Prophylactic lithium was abruptly discontinued (under double-blind conditions and using placebo) in 18 manic-depressive patients for 15 days. Following lithium withdrawal tremor of hands, polyuria, general muscular weakness, polydipsia and dryness of mouth were significantly reduced. No withdrawal symptoms were noted. Three patients relapsed within 4 days of lithium discontinuation. The questions arising from these findings are discussed and the possibility of a rebound phenomenon produced by lithium is considered.

In a prospective study, the authors compared 22 delusional and 36 non-delusional depressive patients with respect to demographic and clinical variables, personality, and response to treatment. Delusional depressives had a higher total score than non-delusional depressives on Hamilton's Rating Scale for Depression, as well as a higher score for depressed mood and psychomotor retardation. The type of treatment failed to differentiate the two groups as to outcome at discharge. However, six of the seven delusional depressives who did not respond to tricyclic antidepressants had a full recovery with ECT. The results indicate that delusional depression represents a more severe type of major depression.

No abstract

We estimated the prevalence of depression in 150 medical and surgical inpatients. Forty-three patients (29%) scoring at 14 or above on the Beck Depression Inventory (BDI) were classified as depressed. An excess of women and white-collar workers and more stressful life events during the last 12 months were found among the depressed patients. Of the 21 BDI items, 6 differentiated the 43 medical-surgical depressed patients from a group of 43 psychiatric inpatients with a diagnosis of primary or secondary depression (Feighner's criteria). Medically ill depressed patients scored higher in social withdrawal, work inhibition and irritability but lower in loss of libido, sleep disturbance, and lack of satisfaction. Our results show rates of depression in a medical inpatient population in Greece comparable with those in other studies. The use of BDI may help assessment of depression in general hospital patients.

In this retrospective study demographic and clinical characteristics, personality traits, family psychiatric history and response to treatment were compared in 55 delusional and 40 nondelusional hospitalized patients who met DSM-III criteria for major depression. Male delusional depressives had a greater frequency of delusional ideas at the index episode than female delusionals. Delusional depressives had a greater frequency of family history for alcoholism, a smaller frequency of previous depressive episodes and tended to respond more favorably to treatment with electroconvulsive therapy or tricyclic antidepressants combined with neuroleptics than to antidepressants alone. The findings and the implications arising from them are discussed.