2~ Abstract Background Depression has a high prevalence in the elderly population; however it often remains undetected. The WHO 5-item Well-Being Index (WHO-5) is a short screening instrument for the detection of depression in the general population, which has not yet been evaluated. The goals of the present study were: l ) to assess the internal and external validity of WHO-5 and 2) to compare the two recent versions of WHO-5. Study population and methods 367 subjects above 50 years of age were examined with the WHO-5. ICD-10 diagnoses were made using a structured interview (CIDI). The internal validity of the well-being index was evaluated by calculating Loevinger's and Mokken's homogeneity coefficients. External validity for detection of depression was evaluated by ROC analysis. Results The scale was sufficiently homogeneous (Loevinger's coefficient: version 1 = 0.38, version 2 = 0.47; Mokken coefficient > 0.3 in nearly all items). ROC analysis showed that both versions adequately detected depression. Version 1 additionally detected anxiety disorders, version 2 being more specific for detection of depression. Conclusion The WHO-5 showed a good internal and external validity. The second version is a stronger scale and was more specific for the detection of depression. The WHO-5 is an useful instrument for identifying elderly subjects with depression. ~] Keywords Depression. WHO Well-Being Index. elderly general population, anxiety, screening When meeting Per Bech, one has to admire his great enthusiasm for clinical and epidemiological research aimed at helping people.Reinhard Heun (1~1) 9 Marzia Bonsignore Katrin Barkow 9 Frank ]essen

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This constellation may propose that HPA dysregulation is the endocrinological basis for neuroticism and depressive temperament; this result supports the view that distinct personality factors and HPA vulnerability interact in mediating depression.

Oestrogen therapy has been suggested to have protective effects against Alzheimer's disease. The effects of natural exposure to oestrogen in cognitive disorders have rarely been studied. Assuming that nulliparous women have a higher exposure to natural oestrogen, it could be hypothesised that these women might have a lower risk of Alzheimer's disease than women who have had children. The fertility and number of children in 106 women with a diagnosis of Alzheimer's disease was examined and compared with that of 189 female subjects from two control groups with subjects without dementia. As additional control, the same comparisons were carried out for 40 male patients with Alzheimer's disease and 105 male control subjects. In female subjects, having had children was found to be associated with a diagnosis of Alzheimer's disease. This was not the case in male subjects. The number of children did not seem to affect the risk of Alzheimer's disease, neither in female nor in male subjects. Natural exposure to oestrogen seems to reduce the risk of Alzheimer's disease in women.

MAD cannot be seen as a stable diagnosis: Most of MAD patients remit; many of them shift to other diagnoses than depression or anxiety. The ICD-10 criteria have to be specified more exactly.

Psychological/psychiatric problems were found to play the most important role in the prediction of depressive episodes while sociodemographic variables were of lower importance. Differences compared with other studies might be due to our prospective design and possibly also to our culturally different sample. Applied stratification procedures, which resulted in a sample at high risk of developing depression, might be a limitation of our study.

Somatic symptoms and anxiety symptoms are often disregarded in the detection of depression in primary care. The present investigation examined to what extent somatic and anxiety symptoms recorded with the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) can improve the detection of depression as compared to the General Health Questionnaire-12-item version alone. Data from the World Health Organization study on Psychological Problems in General Health Care were used. The study sample consisted of primary care attenders from 15 centres from all over the world who underwent a psychiatric examination with the CIDI-PHC. Medically unexplained somatic symptoms (back pain, feelings of heaviness/lightness in parts of the body, periods of bodily weakness, seizures/convulsions, permanent tiredness, exhaustion after a minimum of effort) and-to a smaller extent-diverse anxiety symptoms (e.g. feelings of anxiousness/nervousness, feelings of tension, difficulties relaxing) significantly contributed to the detection of depression in a logistic regression analysis. The results confirm the observation that in primary care somatic symptoms play an important role in the manifestation of depressive disorders. The items investigated herein could prove beneficial for future depression screening instruments to improve the detection of depressive disorders in primary care.

Demographical and clinical characteristics have been reported to modulate the risk for suicide. This study analysed demographical and clinical characteristics with respect to lifetime suicide attempts in 500 individuals affected with schizophrenic or affective disorders. Suicide attempts were associated with poor premorbid social adjustment, low age at onset, low scores on the "Global Assessment Scale" and childlessness in females.