglutinin (PHA)-induced lymphocyte proliferation by in vitro and in vivo administration of glucocorticoids in 20 patients with major depression. The patients were divided into two groups according to the results of the dexamethasone suppression test (DST). Six patients showed cortisol non-suppression. They had significantly higher baseline plasma cortisol levels in comparison with cortisol suppressors. The lymphocytes from cortisol non-suppressors were significantly stronger inhibited by in vitro administration of glucocorticoids compared to the lymphocytes from cortisol suppressors. However, there were no significant differences of lymphocyte inhibition by in vivo administration of glucocorticoids between both patient groups. From our results we conclude that cortisol non-suppressors reveal impaired down-regulation of glucocorticoid receptors of lymphocytes. Furthermore, the effect of glucocorticoids on lymphocyte reactivity may reflect the effects on brain structures in patients with major depression.

Platelet 5-HT levels were determined by fluorescent orthophthaldehyde assay in 33 panic disorder patients with and without obsessive compulsive symptoms (PD + OCS: n = 16; PD-OCS: n = 17) according to DSM III-R criteria, and compared With those of 38 healthy controls. Mean platelet levels were significantly lower in PD + OCS than in PD-OCS patients. The results are discussed in relation to serotonergic dysfunction linked to PD and OCS comorbidity.

This study was designed to verify whether fluoxetine (FL), a serotonin (5-HT) re-uptake inhibitor, would interfere with nortriptyline (NT), a biphasic U-shaped curvilinear dose-response relationship recently described in our laboratory. We associated 10 mg/kg NT or vehicle to 0, 5, 10, 20 and 40 mg/kg FL, in one group, and 10 mg FL or vehicle to 0, 5, 10, 20 and 40 mg/kg NT, in another group, 30 min before the tail suspension test (TST) in mice. Although we were not able to confirm a synergistic effect between FL and NT, FL-NT association seems to require higher doses of NT to block its own anti-immobility effect at high doses, thus widening NT effective antidepressant-like dose range in mice submitted to TST.

Final conclusions and data comparisons from the thyrotropin-releasing hormone (TRH) test results are made difficult by differences in test implementation methods, ie, TRH different administration routes, dosages and blood sampling times. A number of statistical analyses are feasible, which may also influence test interpretation. The authors review some types of statistical analyses and suggest using the area under curve (AUC) method as a means of evaluation. The TRH test was performed before treatment and after a 5-day wash-out period, in 40 depressed patients hospitalized in the Psychiatric Unit of Besancon Teaching Hospital (Centre Hospitalier Universitaire de Besançon). Variation analyses performed by peak and threshold comparison (7.0 IµU/ml) and by the AUC method (386 IµU/ml) in positive and negative patients revealed some statistical differences.