The results indicate a high descriptive validity of the symptom-severity component of the proposed remission definition. However, the new criteria differ partially from previously used outcome measures. This aspect should be considered in the interpretation of clinical trials.
Intensity of symptoms including mood and psychomotor activity has been shown to vary according to the time of the day in a group of depressed patients. This pattern represents one diagnostic criterion for the melancholic type of depression. The variation of intensity is experienced by the patient and can be observed as a behavioral symptom. However, the relation of circadian alterations in psychomotor activity and depressed mood remains unclear. Therefore, spontaneous motor activity and experienced intensity of symptoms were measured in 21 depressed patients who showed daily variations of subjective symptoms. Patients felt significantly less active, awake, and more depressed in the morning compared to the evening. However, corresponding activity levels, which were measured by actigraphy, appeared significantly higher in the morning compared to the evening. Increased motor activity could represent the observable behavioral equivalent of self-experienced psychomotor retardation and depressed mood.
The interaction between the central nervous system and the immune system has been focus of recent research. Whereas cyclic AMP has been described as a link between atopic and affective disorders, a possible link between atopic disorders and schizophrenia has not yet been investigated. A 33-year-old patient showed episodes of allergic-asthmatic and paranoid-catatonic symptoms which appeared in an anticyclic pattern. Biological, clinical and therapeutic aspects are discussed in respect to the interaction between immunological and psychiatric disorders. Cyclic-AMP as a second-messenger is not specific for a certain cell species and might represent a possible link for integrated communication between the nervous and the immune system.
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