A previous Generalized Anxiety Disorder Impact Survey (GADIS I) performed on 15,399 Belgian patients consulting their primary care physicians, revealed high prevalences of generalized anxiety disorder (GAD) and major depression (MD) with important regional differences. The objective of this study (GADIS II) was to replicate previous findings and to evaluate the role of socioeconomic factors in the diagnoses of GAD and MD. A large-scale cross-sectional survey was conducted in a random sample of 377 general practitioners distributed geographically over Belgium and Luxemburg. Each physician was asked to screen 40 consecutive patients at predefined time periods for the presence of GAD and MD using sections of the Mini International Neuropsychiatric Interview (MINI). Socioeconomic parameters were collected. The level of impairment was assessed using the Sheehan Disability Scale. In a sample of 13,699 patients, point prevalences of GAD and of MD were found to be 13.4 and 11.0%, respectively. Overall, 17.8% of the population was positive for GAD and/or MD. Both disorders were significantly more frequent in women than in men. Marked regional differences were observed with prevalences for GAD and/or MD of 24.2% in Brussels, 22.7% in Wallonia, 13.6% in Luxemburg and 12.9% in Flanders. Several socioeconomic factors were significantly associated with positive diagnoses: living alone, a low level of education and unemployment. However, regional differences remained significant even after controlling for socioeconomic factors. The study confirms the high prevalence of GAD and MD in primary care and the role of several socioeconomic and regional factors in the illnesses.

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Prevalence rates of GAD and MD in primary care in Belgium are comparable to other countries. GAD and MD are disabling conditions. Antidepressants are still used only in a minority of subjects with GAD and/or MD in primary care in Belgium and Luxemburg. The prevalence of GAD and MD appears to be much higher in French-speaking parts of Belgium.

Semi-thin sections of three-dimensional reaggregates from adult female rat pituitary, cultured in serum-free defined medium, were stained for prolactin, gonadotropin, thyrotropin, growth hormone and S-100, using the double immunolabelling technique. The frequency of juxtaposition between lactotrophs and gonadotrophs was enumerated and compared with the expected frequency at random distribution of polygonal cell profiles in a hexagonal configuration. The proportions of lactotrophs and gonadotrophs in the aggregate sections were determined using stereometrical analysis. The observed frequency of juxtaposition did not differ significantly from the expected frequency. Hence, no reason was found to assume a selective adhesion between lactotrophs and gonadotrophs in adult female rat pituitary reaggregates. A constant proportion of lactotrophs was found to meet the criteria of a cup-shaped morphology, and 70% +/- 9% (mean +/- S.D.) of these so-called cup-shaped lactotrophs were found to be juxtaposed at their concave side to gonadotrophs. Administration of 0.01 nM 17 beta-oestradiol to the culture medium resulted in a significant reduction of the proportion of cup-shaped lactotrophs but did not affect the selectivity of juxtaposition to gonadotrophs. The selectivity of juxtaposition between cup-shaped lactotrophs and gonadotrophs may be the morphological correlate of the functional relationship between these cells, which are known to be involved in an intra-pituitary paracrine communication system.

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