Twenty-one patients with recurrent endogenous depressions were treated with lithium carbonate for periods up to two and a half years. Although depressions did not recur in six of eight patients with non-periodic disorders who were on lithium, the treatment did not reduce the frequency of exacerbation in eleven of thirteen periodic disorders. Urinary measurements of sodium, potassium 17-ketosteroids, hydroxy-steroids and lithium in several of the patients did not help to differentiate them by their reaction to lithium. It is concluded that the notion of lithium as an effective prophylactic agent against recurrent depressions, based on decreased frequency or increased interval between episodes, is not supported by this study.
Many popular methods of measuring depression have not been adequately validated for discriminant validity from social desirability. In a study of 26 patients, 14 with secondary depression, and 12 nondepressives, it was shown that the commonly used Beck Depression Inventory and MMPI Depression scale and the Carroll self-administering version of the Hamilton scales correlate as highly with social undesirability as with each other. Social desirability ratings of item alternatives on the Beck and Hamilton scales by 12 normal students showed the depth of depression to be significantly related to social undesirability response scores. The difficulty of distinguishing depression and social undesirability response set was discussed and it was suggested that "low self-esteem" may be all that is measured by the rating scales used in this study.
This report constitutes the Newfoundland component of a large scale replication study to assess the relationship of HLA to affective disorders; the Ontario component will be published subsequently. In a collaborative study between the University of Toronto, Memorial University and the University of Rochester, first degree family members of Probands with major affective disorder in Newfoundland were assessed for the lifetime presence of psychiatric disorder; their blood was also typed for Human Leucocyte Antigens (HLA). Because of the high rate of refusal to participate, only 10 Newfoundland families could be assessed completely. While this number of families is too small to evaluate the role of HLA as a marker of susceptibility to affective disorder, the results will be added to those of the larger Ontario component. Some problems of conducting research in communities similar to those found in Newfoundland are briefly discussed in the context of characteristics of the Probands in the study group as compared with those of subjects who refused entry into the study.
One hundred and eighty nine consecutive in-patients with treatment-resistant affective disorder were administered the Renard Diagnostic Interview to determine whether the 45 with secondary affective disorder (SAD) differed from the 144 with primary affective disorder (PAD). The SAD group, including 15 subjects with bipolar disorder, had an earlier mean age of onset of depression and contained more unmarried individuals. The total secondary group could not usefully be differentiated by assessment of clinical symptoms or discriminating analysis of social and clinical variables. While the present study of a severely depressed population does not lend itself to generalisability, this combined sample does have characteristics of patients used in biological investigations. No significant inter-group discrimination was found to support a previous assumption that identification of a prior psychiatric disorder provides the most suitable mechanism for selecting a population for research in affective disorders.
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